European Institute of Women’s Health:
Statement on: EU Beating Cancer 04/02/2020
Cancer is Europe’s second leading cause of death. After cardiovascular diseases, accounting for 26% of all deaths in 2013. More than 1.3 million people died of cancer in 2013 across all EU Member States
The growing cancer incidence in Europe is a major public health challenge. Projected to nearly double by 2030—coupled with ageing Europe and declining birth rates, cancer will take a huge toll on patients, their family members, friends, carers and Europe.
Large strides have been made to reduce the burden of cancer in Europe through improved screening and treatment.
Yet, breast cancer is still the number one killer of women.3 Ovarian cancer is the “silent killer” of women throughout Europe resulting in more deaths than any other women’s reproductive cancer. Beyond traditional “women’s cancer” (i.e. the “bikini model” of women’s cancer), the rates of many other cancers are on the rise, so the face of women’s cancer is
changing in Europe, which comes with unique challenges. The EIWH believes that there is much to be learned from all types of cancer and that we can better fight cancer together.
The EIWH recognises the work of FEMM committee in the European Parliament’s and the adoption on the 13/12/2019 resolution on policy challenges and strategies against women’s cancers and related comorbidities.
The EIWH welcomes the proposed Europe’s Beating Cancer Plan to support Member States to strengthen policy and programmes at every stage of the disease: prevention, diagnosis, treatment, life as a cancer survivor and palliative care.4 The proposed plan provide an opportunity to work together to advance the fight against cancer.
Prevention
Cancer prevention must be the key focus of any cancer strategy as it offers the most cost effective, long term approach to cancer control. Modifiable lifestyles or environmental risks exist for many cancers. The large evidence base that exists to demonstrate that exposure to tobacco products leads to an increased risk of cancer as ensured that anti-tobacco programmes form a key part of any cancer control programme. The WHO Framework Convention on Tobacco Control seeks to limit the use of tobacco world wise and has signed 180 countries. Smoking is by far the most important as it is a risk for upper gastrointestinal, cervical, pancreatic and of course lung cancers.
Prevention both primary and secondary is a key to reducing the burden of cancer in the population. Other prevention measures include physical activity, healthy diet and low alcohol consumption. 40% of cancers are preventable. It is also one of a number of non-communicable diseases that share common risk factors, which include cardiovascular disease and diabetes and whose prevention and control would benefit the majority of citizens.5
Screening
The primary aim of screening programmes is to detect early cancerous cells with the aim of reducing cancer mortality in an asymptomatic population. Most if not all European countries have invested in screening the population Detecting and diagnosing cancer early is critical in reducing mortality as a result of cancer. Methods of early detection lie in screening for the common cancers and ensuring the female population attend their primary care provider with any on-going or unusual symptoms.
Treatment and Care
All women, regardless of age, geographic location, social status, culture and ethnicity are entitled to to the highest quality cancer treatment and care . However this is not the case not, however, the reality, and more and more women are facing difficulties, or are being excluded from these health services, on account of austerity policies and their impact on the public health sector in Member States. Access to the appropriate treatment and to clinical trial should be possible for all women in the EU, however huge disaprities exxsist. The establishment of the EU clinical trials portal should improve information to cancer patients .
Survivorship
Cancer survivorship begins at the time of diagnosis and continues till the end of life across all cancers. This needs a good plan to ensure that all cancer survivors. avail of all cancer services for better medical and psycho-oncological services available to them. It is also very important that all cancer survivors’ avail of all the population-based screening programmes and prevention messages in order to both live healthily and prevent the possible re or a new occurrence of a second cancer.
H2020 Targeted research must be conducted by age, race/ethnicity and type of cancer in order to increase the understanding of the development, prevention, diagnosis, progression, and treatment of cancer.
Efforts must be made to better understand the development, prevention, progression, treatment and prevention of gender-specific cancers that disproportionally affect women, by employing a lifecourse approach from young through older age. Research must not only explore the biological aspects of cancer, but must also explore the mental, social, and economic implications for those with the disease as well as for those who survive it. Research must be conducted to better understand the influence of race and ethnicity on cancer in a European context.
In order to improve existing practice and policy, cancer data must be disaggregated based on various factors, including age and cancer stage. A robust, comparable monitoring system to track cancer across Member States should be set up at the EU level to enable a concerted, common
approach.
