Jasper Kunow, MSD’s managing director for Central Eastern Europe, outlines the threat that cancer still poses to Europe, the challenges of enacting the EU’s Beating Cancer Plan across the CEE region, and how policymakers and payers can help overcome them
“In 2020, while we were all fighting against the COVID-19 pandemic, many of us were fighting a silent battle. The battle against cancer. In 2020, we lost 1.3 million Europeans to this disease. And sadly, the number of cases is on the rise.”
We need to step up this battle and take it out of the hidden shadows. We should trumpet the powerful case that cancer is an urgent public health, social and economic issue that must become a political priority
These stirring words from Ursula von der Leyen, European Commission President, on launching the EU’s Beating Cancer Plan in early February, are designed as a wake-up call to all of us in Europe, not least Central and Eastern European (CEE) countries.
I would go further. We need to step up this battle and take it out of the hidden shadows. We should trumpet the powerful case that cancer is an urgent public health, social and economic issue that must become a political priority.
For Mrs von der Leyen the fight against cancer is personal: she lost her younger sister to cancer. It’s a bitter experience we all increasingly share, both personally and among family and friends. Last year 2.7 million were diagnosed with the disease[1], but we don’t know how accurate that figure is because of the disruption to diagnosis/screening caused by the pandemic.
What we do know is that, without the help of decisive action at national and European levels, cancer deaths could rise by as much as a quarter by 2035[2], reversing slowing trends of cancer deaths recorded in recent years. So, the time for Beating Cancer Plans at home and in Europe is now!
National plans are the proven way forward
The EIU found that 41 percent of EU countries have not updated their cancer control plans in five years, and as many as one in five (19 percent) have no plan at all. Sadly, the bulk of these are in the CEE region where, as the recent GLOBSEC 2021 Bratislava Forum heard, many healthcare professionals are not even aware of national, let alone EU plans.
Yet these plans provide policymakers and payers with a roadmap for organising and delivering care to the benefit of patients and society in general as well as measuring improvements in terms of patient outcomes. We at MSD, in common with others, advocate for cancer control planning, to ensure access to quality treatment and support early diagnosis and higher rates of adequate treatment. But we recognise that this is not enough: sustained and effective enforcement and implementation, including adequate funding, is vital.
Sustained and effective enforcement and implementation, including adequate funding, is vital
That must start, certainly in CEE countries, with putting strong emphasis on primary prevention related to risk factors such as smoking, excessive alcohol consumption, obesity, lack of exercise, poor or fatty diets, but also secondary prevention in form of screening programs, timely and proper diagnosis as well as treatment, plus R&D and new technologies such as digitalisation to be strengthened. In Slovakia, host of this year’s GLOBSEC forum, cancer mortality per capita is one of the highest reported in Europe.[3] Among European countries with low 5-year survival rates from lung cancer, CEE nations such as Bulgaria, Romania and Croatia figure prominently. Poland is treating lung cancer as a high public health priority, but that does not necessarily mean that all patients have access to the latest treatment and care with several barriers across the patient pathway [4].
The EU lends a hand
Europe’s Beating Cancer Plan wisely does not pretend to replace national plans but is designed to buttress these or trigger new strategies. Drawing on an array of EU funding instruments and backed by EU-27 health ministries, it aims to unlock €4bn for actions to “reduce the suffering caused by cancer.” Much of this will go to CEE countries.
Among a range of objectives is reducing the prevalence of smoking to 5 percent by 2040, compared with 25 percent today. Moreover, countries are encouraged to offer breast, cervical and colorectal cancer screening to 90 percent of those eligible by as early as 2025. There is talk of reaching 70 percent long-term survival for cancer patients by 2035. The elimination of cancers caused by HPV through vaccination campaigns is foreseen. These are ambitious but not unachievable targets if all stakeholders row in.
Early diagnosis alone can reduce treatment costs by up to four times compared to managing cancer patients suffering from late-stage disease or even terminal illness
Another flagship idea is to help create an EU network of national cancer centres in all 27 member states, with the aim of ensuring that 90 percent of eligible patients can gain access by 2030. This is a tough ask, given that in countries such as Slovakia, which has no national plan, comprehensive cancer treatment is provided by only three out of 95 hospitals, with the vast majority of cancer patients undergoing treatment in peripheral county hospitals.[5]
Overall, the plan seeks to help countries “turn the tide against cancer”. But, in turn, national governments should devote more of their health budgets to cancer: after all, early diagnosis alone can reduce treatment costs by up to four times compared to managing cancer patients suffering from late-stage disease or even terminal illness. This is an important finding for CEE countries where the risk of cancer mortality is considerably higher than in the west.
As the plan says: “The pandemic has shown that there is enormous strength in collaboration, solidarity and unity of purpose. This lesson also applies strongly to cancer prevention, treatment and care.” So, let’s make this silent battle against cancer a clarion campaign to turn the tide.
References
[1] https://ec.europa.eu/commission/presscorner/detail/en/ip_21_342
[2] Ibid.
[3] ECIS – European Cancer Information System, 6 June, 2021
[4] The Economist Intelligence Unit, Breathing in a new era, a comparative analysis of lung cancer policies across Europe
