Cancer is one of the leading causes of ill health and death in the European Union: around three million people are diagnosed with cancer every year, half of whom sadly lose their life to it.[1] Regular and systematic screening programmes represent a key tool to alleviate this ever-growing burden: by detecting cancer at earlier stages, it is possible to reduce mortality and improve the quality of life of patients, caregivers and families.

Back in 2003, the adoption of the Council Recommendation on cancer screening marked an important breakthrough in the fight against cancer, by setting out fundamental principles of best practice in the early detection of cancer.[2] Now, a further important step towards reducing inequalities in cancer diagnosis and treatment in the EU has been taken with the publication in September of the updated draft Council Recommendation, which contains revised guidance on breast, colon and cervical cancer.[3] Importantly, the scope of the Recommendation has also now been extended to include screening for prostate and lung cancers, as well as additional guidance for gastric cancer testing in specific countries and regions.

According to estimates, the inclusion of lung cancer in screening programmes could prevent up to 22,000 deaths in Europe every year, while 35–40% of gastric cancer deaths could be averted thanks to earlier identification and treatment of Helicobacter pylori infection, the key cause of gastric cancer. [4]^,1

Similarly, the benefit of effective early detection strategies can be just as substantial for prostate cancer, with the prospect of reducing mortality rates by up to half.[5] Prostate cancer was the fourth most common cancer in 2020, according to the World Health Organisation, while in Europe it represents the most prevalent male cancer.[6]^,[7] Moreover, although prostate cancer is often perceived to be a ‘less serious’ cancer, it nonetheless accounts for approximately 10% of male cancer deaths in Europe each year, with more than 108,000 people estimated to have died from the disease in 2020.[8]^, [9] In Northern Europe (most notably in Scandinavia and in the Baltic States) prostate cancer represents the leading cause of cancer mortality in men, while in Germany and Belgium, it is second in terms of mortality rates among men.[10]

_____________________________________________

“The introduction of risk-based prostate screening is welcome news for patients and their families, as it will not only save lives but also lead to important quality of life improvements.” – André Deschamps

_____________________________________________

As members of the Let's Talk Prostate Cancer Expert Group, we welcome the publication of the draft Council Recommendation and congratulate the European Commission on following through on the proposal outlined in Europe’s Beating Cancer Plan. The Recommendation update comes at an important time, considering the peak in the number of cases of advanced cancer as a result of the delays in diagnosis caused by the COVID-19 pandemic. In the case of prostate cancer, timely diagnosis has been further hindered by the widespread recommendations against prostate-specific antigen (PSA) testing, initiated by the US Preventive Service Task Force in 2012, and by the fact that, for many men, discussing their physical health with others remains taboo.^5,[11] In this light, the need for early detection and timely treatment of cancer has never been more significant.

_____________________________________________

“The inclusion of prostate cancer in the Council Recommendation represents a crucial step forward to ensure that no man is left behind. If the EU is to be at the forefront of the fight against cancer, the timely implementation of the Recommendation by Member States is vital.” – Prof. Hendrik Van Poppel

_____________________________________________

It is essential that all Member States incorporate and consistently implement the final Recommendation within national cancer plans to address the rising prevalence of prostate, lung and gastric cancers, ensuring greater equality and outcomes for all patients in Europe. We hope that a European Commission Initiative on Prostate Cancer, following the example of the European Commission Initiative on Breast Cancer led by the Joint Research Centre, can be swiftly put in place to support this work. In this sense, initial funding from the EU4Health programme for pilots and guidelines was an extremely positive way to kick start the process. Further EU funding will need to be in place to support Member States in implementing the Recommendation and to support robust quality assurance processes and data and knowledge sharing across the EU.

Moving forward, we hope the EU will continue to play a pivotal role in tackling inequalities in the early detection and treatment of cancer by ensuring that it remains high on the political agenda, and very much look forward to seeing the draft Recommendation finalised in the coming months.

