Europe’s Beating Cancer Plan: new momentum for EU’s health

On 3 February 2021, the European Commission finally released its Europe’s Beating Cancer Plan. There is no doubt that cancer represents a serious and complex disease, which affects the lives of many Europeans, and causes an increasing and alarming number of deaths. With this Plan, the EU wants to draw attention to its role in health, by creating a wide collaboration with a new approach and ambitious objectives. This is one step closer to building a European Health Union.

Cancer as a persistent concern in the EU

Oncology research has a long history in the EU. In the 1980s, French President François Mitterrand took an interest in combating cancer and, together with other European leaders, put forward initiatives such as the Europe Against Cancer research programme. Since then, many European collaborations have been initiated in the fight against cancer in all its aspects, despite the EU’s limited competences in health. 

Nevertheless, numbers of cancers are rising in Europe. In 2020, there were estimated at around 2.7 million new cases and 1.3 million deaths. Cancer is expected to increase by 24% and to become the first cause of death by 2035. In addition, the overall economic cost is estimated to exceed €100 billion annually. For the relatives of oncology patients, their lives are also severely impacted, often putting their lives on hold to become the carer of the patient.

The European Commission under Ursula von der Leyen defined oncology as one of its main priorities for health as expressed in her mission letter to the Health Commissioner Stella Kyriakides. In 2020, Ursula von der Leyen introduced the ‘Europe’s Beating Cancer Plan’ at the occasion of the World Cancer Day. Yet, cancer is not only a political issue for the President of the European Commission: “This is personal”, she said, “I was 13 years old when my little sister died of a reticulo sarcoma.”

One month after the presentation of the Plan, the COVID-19 outbreak affected Europe, borders were closed and the population was under lockdown. With health systems under unprecedented pressure and travel restrictions, the continuity of oncology care has been hugely challenged: oncology services were disrupted, diagnoses and treatments were delayed, and drugs were lacking even in rich countries. As a consequence, there has been a dramatic increase in the number of Europeans affected by cancers. 

New holistic and modern strategy 

In early February 2021, in response to the critical situation, the European Commission released the proposal for its Europe’s Beating Cancer Plan, with a new holistic and modern approach.

The holistic approach refers to the large scope of the Plan, which covers the entire disease pathway through: prevention, early detection, diagnosis and treatment, and quality of life of patients. In addition, the Plan is not limited to health policies, but touches upon a broad array of interrelated European policies: innovation, employment, education, marketing, agriculture, energy, environment, climate, cohesion and so on. For instance, one objective is to reduce environmental pollution, an underlying cause of cancer. The holistic approach is also visible through the large contribution of a variety of stakeholders, and with the substantial sum of money invested of €4 billion from various European financial sources. 

Besides, the European Commission promotes a modern approach to oncology. It expects to fund, share, and coordinate oncology research and scientific knowledge throughout Europe. The Plan will enhance the development of innovative technologies, including for example, Artificial Intelligence (AI) and big data. In particular, they can help to better understand the disease by monitoring the progression of patients’ cancer, improving and reducing time to diagnose, and thus, accelerating treatment. Indeed, since the beginning of the pandemic, digital transformation in health has been accelerated. For instance, telehealth and teleconsultations have shown interest in ensuring the provision of healthcare services.

Empowerment of patients

The Plan “places the interests and well-being of patients, their families and the wider population at its heart, every step of the way”. According to the growing concept of ‘health democracy’, there is today a cultural change that focuses on empowering the patients. Patients should be more educated, informed, and have greater choice and participation which may improve the quality of treatment, care, and well-being.

One key objective is to prevent the disease by educating patients to make healthier choices. It will notably promote the ‘European Cancer Code’ which already contains scientific recommendations to help reduce the risk of developing cancer. To facilitate greater awareness, recommendations will also be found in a ‘EU Mobile App for Cancer Prevention’. 

New technologies will also contribute to the empowerment of patients. For instance, each patient will have an ‘electronic health record’ containing all necessary individual medical information. It will ensure the efficient exchange of patients’ information between all the healthcare professionals who will have to treat the patient. 

The EU also wants to touch upon patients’ life “after cancer” denoted by work discrimination and financial burden. That is why EU Member States such as France, Belgium, Luxembourg and the Netherlands implemented the ‘Right to be Forgotten’ which allows cancer survivors to apply for financial services, without having to disclose their history of cancer.

Another key measure of the Plan is the establishment of a ‘Cancer Inequalities Registry’. Its role will consist of identifying and evaluating inequalities across Europe and helping policy-makers to make adequate decisions. Not all oncology patients are equal and low-income patients face difficulties in covering their treatments. In addition, oncology care and treatment are not always available in all EU Member States. In Bucharest, for instance, there is only one hospital that treats children’s cancer, with mothers often having to take on the role of nurses due to lack of resources. As a result, patients often will have to seek oncology care in other European countries, excluding poorer patients from that option. The discrepancy with the West is so blatant, that childhood cancer kills one in two patients in Romania, whereas 80 per cent of children survive cancer in Western Europe.

Tobacco at blame but not alcohol

Assuming that 27% of cancers are attributed to tobacco use, the Plan sets an ambitious target to create a ‘Tobacco-Free Generation’, where less than 5% of the population uses tobacco by 2040, compared to today’s 25%. For this purpose, tobacco taxation will be increased, and the scope of the ‘Council Recommendation on Smoke-Free Environments’ will be extended to e-cigarettes and heated tobacco products. 

Criticisms expressed by lobbies of e-cigarettes denounce restrictions on tobacco. The European Tobacco Harm Reduction Advocates (ETHRA) emphasised that “the Plan spectacularly fails to make a distinction between harmful smoked products and smoke-free alternatives.”

Contrary to what is provided for tobacco, the European Commission softened measures regarding alcohol and meat at the last moment. In fact, the Plan only deals with the “harmful” consumption of alcohol. Margaritis Schinas, the Vice-President of the European Commission for Promoting our European Way of Life, specified that the European Commission will only refer to “science” and “will not label or ban wine [which] has been a part of our way of life since the times of antiquity”. Yet, according to a WHO report from 2018, the consumption of alcohol is responsible for 180 000 cases of cancer and 92 000 cancer deaths in Europe. 

Undoubtedly, Europe’s Beating Cancer Plan will remain the major initiative in health of Ursula von der Leyen’s Commission. In the current sanitary crisis, strong European solidarity is more than necessary. In that respect, the Plan requires that EU Member States, researchers, industry, patients, all kinds of healthcare workers, to work together to save Europeans’ lives. And indeed, cancer is a complex, serious, and common issue that affects and changes the lives of a large number of people. We may therefore expect that a wide collaboration will create a new momentum to build a strong European Health Union.