HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE

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EVENT REPORT Cancer, the second leading cause of death globally according https://eurac.tv/9QKt to the World Health Organisation, is responsible for an estimated 9.6 million deaths in 2018.

In light of projections that the cancer incidents in Europe will double by 2035, a new survey conducted by Central and Eastern European Cancer Action Group (CEECAG), has identified large differences between Europe’s west and central and eastern countries in handling cancer.

In her mission letter to the proposed new EU Health Commissioner , the President-elect of the EU executive, , said an EU-wide “Beating Cancer” plan should be put forward in order to help member states improve cancer prevention and care.

“This should propose actions to strengthen our approach at every key stage of the disease: prevention, diagnosis, treatment, life as a cancer survivor and palliative care. There should be a close link with the research mission on cancer in the future Horizon Europe programme,” von der Leyen wrote. Contents

Report finds serious East-West divide in cancer handling in Europe 4

Health expert: Cancer control plans must be implemented 6

How patients’ involvement brings quality to cancer care and policymaking 8

Center-right MEPs call for special EU Parliament committee on cancer 10

Eastern Europe diversity should be considered in EU-wide cancer plan 12

Tackling disparities in cancer care across the central and eastern European 14 4 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV

Report finds serious East-West divide in cancer handling in Europe

By Sarantis Michalopoulos | EURACTIV.com

A new survey conducted by CEECAG, suggests that the cancer cases are expected to almost double by 2035. In the case of Europe, the report says the bloc has 1/8 of the world’s population, but at the same time ¼ of global cancer deaths. [Shutterstock]

new survey conducted by A new survey conducted by differences in relation to outcomes. the Central and Eastern CEECAG suggests that cancer cases The gaps range from the existence or A European Cancer Action are expected to almost double by implementation of National Cancer Group (CEECAG) has found severe 2035. In the case of Europe, the report Control Plans (NCCP) to cancer shortcomings in managing cancer says the bloc has 1/8 of the world’s registries and research. incidents in Central and Eastern population, but at the same time ¼ of For example, according to Dr Europe (CEE), whose “young brains” global cancer deaths. Lawler, 90% of Europe’s west has increasingly move to the west. In its report, CEECAG pointed NCCP compared to only 54% in out a number of challenges that the central and eastern Europe. According to the World Health countries of Central and Eastern “That’s really important because Organisation (WHO), about one in Europe are faced with compared to you need to have some sort of a six deaths is due to cancer worldwide, Western Europe. framework that allows you to look and the disease is the second leading In an interview with EURACTIV, and see what is your current situation cause of death globally. WHO data Professor Mark Lawler, from the in relation to cancer incidence and shows that cancer was responsible Centre for Cancer Research and mortality. You need to use that data or for an estimated 9.6 million deaths in Cell Biology, said there are “cancer 2018. inequalities” in Europe as well as Continued on Page 5 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV 5

Continued from Page 4 BRAIN DRAIN cancer-intelligence to both construct Another worrying challenge and implement a national cancer the CEE countries are faced with is control plan” he said. related to the growing brain drain Dr Lawler said cancer registries of specialised doctors moving to the are a key challenge. Citing Bulgaria as west. This will inevitably make it an example, he noted that up to 2013, much harder for these countries to there was a National Cancer Registry, implement a cancer plan. but was then stopped due to some “So it’s critical that we block or stop local reasons. this brain drain and invest in people “So cancer-intelligence is an because people are the ones who are incredibly important part of how we going to deliver at the end of the day. can plan going forward. So we don’t You can have the infrastructure, which have data on how many cancers are is obviously very important, but we in a particular country, what’s the need people who will deliver,” he said, mortality, what are the survival rates, adding that in the UK, the biggest and then other significant effects,” he increase in terms of the number of added. doctors by country is actually from the Czech Republic. RESEARCH AND SCREENING

Referring to resources in relation to GDP in Central and Eastern Europe, Dr Lawler noted spending is much lower than in the west. However, he called on these countries to spend the money “wisely”. “If we look at several countries in Eastern Europe, they are spending a lot on pharmaceuticals. But that’s not being reflected in improved outcomes. So you need to use your resources appropriately, to actually fund the best possible approach that would give the best outcomes for your patients.” He added that research is an integral part of a cancer strategy. “We have data showing that if you’re treated in a research-active hospital, you’re much more likely to have better outcomes.” He emphasised the role of screening as well as the need to invest more in this direction considering that the CEE region does not have effective screening programs. He cited as an example Romania, which is not equipped with a cancer screening program and this has resulted in 14.3% mortality in cervical cancer cases compared to the EU average of 3%. 6 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV

