The report points to five key trends in innovation - and best practice honed in the pandemic - which can be used to enable more sustainable care: Artificial Intelligence & Machine Learning, Digital Health & Digital Medicine, Precision Medicine & Biomarker Testing, Curative- & Capacity extending therapies, Out-of-hospital care. 30 real-life examples demonstrate the potential of these trends in redesigning cancer care at all stages along the care pathway. They include:
Prevention and early detection:
- The stage of colorectal cancer diagnosis has a significant impact on patient outcomes. 5-year survival rates for patients diagnosed at stage 1 vs stage 4 are 90% and 10% respectively. Through population wide screening by age or hereditary factors, it is possible to increase the proportion of colorectal cancer cases identified at stage 1 from 15% to around 50% significantly improving outcomes for those patients.
- AI-enabled image analysis allows radiation oncologists to reduce reading time of lung cancer CTs by approximately 40%, and to perform image segmentation 13 times faster.
Pre-habilitation and treatment
- Immuno-oncology therapies: Instead of using targeted cancer therapies to affect the tumour cell directly, immune oncology activates the patient’s immune system to fight cancer. In Belgium, the estimated benefit of all immuno-oncology therapies combined, compared to the standard of care, was 27% in life years gained, a 34% increase in QALYs (extra years of life in good or perfect health) and an 80% increase in Progression Free Survival (PFS).
Palliation, Rehabilitation & Survivorship
- Integrated geriatric palliative care: A Comprehensive Geriatric Assessment (CGA) can identify individuals more likely to experience benefits from onco-geriatric care. Those receiving this integrated care reported better quality of life over 24 weeks and underwent significantly fewer unplanned hospital admissions (-41%) over the same period.
- Reducing carbon emissions from keyhole surgery can be cut by 80%, through a range of initiatives including wearing reusable scrubs, reducing energy use, and administering anaesthesia intravenously rather than with gas.
Although cancer outcomes in Europe have improved significantly in recent decades, diagnoses are rising due to demographic changes. This puts pressure on healthcare budgets and resources including healthcare workers. Currently, the yearly economic impact of cancer has hit 100 billion. It is estimated that Europe will experience a shortage of 4.1million health workers by 2030.
From an environmental perspective, around 1,200kg of waste is generated per cancer hospital bed every year – suggesting urgent interventions are needed
The report suggests that the EU is at a ‘fork in the road’; It can continue to battle an aging population and increasing cancer cases with fewer resources, or it can utilise innovation to strategically manage and mitigate cancer prevalence, through more effective prevention and optimised care for those who need it. By using best practice across the cancer pathway we can alleviate the pressures, improve access to cancer care in a sustainable way, and help achieve the goals of Europe’s Beating Cancer Plan and the Mission on Cancer.
The report comes as the European Commission is preparing to publish the revision of the pharmaceutical legislation. The timing of the report provides the Commission and Member States with a golden opportunity to use the findings to help meet its double ambition of ensuring Europe has a supply of affordable medicines for its population, while supporting its industry to remain a world leader in medical innovation, amidst fierce global competition. It will also assist at a time when the EU is facing multiple geo-political and financial challenges in the current perma-crisis.
The report urges policy makers to commit to five areas when making key decisions in the design of cancer care in the future.
- Long-term ambition to adopt policies that put patients and outcomes that matters first
- Investment into the research and development required to make these fundamental changes to cancer care
- Robust evidence, data and analytics to maximise the impact and scale of care
- Reimbursement for healthcare organisations who implement sustainable practices
- Clear progression pathways and networks to scale up successful pilots to foster innovation.
Together, this will make it simpler, and more effective for healthcare providers to adopt the practices described in this report, and easier governments to balance financial constraints with delivering affordable, effective and sustainable healthcare.