Cancer care for women: Why we must continue to strive for equal access (Guest blog)
23.06.22
Many cancer types disproportionately affect women, yet females remain underrepresented in medical research. Despite society’s multi-faceted scrutiny of gender equality today, cancer care systems across Europe are fraught with barriers, preventing women from accessing optimal care and treatment. Whilst the healthcare system has made considerable strides in its pursuit to be more gender equal, it is vital that we work together to go further in addressing the gender disparities that still exist in cancer care today.
The delayed detection of women’s cancers- ovarian, cervical and breast- often correlates with poorer outcomes. A lack of awareness of signs and symptoms can lead to delays in women seeking medical advice, whilst access to routine genetic testing remains scarce and difficult to access. A study by the World Ovarian Cancer Coalition found that over two-thirds of women had not heard of ovarian cancer or knew very little about it prior to their own diagnosis, whilst of those who had two or more relatives with ovarian cancer in their family, 80% had not accessed genetic testing prior to being told that they had the disease.[1]
And it doesn’t end there. COVID-19 has left many women unemployed and without access to health insurance across Europe. Combined with the lack of face-to-face GP appointments, many women feel they have struggled to seek timely diagnoses. The impact is far-reaching, with women presenting with ovarian cancer symptoms, such as bloating and fatigue, reportedly being dismissed without physical examination, only to be later diagnosed with advanced cancer. The fallout of the pandemic’s impact on cancer screening services has hit hard and the reverberations continue to be felt as health systems work to recover and regain patient confidence.
There are considerable inequities within and between the European Union (EU) Member States, and amongst populations where early detection, diagnosis, treatment, and the quality of patient care is concerned. This is true of cancers affecting all genders, but is particularly startling when looking at estimated cervical cancer incidence rates (varying five-fold) and mortality rates (varying eight-fold) in 2020 across the EU. We can begin to explain these stark variations through differences in prevalence of the human papilloma virus (HPV), and levels of vaccination against it, as well as disparities in cervical cancer screening policies across EU countries.
To tackle such disparities head on, in February, the European Commission announced advancements in initiatives part of its Europe’s Beating Cancer Plan - Ensuring Equal Access for All: Cancer in Women – pledging a new EU-wide approach to cancer prevention, treatment and care. With €4 billion earmarked for action, the focus remains on areas where the EU can add the most value. Steps being taken as a part of this initiative include the European Commission supporting Member States addressing four additional EU Cancer Plan actions to pinpoint inequalities, improving screening and vaccination against HPV, updating the 2003 Council Recommendation on screening to ensure that 90% of the EU population who qualify for the breast, cervical and colorectal cancer screenings are offered it by 2025, and increased support for those who have experienced cancer. These measures will address many of the existing inequalities related to gender, whilst also spotlighting disparities based on ethnicity, income status, educational attainment level and urban versus rural areas.[2]
The path that lies ahead will not be without challenges, and the biopharmaceutical industry must also commit to actions and initiatives that continue to promote equity in access to healthcare. At Pfizer, we are working to cast light on the unmet needs of breast cancer patients, the most prevalent cancer in Europe that affected over 350,000 women in 2020. We are proud to transcend boundaries and transform care as part of our Breast Cancer Vision community. Our goal is clear – to provide educational resources and more support to patients through every stage of their breast cancer journey and help to remove barriers to equitable care by bringing together experts from a range of disciplines – healthcare professionals, patients, policymakers and politicians – to discuss and prioritise the critical needs of underserved populations with advanced and metastatic breast cancer. Together, we’ve worked to develop actionable solutions for four key challenges in access to care that have been recognised, demonstrating our proactivity and fervour for progression. A report that outlines the identified disparities and challenges has also followed, with Pfizer Oncology working collaboratively with ABC Global Alliance to develop a toolkit – equipping communities with tangible initiatives and best practice summaries to drive collaboration across the global community.[3]
Changing the conversation around metastatic breast cancer (mBC), which accounts for 90% of breast cancer deaths, is another key priority. In collaboration with the Union of International Cancer Control (UICC), Pfizer launched the Seeding Progress and Resources for the Cancer Community (SPARC) mBC challenge to support new ideas and projects from advocacy groups, hospital networks and other non-for-profit organisations working to address the specific needs of MBC patients. With the ambition of saving more lives by reducing the number of women diagnosed with breast cancer at a late stage, SPARC projects focus on closing the gap in patient information and support, growing awareness, influencing national policies and strengthening health systems. Through training, networking, mentoring and financial support, the SPARC MBC Challenge has awarded over USD 1.5 million to 51 organisations from 35 countries, helping to get their projects off the ground.[4]
Whilst a spectrum of disparities remains in accessing cancer care, the future of our cancer pathways is at a crossroads. For cancer patients to live fuller, healthier and more informed lifestyles, it is vital that we work together to bridge the inequalities gap and provide a cancer care system that is here to serve us all, regardless of ethnicity, status and gender.
[1] World Ovarian Cancer Coalition. The Every Woman Study Summary Report. Available at: https://worldovariancancercoalition.org/wp-content/uploads/2019/11/WOCC-Every-Woman-Study-Summary-Report-Nov-08.pdf. Last accessed: May 2022.
[2] European Commission. Europe’s Beating Cancer Plan: New actions to increase access to cancer prevention, early detection, treatment and care. Available at: https://ec.europa.eu/commission/presscorner/detail/en/ip_22_702. Last accessed: May 2022.
[3] Breast Cancer Vision. Our Shared Breast Cancer Vision: Transcending boundaries and transforming care. Available at: https://www.breastcancervision.com. Last accessed: May 2022.
[4] UICC. SPARC has benefitted thousands of breast cancer patients since 2015. Available at: https://www.uicc.org/news/sparc-has-benefitted-thousands-breast-cancer-patients-2015. Last accessed: May 2022.
