Cancer is the second leading disease burden in Europe. New cancer cases have increased by 50 percent in the past 20 years and it is likely going to continue. (1) At the same time, Europe has been successful in tackling cancer because we know more, and we do better: Taking demographic change out, less people die of cancer than 20 years ago. 4 out of 10 cancer cases are preventable. Ten times more patients with metastatic skin cancer can expect to be alive 5 years after diagnosis, compared to 10 years ago. Considering all this – what should we aim for by 2030?

New era in cancer care

The recently launched Europe’s Beating Cancer Plan starts a new era in cancer care in Europe. (2) The European Commission, together with Member States, is giving such an ambition. The Plan is a strong signal that tackling cancer is a priority and that we all together can do something to prevent and to treat cancer. It was a long time ago that an initiative in health has achieved the status of an EU flagship project, and the Plan might serve as a role model for other health challenges such as Alzheimer’s or chronic diseases.

When the European Commission initiated the consultation on the Plan a year ago many stakeholders had high expectations. In fact, the plan responds to many of them: Clear objectives with regard to prevention of cervical cancer, a strong emphasis on early diagnosis with screening targets, and certainly an openness in future developments and knowledge about screening (e.g. lung).

Treating earlier, treating better

In early diagnosis, for example, the figures speak for themselves: If breast cancer is detected early at stage 1, the 5-year survival is nearly 100%. If detected late at stage 3 it falls to 72%. (3) Lung cancer follows the same pattern, with one-year survival reaching 87.3% for stage 1 disease, but only 18.7% for stage 4. (4) Better awareness such as cancer literacy, screening and new diagnostic tools will reduce suffering and improve cancer patients’ lives dramatically.

The Plan also takes stock of recent medical innovation by dedicating several initiatives to Personalized Oncology. The introduction of Personalized Oncology has allowed targeting the underlying genetic mutations in diseases. It offers the opportunity to achieve initial prescription of optimal therapies so that it ultimately delivers better patient response – as noted in a recent report funded by EFPIA. (5) In line with the Commission and the Cancer Mission Board, we as research-based companies welcome the Plan’s initiatives “Partnership on Personalized Medicine in 2023” and “Cancer Diagnosis and Treatment for All” and are keen to contribute to ensure timely patient access and to strengthen Europe’s research and development skills.

Equal chances for health

Cancer outcomes vary greatly within Europe. 7 out of 10 patients with colorectal cancer in Iceland are still alive 5 years after diagnosis. In Croatia it’s only 50%. (1) The proposed “inequality registry” is an important step to address the variances in prevention, screening but also gaps in survival and access to treatments in Europe.

For patients in the EU there should be no difference, living in Croatia or anywhere else. Equity across Europe is a clear objective of a European Plan and measuring inequalities will help to reduce these differences.

“What we measure affects what we do”

In an article about alternatives for GDP the economist Joseph Stiglitz is quoted as follows: “What we measure affects what we do, and better measurement will lead to better decisions, or at least different decisions.” (6) In short: Indicators matter and even more the selection of indicators. Coming back to the initial question: What should we aim for by 2030?

What matters in the end is what impact the plan has on Europe’s citizens. The plan should also contain a clear vision what good will look like and how it is measured. And it should be visible to European citizens. How many HPV-related cancers should be prevented? How much should 5-year survival of lung cancer patients increase? How quick should access to biomarker testing be? Are all patients with a diagnosis referred to treatment? If not, what is the treatment rate and what should it be?

The Plan as a starting point for a joint commitment

This goes a step further than the “inequality registry”, it’s rather like agreeing on a destination, a travel plan and the respective navigation system – something which does not only tell us whether the loads are evenly distributed, but also helps us to know whether we are heading in the right direction.

We understand that this is a joint responsibility between the Commission, the European Parliament, the Member States and the stakeholders. National efforts such as Germany’s Decade Against Cancer or the 10-Year French Cancer Plan provide a solid basis. (7), (8) In that sense, Europe’s Beating Cancer Plan should be a starting point for a joint ambition and provide the platform for such a discussion. We are ready to contribute to its success in a constructive, inclusive way.

Works Cited

1. Hofmarcher, Thomas. Comparator Report on Cancer in Europe. Lund : Institute of Health Economics, 2019.
2. European Commission. Europe's Beating Cancer Plan. Communication from the Commission to the European Parliament and the Council. Brussels : European Commission, 2021.
3. John, Sophie and Broggio, John. Cancer survival in England: national estimates for patients followed up to 2017. [Online] January 24, 2019. [Cited: February 10, 2021.] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/cancersurvivalinengland/nationalestimatesforpatientsfollowedupto2017#how-does-stage-at-diagnosis-affect-net-survival.
4. Cancer survival data emphasises importance of early diagnosis. Hawkes, Nigel. I408, London : British Medical Journal, 2019, Vol. 364.
5. Gill, Jennifer, et al. Access to Personalised Oncology in Europe. London : London School of Economics and Political Science, 2020.
6. Gertner, Jon. The Rise and Fall of the G.D.P. The New York Times Magazine. 2010.
7. Federal Ministry of Education and Research. National Decade against Cancer. [Online] 2021. [Cited: February 10, 2021.] https://www.dekade-gegen-krebs.de/en/index.html.
8. Républice Française. Stratégie Décenale De Lutte Contre Les Cancers 2021-2030. Feuille de route 2021-2025. Paris : s.n., 2021.