INTERVIEW Health expert: Cancer control plans must be implemented

By Sarantis Michalopoulos | EURACTIV.com

Dr Tit Albreht is a Senior Health Services and Heath Systems researcher at the National Institute of Public Health of Slovenia. [Photo by Sarantis Michalopoulos]

overnments should take Dr Tit Albreht is a Senior Health Summit on 12-14 September 2019 in full responsibility for Services and Health Systems researcher Brussels. Gimplementing national cancer at the National Institute of Public Health plans, which are a commitment of Slovenia. SMOKING AND ALCOHOL toward people and not just a piece of paper, health expert Dr Tit Albreht He spoke to EURACTIV Editor Dr Albreht said the risk factors told EURACTIV.com in an interview. Sarantis Michalopoulos on the sidelines of the ECCO 2019 European Cancer Continued on Page 7 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV 7

Continued from Page 6 called on member states to produce then nothing has happened. National Cancer Control Plans by 2013, “The plan is sitting there. And we in the region, mainly tobacco and a guide and a structure on what the even asked the government or the alcohol consumption, remain plan should include were provided. ministry to provide us with a copy. insufficiently dealt with. “But we still see that people skip And they said they could give us pieces He said there is too much freedom evaluation, that there are no targets of it. What do you mean pieces?” he of smoking as well as exposure to in the plan. The biggest problem is wondered. passive smoking for a large part of the the implementation and the classical Asked if, in Slovenia, his home population. political game. nation, the national cancer plan has “In many countries, almost “We produce the document and brought results, he replied: “We reduce half of the adult population is still now our job is done. So now it’s up the incidence of colorectal cancer smoking. When you go to these to actors in the society to implement because of the screening or program. countries, the restrictions to smoking it. Well, it’s not, because of course, It took us eight years. But we now have in public places are sometimes the cancer plan is a policy, political 25% less incidence than before.” either not introduced, or they’re document, which is a commitment. not implemented. Some of them So the ministry cannot delegate the THE IMPORTANCE OF have not even joined the framework responsibility to someone else. It SCREENING convention of tobacco control. This can of course if they appointed an had been for many years a problem in institution. But generally, it is still in Dr Albreht emphasised the role Bosnia, for example,” he said. the hands of the ministry,” he said. of screening programmes, which in He said for some countries it is a Referring to cancer registries, he the beginning indeed increase the sort of a trade-off, considering that noted that many governments view incidence because more cancers are they also grow tobacco. “Especially them as additional red tape because detected. But in the long run, it saves the tobacco industry was pressuring, they do not understand the capacity lives. even the , that that the data can have. However, he said some countries supposedly the incomes from excise “I was asked to provide my advice have to reconsider their stance toward tax, and from taxation are bigger for Serbia’s national cancer plan. screening programmes, as they view than the costs of losing, basically And the main problem there with the them as an additional cost. productivity and lives. Which is not registry is that it does not catch the “In Slovenia, introducing the true, we know that, and it’s just the whole incidence.” colorectal cancer screening program bias that the industry has always “The second problem is that meant that apart from the tests, had.” the linkages to the registry of the people who are positive have to go for Referring to alcohol, he said it is diseased persons, so that you would colonoscopy and you have to pay for common knowledge that 12 cancers calculate the mortality and survival treatment for all these people that you are related to excessive consumption rate, does not exist, although it’s just a detect earlier than before.” of alcohol. Apart from digestive bureaucratic matter. So, that could be “And this is all technically cancers, he also said there is a link resolved if they could do it. And they additional costs. It’s hard to say between breast cancer and excessive don’t do it. And the ministry doesn’t additional as it’s a cost that would drinking. understand the meaning of that. appear sometime in the future. And “It’s surprising, because, in this Survival is a very important piece of now it appears sooner. More people area, the European Commission did information,” he added. have chances of survival. So it’s cost- act in the past. And it’s one of their Referring to the EU member effective for sure,” he added. missions, considering that in the field states in the region, he said on paper “But, you know, in healthcare, it’s of public health the EU Commission all of them have national cancer often like this. First, you have the cost, has much more space to act than in plans except Slovakia, which has not and then you have the gains. And for the field care itself.” formally adopted it yet. The Czech accounting, first, you have to pay and Republic, Slovenia and have then you will probably see benefits in CANCER CONTROL PLANS, implemented them. the future,” he concluded. JUST ON PAPER But he insisted that in many countries, implementation remains Dr Albreht, who is also an issue. He cited as an example coordinating a joint action on cancer Romania, where the plan was control, said when the EU Commission technically prepared in 2016 but since 8 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV

