Tackling inequalities: how can Europe beat cancer everywhere?

The risk of developing and surviving cancer are shaped by where you live, according to a new report, published today. The report, written by The Swedish Institute for Health Economics (IHE) and commissioned by the EFPIA Oncology Platform, finds deep inequalities in access to prevention and screening, biomarker testing and innovative treatments, and in quality of life for cancer survivors.

The report emphasizes the critical role of efficient use of healthcare budgets in providing high-quality care to address inequalities in patient outcomes. It identifies several common reasons for inequalities, including political prioritisation of cancer care, health expenditure, availability of supporting infrastructure and medical professionals, if clinical guidelines are up to date, geographic distance to health facilities, and health literacy of the public and patients

Key findings:

  • Spending differences: the lowest spending country, Romania (€70 per capita), spent one quarter of the highest spending country, Luxembourg (€294), adjusted for price differentials.
  • Outcome variation: for colon cancer, the five-year survival rates range from 50% in the worst-performing countries (HR, SK, RO, BG, PL) to 70% in the top performers (DE, FI, SE, BE, CY).
  • Prevention: Only Portugal is reaching the EBCP target of vaccinating 90% of girls against HPV. Two countries are still not fully reimbursing HPV vaccination for boys.
  • Screening: Cancer screening rates for colorectal cancer range from 5% (Cyprus, Bulgaria, Romania) to 76% (Denmark).
  • Biomarkers: Access to next-generation sequencing (NGS) testing is low across the EU; patients in Eastern European countries have the lowest access.
  • Treatment: Around 1 out of 2 patients with advanced non-small cell lung cancer in Finland, Poland or Romania receive cancer medicines according to European guidelines although the medicines are reimbursed. In Belgium and Portugal it is nearly 8 out of 10.
  • Supporting survivors: Only eight Member States (France, Belgium, Cyprus, Italy, the Netherlands, Portugal, Romania and Spain) have adopted legislation on the ‘right to be forgotten’, impacting access to financial products for cancer survivors.

The publication provides concrete recommendations to national policymakers, offering short- and long-term actions that can be taken to address shortcomings and enhance and ensure more equal access to cancer care.

As we are approaching the 3rd anniversary of the launch of Europe’s Beating Cancer Plan, the report published today aims to provide an additional perspective of the challenges still faced by cancer patients throughout the EU and serves as a basis for continued multi-stakeholder dialogue on implementation priorities.


The number of cancer cases is projected to rise considerably in the European Union (EU) in the coming decades. In the EU, political commitment to tackling cancer and inequalities has been boosted by the publication of Europe’s Beating Cancer Plan (EBCP, 2021) and the EU Cancer Mission under Horizon Europe 2021–2027. To achieve the goals of the EBCP, EU Member States must improve equal access to high-quality cancer care for all citizens.

Commissioned and funded by EFPIA, this report was produced by the IHE through a combination of desk research and interviews with experts in various areas of oncology, including patient advocates. The authors explore inequalities in spending and outcomes between EU member States, including a detailed analysis of data on HPV vaccination, colorectal screening, biomarker testing, cancer medicine and evidence-based care, as well as cancer survivors’ access to financial products. The report was developed with the input from several international organisations. The European Cancer Organisation provided insights about HPV vaccination, Digestive Cancers Europe about colorectal cancer screening, the International Quality Network for Pathology about access to biomarker testing and precision medicine, Lung Cancer Europe about access to treatment, and Dr. Françoise Meunier about accessing financial products for cancer survivors.