Background
Cancer remains one of the biggest causes of death in Europe. Although enormous efforts are being made in the area of research and significant advances have been made in the fight against this scourge - medicine is currently able to cure one cancer in two – cancer still remains a public health concern. Some cancers can be cured, or the prospects of cure greatly increase, if detected early.
According to WHO estimates, at least a third of all cancer cases are preventable and that prevention offers the most cost-effective, long-term strategy for the control of cancer. Furthermore, another third of the cancer burden could be cured if detected earlier and treated adequately, the MEPs point out.
EU action
Responding to the need of comparable indicators for cancer monitoring
The EUROCHIP Project involves more than 130 European experts in various cancer-related fields to discuss and prioritize the relevance of a preliminary list of 134 cancer health indicators. The main elements of information required for each proposed indicator (i.e.: characteristics, operational definition, possible sources of data, methodological issues, and availability) were summarized on a standard form.
Responding to the need to create cancer information networks
CaMon (Comprehensive Cancer Monitoring in Europe) is an EU project with operational responsibilities on the compilation and maintenance of an updateable database of indicators of cancer burden and outcome for EU countries, the study of time trends and the provision of projections of cancer incidence and mortality for the EU and its Member States.
One of the main outputs of CaMon is the EUCAN database which presents graphical and tabular information on cancer incidence, mortality, prevalence and survival in 15 EU Member States.
Information on cancer survival has been generated by the EUROCARE project.
The European Network of Cancer Registries (ENCR) was established in 1989 within the framework of the former ’Europe Against Cancer’ programme of the European Commission. The Network has the following objectives: to improve the quality, comparability and availability of cancer incidence data, to create a basis for monitoring cancer incidence and mortality in the European Union, to provide regular information on the burden of cancer in Europe to promote the use of cancer registries in cancer control and health-care planning and research.
A comprehensive EU Network for Information on Cancer (EUNICE) has been launched in 2004 EUNICE will take forward the work of ECHI and EUROCHIP, by moving beyond the creation of lists, to the actual compilation of agreed and relevant indicators, their analysis and interpretation, and to making them widely available. The objective of Eunice is to compile, compare, analyze interpret and disseminate information relevant for monitoring of the status of cancer burden in the European populations, planning and evaluation of cancer control measures at national and EU level.
Responding to specific needs of cancer information
Automated Childhood Cancer Information System (ACCIS) is a project supported by the European Commission, with the objective of collection, presentation, interpretation and dissemination of data on childhood cancer in Europe.
Haematologic malignancies (HMs) constitute a large proportion of adult blood diseases. It will be studied on the EU Project Cancer registry based project on haematologic malignancies Project. The main objectives are the revision of HM coding procedures used by cancer registries, ensuring strict adherence to ICD-0 morphology codes, and making them consistent with nosologic categories currently used by clinicians.
The European Cervical Cancer Screening Network is a project supported by the European Commission with the objective of continuation of the long-term monitoring and epidemiological evaluation of the cervical screening in several European regions, with the objective of establishing realistic results outcome indicators, and to estimate costs-benefits and to minimise the adverse effects.
Responding to the need of cancer mortality comparable data
Eurostat began collecting and disseminating mortality data for the Member States of the European Union, broken down by a "shortlist" of causes of death, in 1994. Broadly speaking, the EU has witnessed a very significant reduction in mortality during the last century or so. There were four main developments: a decline in infectious diseases (in the second half of the 19th century); an increase in degenerative diseases (at the end of the 19th century); a slowdown in the increase in life expectancy (the 1960s); and a narrowing of differences between the sexes.
Issues
On 29 January 2008, Parliament’s Committee on the Environment, Public Health and Food Safety adopted a motion for a resolution on Combating cancer in the enlarged EU
The resolution urges Member States to implement statutory cancer registration and ensure capacity for population-based evaluation of programmes for prevention, screening, treatment and survival.
The Commission is asked to support prevention through the promotion of healthy lifestyles and by encouraging research and innovation in the area of screening, early detection, anti-cancer medicines and treatments. Regarding the latter, MEPS argue that the differences in the quality of cancer-treatment facilities, screening programmes and access to new anti-cancer drugs "are among the reasons for the big differences in the five-year survival rate from most cancers across Europe".
The resolution also calls on the Commission to set up an institutionalised EU Cancer Task Force to provide leadership for improved cancer control in Europe. Composed of members of the Commission, the Council and the Parliament, the Task Force would meet on a regular basis to collect and exchange best practices for prevention, screening and treatment.
"An average of only 3% of health budgets are spent on cancer prevention [...] We need to get our act together and invest in cancer prevention," said MEP John Bowis, who referred to cancer as being at "epidemic levels".
Next steps
Reducing cancer is a top priority for the current Slovenian EU presidency. A presidency conference on "How to Reduce the Burden of Cancer?" took place on 7-8 February 2008.
The motion for resolution will be voted on during the March plenary in Strasbourg.
The Health and Environment Alliance will organise this fall an international conference on Cancer prevention and Healthy Environments - Science and Policy Frameworks for Moving Forward.
EPHA comments
EPHA strongly supports any initiative aiming at reducing cancer. This resolution could be a reel step forward for this fight.
EPHA particulary supports any move from a only disease-oriented approach toward a broader one. This proposal would not only strenghten cancer screening, early detection, anti-cancer medicines and treatments, but also prevention by the promotion of healthy lifestyles.
Encouraging healthy lifestyles is indeed the most efficient and cost effective strategy to reduce not only cancer but also other non communicable diseases, such as cardio vascular diseases.
To do so, health determinants need to be addressed by a multi sectoral action. Nutrition, physical activity, pollution, mental wellbeing: here are a few major determinants for a healthy lifestyle. Not only indivual choices have to be targeted, but also how society influences or even shapes our modus vivendi.
For further information
EPHA related articles
Report on "Europe in Wide Screen - A campaign for improved EU-wide cancer screening"
Comprehensive report on the link between cancer prevention and nutrition
One Third of Cancer Cases could be prevented through Government Action, says WHO