How patients’ involvement brings quality to cancer care and policymaking

By Gerardo Fortuna | EURACTIV.com

Considering patients’ voice is crucial when conducting cancer clinical trials, say medical experts and patient advocacy groups. [SHUTTERSTOCK]

edical experts and The idea of a European Master benches during a plenary debate, stakeholders from patient Plan against Cancer was launched asking to set a special committee Madvocacy groups are keen to by the current European People’s tasked with improving the EU point out how crucial it is to consider Party (EPP) parliamentary group coordination in the fight against patients’ voice as an added value president, Manfred Weber, during his cancer. when conducting cancer clinical unsuccessful bid to become European It should not surprise that trials, whatever policy on cancer, Commission president. Commission President-elect Ursula national or EU-wide, will eventually On Wednesday (18 September), von der Leyen, also coming from be put together. Weber himself relaunched his 10- point proposal from Strasbourg’s Continued on Page 9 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV 9

Continued from Page 8 European Cancer Organisation (ECCO), “I was surprised by how much which is preparing a series of charters patients know about treatments,” the EPP, gave Health Commissioner- that advocate for improvements in said Professor Slavica Sović from designate Stella Kyriakides the patient care. the University of Zagreb School mandate to prepare a Europe’s Beating But to bring more quality and of Medicine, who presented the Cancer Plan, which is meant to be deliver excellence, Banks also pointed outcomes of the study. a support tool for member states to out that an overarching approach She added that healthcare improve national cancer prevention should set down guidelines rather professionals measure numbers like and care systems. than mere standards. mortality or complications of a certain The EU has been committed to “We don’t want minimum disease, but not the quality of social finding a cure for cancer since the first standards, but quality cancer care that services or not directly related to “Europe against Cancer” programme can be implemented and applied in healthcare. launched in Milan in 1985, from the any country,” he said. “These are important for the leaders of what used to be called the For instance, some companies wellbeing and the quality of life, and European Community. already started putting patients into bringing quality in health care is the Many things have changed since the design of clinical trials, with the added value of patients’ involvement, then and the new efforts should be aim of overturning the rate of 50% of as well-being which is particularly focused more on bringing quality clinic trials collapsed due to lack of difficult to assess,” she said. in cancer health care, considering recruitment, meaning that not enough Ian banks said that “what patients new challenges of high survivorship, patients make themselves viable for want most from their treatments is rehabilitation and continuity of care. the trial. normality. They want to be able to do “It’s something that is not seen “If you include patient advocacy the things that cancer took away from that much by policymakers, but for group in the design of the trial and all them.” patients changes everything,” said Dr the way through it, the recruitment However, healthcare services tend Tit Albreht, a senior researcher at the rate goes up and the crashed rate goes to be focused more on longevity than National Institute of Public Health of down,” commented Ian Banks. on the quality of life. “But patients Slovenia. are not stupid, they don’t want to live WELL-BEING IS THE NEW forever. They just want normality,” EXCELLENCE, NOT FOCUS concluded Banks. MINIMUM STANDARDS A survey of more than 16,000 In addressing the challenge of participants, recently conducted in the bringing quality in cancer treatment, Eastern countries, has tried to identify however, the patients’ voice has not how patients could drive a positive yet been considered by policymakers, change to cancer healthcare. according to Ian Banks from the The survey highlights that, patient advocacy group European despite the introduction of screening Men’s Health Forum. programs for early detection, “I find it staggering when we’re an average of more than 60% of discussing the lives of patients without participants were diagnosed with actually listening to what they want, breast and colon cancer only after they and how they think it should be done,” first visited the doctor because they he said. felt something was wrong. As it is always difficult to have a one But it also underlines that patients size fits all approach, he added that have faith in doctors or the healthcare countries need both national inputs personnel, although they don’t feel to within national cancer plans, but also get the rest of the support that they an overarching one which lays down want. the essential requirements for the Indeed, patients start seeing the different national cancer approaches. healthy condition not only as the These essential requirements absence of disease but also as the for quality cancer care (ERCC) are presence of social well-being during, currently under development by the and particularly after, the care. 10 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV

