The Commission presents a report on the implementation of the Communication from the Commission on ‘ Action Against Cancer: European Partnership’ and on the Council Recommendation 2003/878/EC of 2 December 2003 on cancer screening.

To recall, the council Recommendation on cancer screening, unanimously adopted, acknowledges both the significance of the burden of cancer and the evidence for effectiveness of breast, cervical and colorectal cancer screening

The Recommendation calls on Member States to take common action to implement national population-based cancer screening programmes with appropriate quality assurance , in accordance with European best practice guidelines . It further invites the Commission to: (i) report on the implementation of cancer screening programmes, (ii) consider the extent to which the proposed measures are working effectively, and (iii) consider the need for further action. In 2008 a first implementation report on the Recommendation was published, covering the period 2003-2007 ( please see summary dated 22/12/2008. )

The report summarises the main achievements in the fight against cancer in the EU in the framework of both initiatives towards the target to reduce cancer incidence by 15% by 2020.

Main results :

· Political will : the vast majority of Member States – 24 out of 28 - met the target of producing a National Cancer Control Plan (NCCP) before 2013.

· Support for Member States : through a Joint Action under the Health programme, guidance for Member States on establishing national cancer plans and on cancer care has been developed. A new Joint Action launched in 2014 will lead to a European Guide on Quality Improvement in Comprehensive Cancer Control. The Directive on the application of patients’ rights in cross-border healthcare provides further opportunities for increased cooperation through European Reference Networks between healthcare providers and centres of expertise.

· Prevention: the fourth version of the European Code Against Cancer supported by the Commission through administrative agreements with the International Agency for Research on Cancer will be launched soon.

· Screening: based on current projections, well over 500 million screening examinations for breast, cervical and/or colorectal cancer will have been performed in publicly mandated programmes in the EU between 2010 and 2020. European Guidelines for quality assurance in screening and diagnosis have been produced for breast cancer (2006, supplements 2013), cervical cancer (2008, second edition 2014) and colorectal cancer (2010).

· Quality assurance : the Commission is developing a Quality Assurance scheme for Breast Cancer Services based on the European legislative framework.

· Research: during the last seven years, the EU has invested more than EUR 1.4 billion in research efforts in relation to cancer. More than half of this budget – EUR 770 million – has been invested in collaborative research projects to find new ways of fighting cancer and supporting patients.

· Cancer information : in 2012, the Joint Research Centre was made responsible for coordinating the European Cancer Information System and acting as repository of European Union data and tools.

· Coordination: to improve the coordination of the range of cancer initiatives at EU level, the Commission established a European Union Group of Experts on Cancer Control in 2014.

Next steps : EU action on cancer based on the Commission Communication has strengthened cooperation between the European Union, Member States and relevant stakeholders and has created European added value in relevant areas (NCCP, screening, cancer information system, rare cancers, etc.) as well as a practical basis on which to continue and expand mechanisms for cooperation.

This cooperation in strategic areas provided a framework which made a sustainable contribution to reduce the burden of cancer in the EU and towards maintaining the target of a 15% reduction by 2020. According to the last available data, in the period 2000-2010, the incidence of the most frequently occurring forms of cancers (i.e. breast, lung, prostate and colorectal) decreased by about 10%.

In order to take forward this cooperation, the Commission sets out some of the next steps:

- the 3rd EU Health Programme offers opportunities to promote public health action on cancer and Horizon 2020 , in particular its Health, demographic change and wellbeing objective, offers opportunities to pursue research on cancer and other major chronic diseases.

- continued support for the development of high quality National Cancer Plans in the European Union;

- the new Tobacco Products Directive which should be fully operational by ensuring full use of its delegated and implementing powers as well as supporting its implementation by Member States in order to reduce smoking throughout the EU and contributing to reduce the incidence of cancer;

- enhance cooperation between the fields of Public Health, Environment and Occupational Health in order to tackle the avoidable causes of cancer from a broader perspective;

supporting a voluntary European Quality Assurance scheme for breast cancer services;

- creation of European Reference Networks, including on rare tumours. The Commission intends to organise calls for Networks in 2014 and 2015;

improving screening programmes and networking between centres and experts, at the EU, national and regional level;

- consideration of a specific Action on Rare Cancers;

- wider uptake of eHealth for efficient disease management and to strengthen effective prevention practices.

The recommendations of Members States and stakeholders, in the framework of the Commission Group of Experts on Cancer Control, will also be taken into account.

The report states that the Commission maintains the objective of reducing the burden of cancer in the EU, and the target of a 15% reduction of cancer incidence by 2020 ( 510,000 new cases ).

