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.
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
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.