Center-right MEPs call for special EU Parliament committee on cancer

By Aneta Zachová and Sarantis Michalopoulos | EURACTIV.com and EURACTIV.cz

MEP also emphasised the critical role of data for both research and patients’ therapy. []

he European People’s Party Commissioner,” said Peter Liese, Beating Cancer Plan to support (EPP), the biggest political a German MEP from the Christian member states to improve cancer Tgroup in the EU assembly, Democratic Union (CDU), in prevention and care.” will ask for the creation of a special comments to EURACTIV. “This should propose actions to parliamentary committee to help Ursula von der Leyen, the strengthen our approach at every formulate a new EU-wide plan to President-elect of the European key stage of the disease: prevention, combat cancer. EURACTIV.com and Commission, has said she would put diagnosis, treatment, life as a cancer EURACTIV.cz report from Strasbourg. forward a new plan to combat cancer survivor and palliative care. There during her five-year mandate, which should be a close link with the “The EPP will ask for a special begins on 1 November. research mission on cancer in the committee on cancer, so that we In her mission letter to Stella future Horizon Europe programme,” really have a parliamentary follow- Kyriakides, the incoming EU health the letter reads. up on all the related issues and be Commissioner, von der Leyen wrote: the counterpart for the new Health “I want you to put forward Europe’s Continued on Page 11 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV 11

Continued from Page 10 importance. And the EU’s upcoming in the area of social and private Horizon 2020 programme for insurance, jobs. They are labeled as HEALTH POLICY, A innovation and research will include cancer patients even though they are NATIONAL COMPETENCE a particular “mission” on cancer to no longer,” the German MEP said, this effect. adding this issue should be addressed Peter Liese said he wanted the According to him, the priority under the EU’s non-discrimination Parliament to assist the European should be to save children who principles. Commission in this endeavour. suffer from cancer. “More European Last but not least, Liese said “I believe that Europe can really cooperation – more than in other member states should enhance cross- do a lot,” he told EURACTIV. “We areas – is needed,” he said. border collaboration. shouldn’t give the impression that it’s Liese also emphasised the critical “Sometimes, especially in children only us because we need the member role of data for both research and and rare cancers, the specialist is not states,” he said. patients’ therapy. in one particular member state, but Health policies are mainly a “The cancer registries established maybe just across the border. We national competence where the EU in the member states are not yet able need to strengthen patients’ rights,” has little say. But the rising number of to communicate with each other. he said. cancers in Europe has raised concern So we need to develop a European The German MEP also called on among policymakers, who have network of cancer registries,” he said. the pharmaceutical industry to get started exploring ways of addressing EU institutions, including involved, saying public institutions the issue collectively. the European Centre for Disease alone won’t be able beat cancer. According to the World Health Prevention and Control (ECDC), “But we need to understand that the Organisation (WHO), Europe is should also do their part and exchange pharma industry will only invest in faced with more than 3.7 million as much data as possible to achieve research which pays off,” he added. new cancer cases and 1.9 million the best outcomes for patients, Liese For instance, Liese said the deaths each year. Cancer represents continued. pharma industry wouldn’t necessarily the second most important cause of The so-called national cancer invest in research to reduce patient death and morbidity in Europe. intelligence units, which inform suffering during chemotherapy. But “If everything goes right, we can about the number of cases in a there are non-commercial scientists really save many lives. Our goal is that, particular country, the mortality and universities who are looking for in 20 years, nobody would die from and survival rates, is considered an ways of reducing the doses so that cancer anymore. And that’s of course integral part of national control plans chemotherapy still effectively treats an ambitious goal, but scientists tell to combat cancer. patients while taming the side effects. us it is possible,” Liese said. But in reality, studies have found “And this kind of research needs Elena Kountoura, a leftist MEP severe discrepancies among member public funding. The pharma industry (GUE-NGL), believes cancer could be states when it comes to cancer won’t do it because they don’t earn more effectively tackled if a common registries. money by selling less,” he said. European policy were in place. “Many governments view them “In this respect, the will as additional red tape because they and determination of Cyprus do not understand the capacity that Commissioner Stella Kyriakides will the data can have,” told EURACTIV Dr be of high importance to push the first Tit Albreht, a Senior Health Services European plan to address cancer,” she and Health Systems researcher at the told EURACTIV. National Institute of Public Health of “Kyriakides is a woman who is Slovenia. deeply aware of the problem and the challenges created by national health TAMING THE systems’ differences,” she added. SIDE EFFECTS OF CHEMOTHERAPY FOCUS ON RESEARCH, EXCHANGE OF DATA Another issue relates to patients who survived cancer but who are still Peter Liese, for his part, said socially marginalised, Liese said. focusing on research will be of crucial “They are still discriminated 12 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV

