Let the stars align: Cancer Policy in the next European Parliament term

Stars already aligned once in 2019. In that year Manfred Weber of the European Peoples Party (EPP) launched the “European Master Plan to join our forces in the fight against cancer”.[1] The “Master Plan” was not only part of his election campaign. It stimulated a policy process that led to the launch of Europe’s Beating Cancer Plan (EBCP) in 2021. The EBCP, the EU Mission on Cancer, and many initiatives complementing it are Europe’s bold response to tackle cancer.[2] Five years later, we are just ahead of another European election. Has the mission been accomplished?

Europe’s Beating Cancer Plan – A Flagship in EU Health Policy

EBCP was “Europe’s new commitment to cancer prevention, treatment and care”.[3] It kicked off new promising projects in the field of health literacy, prevention, and early detection. It also has been a driver for the “Right to be forgotten”, a key issue for many people living with cancer who are disadvantaged in daily life.

A landmark was the update of the Council Recommendations on Screening which have been issued end of 2022.[4] Representing a consensus amongst all Member States, they create a framework for earlier detection of cancer. Finally, another critical objective is reducing inequalities and ensuring that every person in Europe has the same access to prevention and cancer care, independent from where they live.

Mission accomplished?

In parallel to cancer policy, cancer care also has evolved in the meantime. The long-standing focus on treating patients with progressed, so-called metastatic cancers has begun to shift more recently towards early detection, early treatment, and personalization, thanks to developments in genomics, testing, and early-state treatments.

Why is this shift important, why does detection and treating early matter for patients? More than 55 out of 100 people with stage-1 lung cancer will survive their cancer for 5 years or more after they’re diagnosed.[5] This rate falls to 5 out of 100 people if diagnosed with stage 4 lung cancer.

Demographic Change, Inequalities, Patient Access

Cancer has become the leading cause for premature death in 57 countries.[6] Because of demographic change cancer is the future challenge for health systems in Europe but also globally.

Inequalities are still a reality in Europe: Screening rates vary largely in Europe as does the availability of treatments. In Denmark, 8 out of 10 women between 50 and 69 receive a mammography in 2021. In Hungary, it was only 3 women.[7] And even when treatments are available, not all patients have access to them. In lung cancer, less than 1 out of 2 patients diagnosed with lung cancer in Finland, Poland or Romania have access to the treatment according to guidelines although the treatments are reimbursed. In Belgium, Norway and Portugal, e.g., it’s nearly 8 out of 10.[8]

Making Progress for Patients

There is still work to do. The EU Mission on Cancer aims to improve the lives of more than 3 million people by 2030, through prevention, cure and for those affected by cancer including their families, to live longer and better.[9] Where should Europe focus 2024 onwards?

Better data: We need better data. Health systems often don’t know how and whether patients are treated according to guidelines – the research on treatment rates mentioned above highlights how this is a real problem. Many health systems do not track for what cancer a treatment is used. How can we improve patient care if we don’t have the data.

Better measuring: What’s measured gets done. The Inequalities Registry is a right step towards improving cancer care by collecting better data. But it needs to become more ambitious in terms of the data collected and should correspond to a Cancer Dashboard: going beyond registering data, such integration can inform evidence-based decision-making by telling us where we are, where to go, and where to adjust.

Better implementation: Ultimately, it is implementation of well-crafted plans that will make a difference for patients. That’s why a process needs to be in place to turn observation and measurement into action. Existing processes like the European Semester are in place, which could serve as example and also include health topics in the future.[10]

In short: Better data, better measuring and better implementation will help to achieve the EU Mission on Cancer goals and benefit patients. If I had a wish for 2024, then: Let the stars align, again.

[1] https://www.eppgroup.eu/sites/default/files/attachments/2019/09/2019-04-26-final-paper-european-master-plan-to-fight-cancer.pdf

[2] European Commission (2021), Europe’s Beating Cancer Plan: https://health.ec.europa.eu/system/files/2022-02/eu_cancer-plan_en_0.pdf; EU Mission on Cancer: https://research-and-innovation.ec.europa.eu/funding/funding-opportunities/funding-programmes-and-open-calls/horizon-europe/eu-missions-horizon-europe/eu-mission-cancer_en

[3] https://health.ec.europa.eu/system/files/2022-02/eu_cancer-plan_en_0.pdf

[4] Council of the EU (2022), Council Recommendation on strengthening prevention through early detection: A new EU approach on cancer screening replacing Council Recommendation 2003/878/EC; https://www.consilium.europa.eu/en/press/press-releases/2022/12/09/council-updates-its-recommendation-to-screen-for-cancer/

[5] UK Cancer Research (2023), Survival for lung cancer; https://www.cancerresearchuk.org/about-cancer/lung-cancer/survival

[6] Sung H et al. (2021), Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries; ACS Journals

[7] Eurostat (2023), Cancer Screening Statistics; https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthcare_activities_statistics_-_preventive_services&oldid=581617

[8] Hofmarcher T (2022), Systemic anti-cancer therapy patterns in advanced non-small cell lung cancer in Europe; J Cancer Policy; https://pubmed.ncbi.nlm.nih.gov/36087918/

[9] https://research-and-innovation.ec.europa.eu/funding/funding-opportunities/funding-programmes-and-open-calls/horizon-europe/eu-missions-horizon-europe/eu-mission-cancer_en

[10] Zielinski C et al. (2023), “What’s measured gets done”: a call for a European semester for cancer to improve cancer outcomes in Central and Southeastern Europe; Archives of Public Health