COM(2014)0584
EUR-Lex

This report examines the implementation of Council Recommendation 2003/878/EC of 2 December 2003 on cancer screening programmes. Recall that the Recommendation spells out fundamental principles of best practice in early detection of cancer and invites Member States to take common action to implement national cancer screening programmes with a population-based approach and with appropriate quality assurance at all levels, taking into account European Quality Assurance Guidelines for Cancer Screening, where they exist. Updated and expanded EU guidelines for breast and cervical cancer screening have recently been published by the Commission; comprehensive European guidelines for quality assurance of colorectal cancer screening are currently in preparation.

Moreover, the Recommendation invites the European Commission to report on the implementation of cancer screening programmes, to consider the extent to which the proposed measures are working effectively, and to consider the need for further action. This is the first such report.

Main findings : after circulatory disease, cancer is the second most common cause of death in the European Union in 2006, accounting for two out of ten deaths in women, which amounts to a total number of 554 000 women, and three out of ten deaths in men, which amounts to 698 000 men. Due to the ageing population this number is expected to rise further every year, if no preventive action is taken by the EC and the Member States.

As regards cancer cases, every year, 3.2 million Europeans are diagnosed with cancer, most of whom are suffering from breast, colorectal or lung cancers. However, the burden of cancer is far from being equally distributed across the European Union. Breast, cervical and colorectal cancer are a major cause of suffering and death in the Member States of the European Union. According to estimates of incidence and mortality by the International Agency for Research on Cancer (IARC), there were 331 000 new cases and 90 000 deaths due to breast cancer, and 36 500 new cases and 15 000 deaths due to cervical cancer among women in the EU in 2006. At the same time, new cases of colorectal cancer were estimated at 140 000 in women and 170 000 in men. Colorectal cancer deaths were estimated at 68 000 for women and 78 000 for men in the EU. Together, these cancers account for almost one out of two (47%) new cases and one out of three (32%) cancer deaths in women in the EU . In men, colorectal cancer currently accounts for one out of eight (13%) new cases and one out of nine (11%) cancer deaths.

Main conclusions : four years after the adoption of a Recommendation on Cancer Screening, most Member States have acted on the Recommendation and intend to undertake further action where implementation is not yet complete. Thus, the formulation of joint priorities and principles of health policy at the European level has been followed up by actions at the level of the Member States to implement the shared policies and priorities.

Nevertheless, and despite these substantial efforts, overall the EU is still only around half-way towards implementing the Recommendation. Slightly less than half the population who should be covered by screening according to the Recommendation actually are and less than half of those examinations are performed as part of screening programmes meeting the stipulations of the Recommendation. This illustrates the need for greater efforts within Member States , supported by collaboration between Member States and professional, organisational and scientific support. Substantial added value may be expected from such support and from additional efforts to improve and maintain high quality of screening programmes.

Even though the current volume of activities is still far from the level which can be expected in the future, the current expenditure in human and financial resources is already considerable. A sustained effort is therefore necessary at Community level and within Member States in identifying appropriate and effective measures to assure the quality, effectiveness and cost-effectiveness of current and future screening activities, taking into account scientific developments. Regular, systematic investigation, monitoring, evaluation and EU-wide status reporting on implementation of cancer screening programmes will continue to support exchange of information on successful developments and to identify weak points requiring improvement.

Cancer continues to represent one of the greatest burdens of ill-health within the European Union. The Recommendation on cancer screening represents a shared EU-wide commitment to taking practical steps to minimise that burden in practice, to the benefit of individual citizens and their families as well as to society as a whole. Actions to better monitor and prevent cancer at Community and Member States’ level can help to reduce the number of cases arising at all. Application of best-practice treatment can help to ensure better outcomes for people with cancer, as can European cooperation on cancer research for the future.

In 2009 the Commission intends to launch a partnership for action against cancer. This partnership intends to put in place EU-wide commitments on concrete action to prevent and control cancer and thus contribute to reducing inequalities in tackling cancer. It will aim to support the Member States by providing a framework for identifying and sharing information, capacity and expertise in cancer prevention and control, and by engaging relevant stakeholders across the European Union in a collective effort to reduce the burden of ill health that cancer represents.

COM(2008)0882
EUR-Lex

T5-0502/2003
OJ C 087 07.04.2004, p. 0074-0263 E

T5-0502/2003

Debate in Parliament

A5-0381/2003

A5-0381/2003

EUR-Lex
COM(2003)0230

EUR-Lex
COM(2003)0230