Eastern Europe diversity should be considered in EU-wide cancer plan

By Gerardo Fortuna | EURACTIV.com

Many of central Eastern European countries are not at the same pace, but science is moving very quickly, said Pfizer’s Linda Gibbs. [SHUTTERSTOCK]

aving a pan-European cancer assess national cancer plans on the plans all over Eastern Europe, they’re control plan is crucial, but ground in many member states over a all somewhat different,” she said, Hsome flexibility should be number of years. adding that even clinical trials are not granted to member states in choosing According to her, relaunching the comparable, as they all have different which aspect to prioritise within the idea of an EU framework could be very inclusion criteria or design. framework, said Linda Gibbs from useful, as progress on cancer may be Similar to what happened with the the Eastern European Cluster Lead of more difficult if national plans are debate over the Health Technology Pfizer Oncology in an interview with different across Europe. Assessments (HTA), countries should EURACTIV.com. However, she argued that a pan- look at the overall impact of cancer European plan should also take into control framework based on the way Gibbs has worked in central account the differences in healthcare their current systems are able to Eastern Europe for ten years and in systems existing between Eastern and accept innovation. the health quality sector for fourteen Western countries. years, having the opportunity to “Having looked at national cancer Continued on Page 13 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV 13

Continued from Page 12 infrastructures. “For instance, we sometimes “We’re basing HTA in Eastern discuss access, like in the HTA debate, Europe as if they are Western but we should think about access to European countries. Can you really good health care, as opposed to only do it the same way? It cannot be a the treatment perspective,” she said. blanket approach,” she said. The main contribution the industry Besides an overarching and can give is in making investments uniform framework, national cancer more effective, in a way that is good control plans will still be necessary for patients and for countries’ budgets as they can help to prepare these as well. countries for the innovation they In this regard, molecular testing need. is a good example. “In many central “Many central Eastern European Eastern European countries, the countries are not at the same pace, government is not supporting this but science is moving very quickly,” technology, although the science Gibbs said. of targeting different genes for the Romania, for instance, has blocking of cancer is advancing,” showed its intention to adopt some Gibbs explained. kind of risk-sharing pricing schemes, Many governments have asked considered by many experts a good the industry to pay for the testing, means to bring innovation. which was considered by the private However, these programs are sector a short-term approach, but still very much based on how many a positive one in addressing a bigger patients are going to be treated and advancement in cancer care. unfortunately, there has been no good “We were happy to play a part in cancer registry in Romania since 2011 building infrastructure and helping and no reliable data. governments on how to do the “If we had a national cancer plan testing, and this should be done in the that works, we would have a registry, context of a cancer control plan,” she so we would have data to inform our concluded. decisions and maybe to help countries making their important investment decisions,” she pointed out.

INDUSTRY ROLE

Asked about what the industry could do to in reducing the gap in cancer treatment, she said that the private sector has a role in helping countries not just by bringing innovation, but also by bringing it in in a way that will be sustainable for these countries. In her view, the industry has not been recognised yet as a player, or at least a partner, in informing people, despite the fact that companies have not only financial but, above all, human resources to better understand a variety of different healthcare systems and to develop health 14 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV

OPINION / PROMOTED CONTENT

DISCLAIMER: All opinions in this column reflect the views of the author(s), not of EURACTIV.COM Ltd. Tackling disparities in cancer care across the central and eastern European region

By Linda Gibbs | Pfizer Biopharmaceuticals Group/Oncology

Linda Gibbs at this year’s Annual CTRL Cancer Summit. [Pfizer]

espite encouraging advances in Linda Gibbs is the Senior Director a quarter of all deaths and is the science and technology, cancer for Central and Eastern Europe in number one cause of death for people Drates continue to rise across the Pfizer Biopharmaceuticals Group/ aged 45-64 in an increasing number world. The International Agency for Oncology. of member states. In particular, the Research on Cancer (IARC) estimates Even in developed regions inequality between countries in that one-in-five men and one-in-six such as Europe, cancer continues Central and Eastern Europe (CEE) and women worldwide will develop cancer to place a significant burden on Western Europe (WE) is stark. In 2018, over the course of their lifetime, and that patients and countries across the CEE countries reported the lowest one-in-eight men and one-in-eleven continent. According to the European women will die from their disease. Commission, cancer accounts for Continued on Page 15 EVENT REPORT | HOW EUROPE CAN BETTER TACKLE RISING CANCER INCIDENCE | EURACTIV 15

