According to most recently published data, there were an estimated
1.4 million new cases of cancer in men and 1.4 million in women in the
EU in 2012. In the same year, approximately 707 000 men and 555 000
women died from cancer. Although significant
advances are being made in the fight against the disease, cancer remains
a key public health concern and a tremendous burden on European
societies. Cancer is the second most common cause of death in the
European Union – a figure that is expected to rise due to the ageing
European population.
Where does the EU come into the
picture? On this year’s World Cancer Day, we present 10 little known
facts about EU action in the field of cancer.
Fact #1: The EU has a 29 year history in the fight against cancer
It all started back in 1985, when
the heads of state of the (then 12) countries of the then European
Community met in Milan and committed themselves to launching the first "Europe against Cancer"
programme. The plans of action that stemmed from this meeting
contributed to the adoption of the first 'European Code against Cancer',
as well as landmark Directives prohibiting the advertising of tobacco
products, regulating tobacco products chemicals, pesticides and
exposure to carcinogens at work – all major risk factors for developing
cancer.
For nearly three decades, numerous
actions have been undertaken and supported at EU level – actions which
have helped to save lives.
Fact #2: In 1987 the European Commission gathered top cancer experts and developed the 'European Code against Cancer'
With the knowledge that cancer
can, to a certain extent, be avoided by adopting healthier lifestyles,
and outcomes greatly improved if cancer is detected early on, the "Code"
aims to arm citizens with key information through its 11
recommendations :
- Do not smoke.
- Avoid obesity.
- Undertake some brisk, physical activity every day.
- Increase your daily intake and variety of vegetables and fruits.
- Moderate your daily consumption of alcohol.
- Avoid excessive sun exposure.
- Avoid exposure to known cancer-causing substances.
- Women from 25 years of age should participate in cervical screening.
- Women from 50 years of age should participate in breast screening.
- Men and women from 50 years of age should participate in colorectal screening.
- All should participate in vaccination programmes against the Hepatitis B virus.
The European Code against Cancer is currently being revised by
the Commission and the International Agency for Research on Cancer,
based on the latest scientific evidence, and the fourth edition of the
Code is expected to be published during 2014.
Fact #3: The Commission coordinates EU action to address the risk factors of cancer
With one in three cancers being
preventable, addressing the risk factors (or determinants) is at the
forefront of the Commission's strategy to reduce the burden of cancer.
The Commission addresses all the key risk factors, e.g. through an
ambitious tobacco control policy comprising both robust laws regulating
tobacco products and prohibiting the advertising and sponsorship of
such products; an award winning pan-EU campaign "Ex-smokers are unstoppable";
strategies and platforms for joint action on alcohol and nutrition
& physical activity bringing together Member States and a wide range
of stakeholders including NGOs and industry.
The Commission further contributes
to cancer prevention by addressing environmental factors such as
exposure to carcinogenic and mutagenic substances both indoors
(including in the workplace) and outdoors. It does so mainly by
developing and implementing legislation on air, soil and water quality
and on general chemical exposure (ie. in water, waste and organic
pollutants).
Fact #4: EU Joint Action aims to reduce cancer incidence by 15% by 2020 ...
In 2009, the Commission launched "The European partnership for action against cancer"
(EPAAC), financed as a Joint Action under the EU Health Programme. Work
under this Joint Action has helped to ensure that today 24 out of 28 Member States have adopted National Cancer Plans, compared with 17 in 2009. Cancer plans contribute to the ambitious goal of reducing cancer incidence in the EU by 15% by 2020.
The Partnership has covered the broad spectrum of cancer prevention and control and focused action on 4 areas:
- Health promotion and cancer prevention, including screening;
- Identification of best practice in cancer-related healthcare;
- The collection and analysis of comparable data and information;
- A coordinated approach to cancer research.
It has also facilitated transfer of knowledge and best practices between EU Member States.
Member States have already started
cooperating on a new 2014-2016 Comprehensive Cancer Control Joint
Action (CANCON). The new Joint Action, scheduled for launch in March
2014, has two main objectives:
- To identify key elements and quality standards for comprehensive cancer control in Europe, to prepare an evidence-based European Guide on Quality Improvement in Comprehensive Cancer Control; and
- To facilitate cooperation and exchange of best practice between Member States, to identify and define key elements to ensure optimal, comprehensive cancer care.
Cancer also features prominently in the 3rd EU Health Programme (2014-2020).
Fact #5: Population-based
screening programmes for breast, cervical and colorectal cancer are
being rolled out across Europe following an EU recommendation
Quality screening gives patients
the chance to receive timely and often life-saving treatment, through
early diagnosis. If detected at an earlier stage, cancer is more
responsive to less aggressive and less debilitating treatments.
The 2003 Council Recommendation on cancer screening
set out principles of best practice in the early detection of cancer
and called on all Member States to take common action to implement
national, population-based screening programmes for breast, cervical and
colorectal cancer, with appropriate quality assurance at all levels.
The latest report (from 2008) on
the implementation of this Recommendation showed that progress is being
made but Member States fell short of the target set for the minimum
number of examinations by more than 50%. Improvements are expected when
the next implementation report is published in 20141.