Background

The Let’s Talk Prostate Cancer campaign is a multidisciplinary and multi-stakeholder initiative to address the challenges faced by people affected by prostate cancer and increase its policy prioritisation across Europe. It is led by an Expert Group representing key prostate cancer stakeholder organisations, including Europa Uomo, the European Oncology Nursing Society (EONS), the European Association of Urology (EAU), and the European Association of Urology Nurses (EAUN).

Astellas Pharma Europe Ltd., Amgen and Pfizer support the goals and objectives of the Let’s Talk Prostate Cancer Expert Group. The activities of the Expert Group are funded by Astellas Pharma Europe Ltd and Amgen.

[1] Science Advice for Policy by European Academies (SAPEA). Improving cancer screening in the European Union. 2022. Available at: https://sapea.info/wp-content/uploads/cancer-screening-report.pdf. Last accessed August 2022.

[2] Council of the European Union. Council Recommendation of 2 December 2003 on cancer screening. Available at: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32003H0878&from=EN. Last accessed August 2022.

[3] European Commission. Proposal for a Council Recommendation on strengthening prevention through early detection: A new EU approach on cancer screening replacing Council Recommendation 2003/878/EC. Available at: https://ec.europa.eu/transparency/documents-register/detail?ref=COM(2022)474&lang=en. Last accessed September 2022.  

[4] European Federation of Pharmaceutical Industries and Associations (EFPIA). We won't rest until lung cancer patients can achieve the best possible outcomes. 2022. Available at: https://www.efpia.eu/news-events/the-efpia-view/blog-articles/we-wont-rest-until-lung-cancer-patients-can-achieve-the-best-possible-outcomes/#_ftnref5. Last accessed August 2022.

[5] Van Poppel H, et al. Prostate-specific Antigen Testing as Part of a Risk-Adapted Early Detection Strategy for Prostate Cancer: European Association of Urology Position and Recommendations for 2021. Available at: https://www.europeanurology.com/article/S0302-2838(21)01927-8/fulltext. Last accessed August 2022.

[6] World Health Organisation (WHO). Fact Sheet on Cancer. 2022. Available at: https://www.who.int/news-room/fact-sheets/detail/cancer. Last accessed August 2022.

[7] European Association of Urology, White paper on prostate cancer, recommendations of the EU cancer plan to tackle prostate cancer 2020. Available at: https://uroweb.org/wp-content/uploads/EAU_PCa-WhitePaper-FINAL-VERSION.pdf. Last accessed August 2022.

[8] World Helath Organization (WHO). GLOBOCAN 2020. 2020. Estimated number of incident and deaths in Europe. Available at: https://gco.iarc.fr/. Last accessed August 2022.

[9] The Global Cancer Observatory, Fact Sheet on Prostate Cancer 2020. EUROPE SPECIFIC DATA. Available at https://gco.iarc.fr/today/data/factsheets/cancers/27-Prostate-fact-sheet.pdf. Last accessed August 2022.

[10] European Cancer Information System (ECIS). Estimates of cancer incidence and mortality in 2020. Available at: https://ecis.jrc.ec.europa.eu/explorer.php?$0-0$1-All$2-All$4-1$3-34$6-0,85$5-2020,2020$7-7$CEstByCountry$X0_8-3$X0_19-AE27$X0_20-No$CEstBySexByCountry$X1_8-3$X1_19-AE27$X1_-1-1$CEstByIndiByCountry$X2_8-3$X2_19-AE27$X2_20-No$CEstRelative$X3_8-3$X3_9-AE27$X3_19-AE27$CEstByCountryTable$X4_19-AE27. Last accessed August 2022.

[11] European Federation of Pharmaceutical Industries and Associations. Leaving no stone unturned — Europe beating cancer, together. 2022. Available at: https://www.efpia.eu/news-events/the-efpia-view/blog-articles/leaving-no-stone-unturned-europe-beating-cancer-together/. Last accessed August 2022.