Continued from Page 14 their cancer diagnosis in the Czech Investment in research, education Republic, Hungary and Slovenia6. and training to develop expertise and incidence rates for cancer in males Thus far, only 46% of CEE countries retain professionals in the clinical and females (280.1 and 216.5 million have implemented screening communities is also key, as well respectively) yet the highest mortality programs for cervical, breast and as developing and standardizing rates (171 and 92 million respectively) colorectal cancers[7] whilst Bulgaria patient pathways and models of in comparison to the countries in and Slovakia are 2 of the 3 EU member care that reflect patient needs and Northern, Southern and Western states which lack a population-based requirements. For example, the Europe. breast cancer screening program[8]. European Cancer Organisation These statistics can be attributed To put these data into comparison (ECCO), have produced checklists to varied levels of cancer control and with WE, the recent CONCORD-3 study and explanations of organizations preparedness among and within CEE found that five-year standardized net and actions that are necessary to countries. Furthermore, significant survival for rectal cancer tended to be give high-quality care to patients. discrepancies in investment in health higher in non-CEE countries across They are written by European experts systems and infrastructure between Europe from 2010-2014. For example, representing all disciplines in cancer the WE and CEE regions impede the Norway reported as high as 69.2% and care and give an overview to oncology adoption of advanced technologies the lowest rate was from Malta with teams, patients, policymakers and and services available in WE. 56.1%. In comparison for CEE, Bulgaria managers of how high-quality care From this view, it is clear that for reported as low as 45.9% and only can be provided[10]. Finally, the any strategy to improve cancer survival one country, Slovenia, reported over enhancement of capacity building for in Europe to be effective, it must focus 60%[9]. Similarly, non-CEE countries patient organizations is also needed. on addressing the evident inequalities tended to have higher survival rates The value of such changes will present in the CEE region, with the for breast cancer from 2010-2014. be significant in my view, allowing advocation of National Cancer Control Notably, Iceland went as high as 89.1% genuine, meaningful progress towards Plans (NCCPs) at its centre. This will whilst the lowest was Ireland with better outcomes in cancer across the not only help address the problems 82%. In comparison, the highest CEE CEE region. of today but also aim to reduce future rate was Slovenia with 83.5% whilst burden, as there is a significant chance the lowest was the Russian Federation THE NEXT STEPS that there will be more problems in with 70.8%.9 future if we do not address them now. Key stakeholders realise this, HOW NCCPS CAN SOLVE and in the words of Professor Tit THE EXTENT OF THE THE PROBLEM? Albreht[11] – “It is vital that clinicians, DISPARITY PROBLEM policymakers, patient organizations The adoption of national cancer and other stakeholders unite to ensure At present, NCCPs are either not control strategies, supported by that we can improve cancer outcomes in place or not being implemented NCCPs, will be vital in reducing the in CEE. Otherwise, we risk widening effectively across CEE countries. Of considerable inequalities across the the disparity of care.” the CEE countries, 7 of 13 (54%) have region by ensuring a more balanced There is much to be done in not produced a NCCP and of countries and efficient use of resources for better addressing cancer across Europe, that have produced an NCCP, many prevention, outcomes and quality of ranging from prevention to survival. face problems in implementation[5]. life for cancer patients and survivors. Reducing the inequalities that the CEE The problem extends from Across the CEE region, there region faces can be a major contributor diagnosis to screening and treatment. must be a coalition of policymakers, to helping address cancer across A 2019 patient survey found that in politicians, patient organizations, Europe. With an already existing Bulgaria, 94% of patients reported the pharmaceutical industry and disparity between CEE and the other their cancer was only detected clinicians to improve the uptake regions of Europe, these inequalities after seeing a physician due to the and development of NCCPs. This must be urgently addressed with the suspicion of a problem whilst only coalition can be achieved via several adoption and development of NCCPs 6% reported detection via a screening means, firstly by improving cancer to ensure that no patient is left behind. program for an unrelated health intelligence to inform an evidence- problem[6]. Similarly, this survey also based approach to decision making revealed that only 47% of patients and policy for affordable, high quality began treatment within 1 month of and equitable cancer control. For information on EURACTIV Event Reports...

Contact us Teresa Dominguez Project Manager - Events & Accounts [email protected] tel. +32 (0)2 788 36 93 Sarantis Michalopoulos Reporter [email protected] tel. +32 (0)2 226 58 28