Existing data collection tracking new and existing cancer cases and respective deaths from genderspecific cancers that disproportionally affect women cancers across the EU must be improved and harmonised. Comprehensive, longitudinal data is essential to improve efforts to combat cancer as well as to assure quality and equity in prevention, diagnosis, treatment, and care.
Cancer screening programmes must be designed, assessed, and regularly updated based on evidence gathered by national cancer plans and registries. National and European capacity-building and systematic, quality-assured screening implementation must be supported by EU funding, particularly in under-resourced EU Member States.
Stakeholders across Europe must continue to promote the development and the improvement of national cancer plans as part of their national cancer control programmes and their national cancer registries. The ECIBC should encourage Member States to implement and improve the national cancer screening programmes, especially in those countries without established population-based screening programmes. As part of effective national cancer plans, comprehensive national cancer registries should be supported to allow for cross-national analysis over time in order to develop more effective strategies and programmes to avoid cancer progression. Quality-assured cancer screening programmes that utilise and strengthen exchanges between programme coordinators and evaluators across European countries and regions should be encouraged.
The EU and Member States must work together to improve policy and programmes to more forcefully tackle cancer.
Health literacy campaigns to educate key stakeholders – including women themselves – about national screening programmes should be promoted. Additionally, more should be done to promote the understanding of the importance of healthy lifestyle and behaviours in preventing cancer.
Vulnerable groups, including migrants and those living in poverty and those women under-utilising screening programmes should be specifically targeted.
Efforts must be taken in order to reduce health inequities with regard to cancer within and across Member States.
The EU together with the Member States and key stakeholders—including health organisations, patient organisations, and other relevant stakeholders—must encourage and support improved education, research, prevention, screening, and treatment guidelines. Europe must also provide
guidance and support in to order to reduce health inequalities across Member States.
The 2003 Council Recommendations on Cancer Screening must be regularly re-evaluated based on the existing knowledge base and best practice to address existing gaps and to reduce health inequities.
The EU has undertaken many efforts to promote cooperation and harmonisation with regard to cancer screening services. Currently, many healthcare systems face pressures to curb expenditures, but concerted efforts must be made to ensure effective screening programmes remain a top priority.The benefits of co-testing (performing a Pap smear and a HPV test) in a European context as the basis of a national screening programme for cervical cancer should be investigated.
Initiatives need to be developed to better understand and to support women with cancer, physically, emotionally, and socially. In developing these initiatives, it is crucial to consider age, cultural differences, and other relevant factors.
Women with cancer face many physical, psychological, and financial burdens. Programmes must be put into place to support patients with cancer, particularly those women with advanced cancer. In order to reduce health inequalities, Europe must also encourage and support improved education, research, prevention, screening, and treatment initiatives for disadvantaged groups of women, their families, and their communities.
Strategies must be developed to support and empower cancer survivors throughout their recovery.
Strategies must be developed to support cancer survivors throughout their recovery to ensure that their health is managed and monitored. Moreover, survivors must be supported in their everyday lives, for example by providing necessary employment supports. It is also important to empower survivors to help manage their own health. Survivors face unique challenges that require tailored programming.
About the European Institute of Women’s Health (EIWH)
Founded in 1996, the European Institute of Women’s Health (EIWH) is a non-governmental organisation (NGO) that uses an evidence-based approach to advocate for an equitable, sex- and gender-sensitive approach in health policy, research, promotion, treatment and care. The Institute promotes biomedical and socio-economic research that addresses sex and gender-based differences to ensure access to quality treatment and care for women across their lifespan. The EIWH strives to reduce inequities by drawing policymaker’s attention to the obstacles that women in minority, migrant, refugee and socio-economic disadvantaged groups face. The Institute’s activities work to empower individuals to play an active part in their own health management.
For more information, please visit:
• European Institute of Women’s Health website:
• EU Manifesto for Women’s Health:
https://eurohealth.ie/manifesto2018/
• European Institute of Women’s Health Policy Briefs
https://eurohealth.ie/policy_briefs/?highlight=policy%20briefs
References
1 American Cancer Society. Global Cancer Burden to Nearly Double by 2030.
http://www.cancer.org/myacs/newengland/global-cancer-burden-to-double-by-2030
2 IARC. 2017. The GLOBOCAN Project. http://globocan.iarc.fr/Default.aspx
3 http://www.europarl.europa.eu/doceo/document/TA-8-2019-0112_EN.html?redirect
4