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In the wake of the COVID‑19 pandemic’s global upheaval, longstanding disease threats return to the forefront of the healthcare policy agenda. Foremost among these – and long considered the most daunting – is cancer, which is set to become the leading cause of death in the 27 European Union (EU) Member States, Norway and Iceland (EU+2 countries) by 2035. The cancer context today is multi-faceted. Longstanding behavioural, metabolic and environmental risk factors drive about 40% of cancer cases. In parallel, emerging screening innovations are capitalising on artificial intelligence and genomic advances, while the cost of new cancer pharmaceuticals is skyrocketing. This complex scenario is compounded by challenges in the healthcare workforce and evolving organisational care models. Moreover, large disparities are evident through the entire cancer pathway: from prevalence of cancer risk factors to cancer outcomes. These disparities exist not only across but also within countries, varying by region, gender and socio‑economic status.
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Cancer is a major public health concern in Europe. In 2022, there were an estimated 2.78 million new cancer cases in the 27 European Union Member States (EU27), plus Iceland and Norway (EU+2 countries), which is equivalent to about five new diagnoses every minute. By 2035, it is anticipated that cancer will be the leading cause of death in Europe.
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As cancer is anticipated to become the leading cause of death in Europe by 2035, this report aims to provide policy insights for preventing cancer, ensuring timely identification of emerging cases, and improving care for diagnosed patients. This chapter highlights the key findings, beginning with an overview of trends in cancer incidence, mortality and survival, and assessing inequalities in these indicators. It offers an overview of the main behavioural, metabolic and environmental risk factors for cancer, and provides overarching recommendations for addressing them. The chapter also discusses key messages on cancer screening programmes, existing initiatives and emerging approaches to enhance screening reach. It concludes by highlighting major challenges to delivering high-quality cancer care, including workforce limitations, access to oncology medicines and care system organisation.
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Cancer mortality rates in the EU declined by 10% in the decade leading to 2020, with substantial reductions across many important cancers. However, without major changes, cancer will become the leading cause of death in Europe by 2035. Indeed, new cancer cases have been increasing, with breast, prostate, colorectal and lung cancers estimated to account for half of all cancers diagnosed in EU countries in 2022. Furthermore, the gaps in cancer outcomes between countries – as well as by region, socio‑economic status and gender within countries – are large, providing opportunities to learn from good practices. Alongside national cancer control plans, the European Commission’s Europe’s Beating Cancer Plan is underpinning efforts to tackle cancer in EU countries. National cancer registries that integrate or can be linked to information on clinical data, screening, genomic and socio‑economic status will be a key instrument in monitoring policies across the spectrum of cancer prevention and care.
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With cancer expected to become the leading cause of death in the EU by 2035, countries are examining opportunities to prevent cancer and decrease its incidence at a population level. This chapter provides an overview of trends in the leading known and modifiable risk factors for cancer, such as tobacco, alcohol, high body weight, unhealthy diet, physical inactivity, environmental risk factors and viral infections such as human papillomavirus and hepatitis B and C. It examines the gaps in prevalence of these risk factors between countries and between socio‑economic groups and sexes. Finally, the chapter provides insights into the current practices, policies and programmes countries are implementing to prevent cancer.
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This chapter provides an overview of current screening programmes for various types of cancer, including their governance, operationalisation and recent developments. It reviews the relevance of evidence‑based cancer screening programmes to tackle the burden of cancer among EU countries. The chapter also delves into the policies and innovations aimed at enhancing awareness of, access to and quality of early diagnosis and cancer screening, with a focus on vulnerable populations. The overarching objectives are to share evidence‑based guidance and good practices, to highlight promising innovations being tested across countries to improve cancer care screening and early diagnosis, and to close inequalities across and within EU countries.
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In order to address the growing demand for cancer care, countries need to seek effective and efficient ways of delivering high-quality cancer care. Most EU countries, however, have a shortage of healthcare experts in this field, leading to a shared challenge of ensuring widespread access to highly qualified professionals across their regions. With emerging technologies in cancer medicines and medical equipment, EU countries also face difficulties in securing adequate access and ensuring financial sustainability in the provision of high-quality cancer care. Countries address these challenges through policies that encompass enhancing the healthcare workforce, investing in medical technologies and optimising their utilisation, refining the organisation of cancer care delivery, and ensuring high-quality cancer care.