The EU cancer plan: a robust response to fight cancer in its entire pathway
“This Cancer plan is about resilience, resistance, and action.”— Stella Kyriakides, European Commissioner for Health and Food Safety.
Every year, cancer kills 1.2 million Europeans and another 2.6 million people are also diagnosed with it. These numbers will only increase as the European population ages and increases. While concerns about this disease are personal for some, for others just hearing the word cancer evokes stories of resilience, fear, and unfortunately, loss, despite the fact that the number of people who survive cancer keeps growing thanks to advances in science and early detection. Yesterday, the European Commission said the EU needs to do better.
It was not too long ago that the European Commission President said that Europe would lead in the fight against cancer. Unfortunately, it was not the focus of the past year due, as we all know, to a pandemic that distracted the European Union’s focus on this issue. Yesterday, this focus was fully back. The European Commission presented a strong EU response to this growing challenge: Europe’s Beating Cancer Plan.
The Plan is a comprehensive one, tackling the entire disease pathway. Its structure is based around areas where the EU can add most value: prevention, early detection, diagnosis and treatment, and the quality of life of cancer patients and survivors. Over the coming years, it will focus on research and innovation, boost the use of new technologies, and mobilise financial instruments to support Member States’ efforts to beat cancer under each of the four pillars.
Europe’s Cancer Plan will be supported by many actions linked to other Commission policies, such as in the areas of digitalisation, employment, energy, education, agriculture, climate, transport, social policy and taxation, and backed up by significant investments from the EU budget.
Knowledge and research will play a key role in the 21st-century fight against cancer. The Mission on Cancer will be a major component of investment in cancer research and innovation, deepening our knowledge of the complexity of the disease. A new ‘Knowledge Centre on Cancer’ will also be launched to help coordinate scientific and technical cancer-related initiatives at EU level. It will act as a knowledge broker and provide guidelines to feed the design and roll-out of future actions. The incorporation of digital tools into the arsenal of the fight against cancer will be key as well, and electronic health records will help in cancer prevention and care under the future European Health Data Space. The European Cancer Imaging Initiative is also meant to be set up in 2022. This EU ‘atlas’ of cancer-related images will make anonymised images accessible to a wide range of stakeholders as well as link the data to tools such as High-Performance Computing and AI.
As former EU Health Commissioner Vytenis Andriukaitis emphasised several times, prevention is better than cure. About 40% of cancer cases in the EU are preventable and prevention is the most cost-efficient long-term cancer control strategy. The prevention pillar on the Cancer Plan aims to raise awareness of and address key risk factors, such as alcohol and smoking. The plan will raise health literacy, updating and increasing awareness about the European Code against Cancer as well as developing an ‘EU Mobile App for Cancer Prevention’.
Crucially, this Cancer Plan will attempt to create a ‘Tobacco-Free Generation’ where less than 5% of the population uses tobacco by 2040, compared with around 25% today. The Tobacco Products Directive, the Tobacco Taxation Directive, and the legal framework on cross-border purchases of tobacco by private individuals, for which a public consultation was unveiled earlier this week, will all be reviewed. Additionally, by 2023, the Commission will update Council Recommendations on Smoke-Free Environments and recommend that it includes e-cigarette and heated tobacco products to “strengthen smoke-free environments”, such as outdoor public spaces. Furthermore, alcohol consumption is another priority and the Commission will review the EU legislation on alcohol taxation, introducing nutritional and warning labels by 2023, and will seek to clamp down on online alcohol ads. Finally, the plan wants to improve health promotion, attempt to reduce environmental pollution, and prevent cancer caused by infections through extensive vaccination programmes.
Still, screening offers the best chance of beating cancer and saving lives, and this has been emphasised dramatically in this plan. The Commission will put forward a new EU-supported Cancer Screening Scheme to help Member States ensure that 90% of the EU population who qualify for breast, cervical, and colorectal cancer screenings, are offered screening by 2025. The scheme will be supported by EU funding and focus on making improvements in three key areas: access, quality, and diagnostics. The Commission will also propose by 2022 to update the Council Recommendation on cancer screening to ensure it reflects the latest available scientific evidence. Such evidence will feed into the work of the Knowledge Centre on Cancer, which will provide new guidelines and quality assurance schemes. The European Cancer Information System to monitor and assess cancer screening programmes will also be updated with such information.
To ensure high standards in terms of diagnosis and treatment, the Commission will establish an EU Network linking recognised National Comprehensive Cancer Centres in every Member State, facilitating collaboration across the EU. This action will help deliver higher-quality care and reduce inequalities while enabling patients to benefit from diagnosis and treatment close to home. The Cancer Plan aims to ensure that 90% of eligible patients have access to such centres by 2030. To ensure a high-quality health workforce, the Cancer Plan will try to build a stronger multidisciplinary cancer workforce through training and continuous education, including on digital skills, AI, genomics, and personalised medicine. The Commission will also launch an ‘Inter-specialty cancer training programme’ in 2021, optimising collaboration among cancer specialists and ultimately benefit diagnosis, treatment, and follow-up for cancer patients. In addition, a new Cancer Diagnostic and Treatment for All’ initiative will improve access to innovative cancer diagnosis and treatments and use ‘next-generation sequencing’ technology for efficient genetic profiles of tumour cells.
Finally, to improve the quality of life of those who are touched by cancer, the Cancer Plan aims not only to ensure that cancer patients survive their illness, but also that they live long, fulfilling lives, free from discrimination and unfair obstacles. The Commission will promote programmes for re-skilling and upskilling to help cancer survivors re-join the labour market, as well as it will also launch a new study related to the return to work of cancer survivors. But, most importantly, the Commission will launch the ‘Better Life for Cancer Patients Initiative’, aiming to provide by 2022 a ‘Cancer Survivor Smart-Card’. This will summarise their clinical history and facilitate and monitor follow-up care including the patients’ own experience. Furthermore, the Commission pays attention to financial services activities in this area it will closely examine their practices in terms of fairness towards cancer survivors in long term.
Interestingly, and this is something that was emphasised during the launch of the plan by Commissioner Kyriakides, several actions outlined in the Cancer Plan will address inequalities between and within EU Member States. In 2021, the Commission will establish a Cancer Inequalities Registry that will identify trends, disparities, and inequalities between Member States and regions. This will guide investment and interventions at EU, national and regional levels in the future. The Commission will additionally promote the use of advanced mobile technologies by healthcare providers through the EU4Health and Digital Europe programmes. Finally, the Smart and Sustainable Mobility Strategy will help to better connect people and patients in remote areas with hospitals and healthcare hubs.
Europe’s Beating Cancer Plan, together with the Pharmaceutical Strategy, is designed to build the foundations of a stronger European Health Union by placing the interests and well-being of patients and the population at its centre. If implemented in full, the plan will create more secure, better prepared and more resilient European health systems. It is now in the hands of EU governments to deliver.
By Daniel Costa
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