In the meantime, as a further aid to Member States, the Commission has produced a full set of European Guidelines for quality assurance
for the screening of all three types of cancer. Supplements to the
guidelines on breast and cervical cancer screening - originally
published in 2006 and 2008 respectively, are now available as a result
of an EU-funded project coordinated by the International Agency for
Research on Cancer.
Fact #6: Major progress is being made in breast cancer care screening
Breast cancer is both the most
prevalent cancer amongst women in the EU and the most frequent cause of
cancer related death. In light of population ageing, this trend is set
to continue. The burden of this disease can be lessened through a
combination of prevention, early detection, effective diagnosis and
optimal treatment.
The Joint Research Centre, the
'science arm' of the European Commission, is working towards a
voluntary, evidence-based quality assurance scheme for breast cancer
services. Clinical departments that adhere to this scheme will be
recognised as the 'gold standard' by women across Europe, in terms of
screening, diagnosis, treatment and post-treatment of breast cancer.
This is the first European Quality Assurance scheme, underpinned by
accreditation, developed in the area of health services in Europe.
Fact #7: The EU invests over €200 million per year in cancer research
The EU is an important cancer research funder. During the past seven years, the EU has invested more than €1.4 billion
in international collaborative research, frontier research, mobility
programmes, public-private partnerships and coordination of national
cancer research efforts.
More than half this budget - €770
million – has been used to encourage key players from across Europe and
beyond to join forces in 'collaborative research projects',
to find new ways to fight cancer and help patients. These projects help
us better understand how various types of cancer develop, how they can
be diagnosed earlier and treated more successfully.
For instance, the EU-funded RATHER project
is delivering a proof-of-concept for novel therapeutic interventions,
together with matched personalised diagnostic approaches for ‘triple
negative’ and ‘invasive lobular’ breast cancers. RATHER has initiated a
phase I/II clinical trial to examine patient responses to a novel drug
in a clinical setting.
The application of nanotechnology
in medicine (nanomedicine) also creates new opportunities for early
diagnosis and therapy of cancer. The EU-funded projects NAMDIATREAM and Save Me develop nanotechnology-based diagnosis and therapy for cancer.
Clinical trials to validate new cancer medicines and treatments are also at the core of the EUROSARC network,
which focuses on rare malignant tumours affecting soft tissues and bone
tissues. For this project, working across the whole of Europe is the
only way to gather enough patients in a reasonable timeframe to carry
out the tests, something that would not have been possible for one
individual country.
Fact #8: Through a public-private partnership, the EU is speeding up breakthrough innovation in the fight against cancer
Through its Innovative Medicines Initiative (IMI),
the EU has joined forces with Europe's pharmaceutical industry to
achieve breakthrough innovation and bring new medicines and treatments
to patients faster, including for cancer.
Within the IMI, EU funding –
exclusively used to support partners such as small and medium-sized
companies, academia, patient organisations and regulatory agencies – is
matched with in kind contributions from large companies which are part
of the European Federation of Pharmaceutical Industries and Associations
(EFPIA).
To date, the initiative has
devoted some € 80 million to international cancer research and
innovation projects which identify novel biomarkers to make new
treatments and medicines safe and effective.
For instance, the 'OncoTrack' project
pioneers the use of large-scale genomics to improve the early diagnosis
of colon cancer, which will increase the chances of survival and
successful treatment. And the 'QuIC-ConCePT' project,
led by the European Organisation for Research and Treatment of Cancer,
carries out research into new biomarkers to improve cancer drug
development.
Fact #9: The Commission harmonises and improves EU-wide information on cancer
Reliable, comparable, high-quality
data and indicators on cancer are essential to improve prevention
programmes and control and care processes across the EU. Harmonised
cancer data is also an invaluable resource for cancer epidemiology,
allowing greater understanding of the differences and related causes in
population-based studies across regional and national boundaries.
The Joint Research Centre is spearheading the development of a harmonised cancer information system for Europe
in collaboration with the European Network of Cancer Registries (ENCR)
and important stakeholders, such as the International Agency for
Research on Cancer (IARC), the EUROCARE group and others. This will
generate a dynamic European cancer monitoring tool which will steer and
support effective policies on cancer.
Fact #10: Patients with rare forms of cancer benefit greatly from the added value the EU provides
Rare tumours are rare diseases
(diseases affecting fewer than 5 people in 10 000) and carry the same
challenges. Compared with adults, a far greater proportion of the 40 000
children diagnosed with cancer every year in the EU have rare forms of
the disease. Childhood cancer is almost always very severe and is the
main cause of disease-related death in children.
Patients with rare cancers are
faced with particular challenges including late or incorrect diagnosis,
difficulty finding clinical expertise and accessing appropriate
treatments. Researchers and clinicians face challenges when carrying out
clinical studies, possible lack of interest in developing new
therapies, uncertainty in clinical decision-making, and scarcity of
available registries and tissue banks.
European cooperation on rare
diseases can make a difference to patients suffering from rare cancers.
The European Commission helps to bring together the scarce knowledge
and fragmented resources across individual EU countries and maximise
synergies and results.
The 'Patients' Rights in
Cross-border Healthcare Directive' (2011/24/EU) foresees the creation of
European Reference Networks, of which some are expected to focus on
rare tumours. Its main added value is to help improve access to early
diagnosis as well as delivery of high quality and cost-effective
healthcare for patients with a medical condition that requires specific
expertise or resources, particularly in medical domains where such
expertise is hard to find.
