Cancer care in Europe: Where are we in 2020?

Among the key findings of the Comparator Report on Cancer in Europe 2020, is what looks like a paradox: although more people are being diagnosed with cancer, a smaller proportion of those people appear to be dying from the disease. The report, a comprehensive overview of major cancer trends across Europe, quickly unravels the mystery. 

Nathalie Moll

Nathalie Moll joined the European Federation of Pharmaceutical Industries and Associations (EFPIA) as Director...
Read Morechevron_right
Yes, the number of people with cancer is rising – for a range of reasons including population ageing, lifestyle factors and earlier diagnosis. In fact, the absolute number of people diagnosed with cancer rose around 50% in Europe over the past 20 years. However, the number of deaths only increased by 20%. Allowing for population growth and ageing, in real terms cancer deaths are actually falling. 

 A combination of preventative programmes, timely diagnosis and intervention, and advances in treatment are helping to extend people’s lives. More than that, new therapies have delivered reported improvements in quality of life for several cancer types. 

Targeted therapies

Take skin cancer, for example. In 2009, the five-year survival rate was just 5%. Fast forward 10 years and this has risen to 50%. A shift from chemotherapies to immune-therapies or targeted therapies, the latter tailored to the specific characteristics of the tumour is delivering more effective treatment with fewer side effects. There have been significant improvements too in lung and breast cancer, giving thousands of people the greatest gift of all: more moments that matter. For patients it means more moments with family, friends, children, and simply more moments to enjoy life. 

However, there is still a long way to go if we want to extend these benefits more widely and more equitably. The report, developed by the Swedish Institute for Health Economics for the EFPIA Oncology Platform, points the way forward by putting the spotlight on patient outcomes, disease burden and patient access to care. 

The comparisons in the report highlight significant variations across Europe. For example, the five-year survival rates for colon cancer. In Iceland, it’s 70%; in Croatia, it’s 50%. If we all raised our game to the standard set by Iceland, an additional 15,706 people would survive for at least five years after diagnosis. It’s a sobering thought and one that should inspire action. 

Accelerating access for all
What can we do to address the significant personal and economic burden posed by cancer in Europe? 
We must improve the sustainability and integration of cancer care in every corner of Europe. This requires some hard thinking, involving all stakeholders, on how best to resource and design cancer services that are fit for the future. Some steps will require financial resources; others are a question of redesigning patient pathways and incentivising good practice. 
It is also vital that we accelerate the time it takes to get new treatments to patients. For this, we need to work together to embrace new approaches to clinical research and regulation, healthcare technology assessment and decision-making, and the use of new tools for data monitoring of patient outcomes. Above all, we must apply the patient-centred approach that we all aspire to. 
The third piece of the puzzle is pricing and reimbursement. Public and private investment in research has delivered a revolution in oncology. However, innovation is in vain if it does not reach the patient. And, without a clear route for new cancer medicines to reach those who need them, the incentive to invest in the next generation of advances in oncology is at risk.
To match the revolution in cancer therapy, we need new models for paying for medicines. If patient access is our goal, we must find ways to reimburse cancer medicines that manage clinical uncertainties, budget uncertainty and the sustainability of our healthcare systems in the short and long term. 
Finally, if we want to beat cancer, we must put resources behind the fight. Currently, governments spend between 4 and 7 percent of total healthcare expenditure on cancer. Cancer plans are in place and require actioned political will to implement them. Considering that cancer is set to become disease burden #1, we must consider how to invest financial and political resources efficiently in prevention, diagnosis, treatment and survivorship – for the benefit of cancer patients, to deliver more moments that matter.
Looking to 2030
As always in life, there are challenges, but we should be optimistic. The outlook for many cancer patients has been transformed by advances in cancer care. The Comparator Report highlights the success of the past 20 years. And there is so much more to be done. Now is the time, there is a sense that we are approaching a period where political momentum in Europe is gathering behind better cancer care: Europe’s Beating Cancer Plan. 
A European Cancer Plan must reflect the lessons of this new report. It should address prevention, screening, diagnosis, treatment and survivorship. It should address inequalities in access and outcomes. It should be a clear and actionable political statement about tackling cancer. And it should enhance collaboration among stakeholders.
We are excited about exploring new partnerships with new stakeholders, who are just as committed as we are to improving the prognosis for cancer patients.
Some day we’ll be reading a report on Cancer in Europe 2030. Let’s work together to make it a success story which matters to patients.