Brussels – Eighty but also 90% against 10-20%. In the midst of so many lives interrupted. These are the survival rates five years after diagnosis that are recorded today respectively for breast and lung cancer. An enormous difference to be filled as soon as possible by aiming for secondary prevention through a diagnosis and subsequent treatment that are able to be timely. It is this ambitious goal that the experts who recently took part in the 4th European Cancer Forum in Brussels hosted by MSD in collaboration with Lung Cancer Europe (LuCE) and the Swedish Institute of Health Economics (IHE) are aiming for. From there, a Call to Action was launched to promote the integration of innovation into health systems and the adoption of timely actions that allow the objectives of the European fight against cancer to be achieved.
The European plan to fight against cancer
The Call to Action focused on lung cancer. How come? “All tumors have the same importance – he replied Antonella Cardone, Cancer Patients Europe – but lung cancer is the leading cause of death in the European Union and is responsible for 20% of all cancer deaths in Europe. Therefore, we can consider it a sort of ‘pilot case’ which will be followed by other initiatives focused on other types of tumours”. According to experts meeting in Brussels, despite the incidence, lung cancer has not received the attention required by the European fight against cancer plan. The European Commission recently published a Council Recommendation on extending screening to several new types of cancer, including lung cancer, and this represents an unprecedented opportunity to improve the treatment of lung cancer and other related cancers, including rare cancers of the chest, reducing inequalities. “We are at a crucial stage in the implementation of the European Plan – reads the Call to Action – and in view of the revision of the Plan in 2024, now is the time to act to ensure that Europe turns the tide in the fight against cancer ”.
Una Call to Action europea
The urgency of this initiative arose precisely from this data and at the Forum the MEP Cristian Busoi, member of the European Parliament, president of the ITRE commission (Industry, Research and Energy) as well as of the Challenge Cancer Intergroup and rapporteur for the EU4Health programme, launched the Call to Action. We must prioritize prevention, act for early diagnosis and treatment, and increase health literacy and data collection if we are to reduce mortality from lung cancer, but also from other cancers. This call to action provides practical solutions that have the potential to improve cancer care across the European Union,” he said Cristian Busoi participating in the round table in Brussels.
The three priorities
The Call to Action has identified three key priority areas starting with the need for early diagnosis because it is truly the winning strategy for improving cancer outcomes by providing care at the earliest possible stage and is therefore an important public health strategy in all contexts. The second priority to focus on is to guarantee access to therapies for all types of cancer throughout Europe and in the world because health must have no borders. Finally, in Brussels, experts underlined the urgency of developing and implementing national cancer control plans in each country to support the objectives of the European cancer plan.
Lung cancer diagnosis is more difficult
Although the initiative was launched with lung cancer in mind, the Call to Action concerns all cancers because it is undeniable that early diagnosis is the best strategy for any disease. Every year there are 1.3 million deaths from cancer across Europe. “While breast cancer is something that every woman can detect with self-examination – she explained Thomas Hofmarcherdirector of research at the Swedish Institute for Health Economics and speaker of the Call to Action – in the case of lung cancer this is not the case because internal organs are affected and when symptoms appear it is often already late also because the persistent cough, for example, can be traced back to various other pathologies such as asthma, bronchopneumopathy or even a simple flu and this means that a diagnosis is often reached very late”.
Break down barriers
Early diagnosis and screening can make a real difference to the effectiveness of treatment. “Unfortunately, many cancer patients are left without a cure despite being diagnosed. This could be because they were diagnosed too late or because there are no modern diagnostic tools or treatments themselves, and the list goes on. We have identified the barriers, now is the time to do something about them,” said Thomas Hofmarcher.
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Personalized medicine still for a few patients
As with other malignancies, lung cancer treatment has also moved from a one-size-fits-all approach to personalized treatment. However, the use of advanced lung cancer drugs require preliminary diagnostic tests. For this reason, the Call to Action invites the European Commission to encourage Member States to participate in the “Diagnosis and treatment of cancer for all” initiative, foreseen in the European fight against cancer, to improve access to and reimbursement of profiling complete genomics through next generation sequencing (NGS) technology as well as the PD-L1 Test.
To gain some time
Time is usually not on the side of patients diagnosed with cancer, so one of the key actions of the Call to Action is to speed up access to diagnosis and treatment. “It can often be more frustrating to know that a solution is available in a neighboring country than to know that there is no solution available,” he stressed. Ewelina SzmytkeVice President LuCe.
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An Italian example of clinical management
Among the participants in the European Cancer Forum also Francesca Ferre of the Management and Health Laboratory (MeS) at the Scuola Superiore Sant’Anna in Pisa who provided an overview of the current Italian system of interregional performance evaluation for cancer care, discussing the potential of continuous and systematic benchmarking (comparison) of public health organizations for improvement, suggesting insights into the need to continue investing in more person-centred measures to support clinical management. Performance indicators range from participation in cancer screening programs to the appropriateness of end-of-life care and also include measures of well-being and patient satisfaction.
How to move from theory to action
Already the European Plan and then the national ones in cascade trace the way for the improvement of the conditions of care and survival of cancer patients. But the ‘Call to Action’ is a further push to roll up one’s sleeves by rallying all the actors involved and also by indicating practical recommendations for the Member States of the European Commission on how to implement the identified priorities. For example, to promote prevention and early diagnosis, it is necessary to focus on health literacy, but it is also important to work to ensure faster access for patients to modern molecular tests that can improve both diagnosis and treatment. And finally, it is essential – the experts have recommended – to improve the collection of data on treatments and their inclusion in the Cancer Inequalities Registry, an initiative that is part of the European Plan to fight cancer in which data on prevention and treatments are collected with the objective of identifying any inequalities and disparities within the Member States.
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The signatories of the Call to Action
“We have an opportunity to create a greater sense of collective responsibility for the need to beat cancer through tracking the percentages of patients in treatment and also their potential inclusion in the Cancer Inequalities Registry,” he explained. Klaus Feldman, Vice President Oncology Europe and Canada, MSD. “However, we need to ensure that the focus is on early cancer detection and access to treatment across Europe if we are to make real change.” At the moment the Call to Action has been signed by 14 MEPs, patient associations as well as MSD which promotes the European Cancer Forum. Among the signatories are the Rare Thoracic Cancer Association, Cancer Patients Europe, the Center for Innovation in Medicine and Lung Cancer Europe. But today the invitation to sign the Call to Action also went out from Brussels to other organizations and institutional representatives.