European Cancer Inequalities Registry – bold step towards addressing cancer injustice in EU!
ancer concerns us all in one way or another. It has important impacts on patients, but it also severely affects the lives of their families and friends. In 2020, it is estimated that 2.7 million people in the European Union were diagnosed with the disease, and another 1.3 million people lost their lives to it. Unless we take decisive action now, in the EU by 2040 new cancer cases are set to increase by 21%, while cancer deaths by 31%.
In February 2021, the European Commission established Europe’s Beating Cancer Plan as a political commitment to turn the tide against cancer and another stepping stone towards a stronger European Health Union and a more secure, better-prepared and more resilient EU. It outlines substantive actions to mitigate the impact of the COVID-19 pandemic on cancer care and support structural improvements for a more sustainable cancer pathway.
Tackling inequalities in cancer prevention and care is identified as one of the key challenges in ‘Europe’s Beating Cancer Plan’. This was strongly supported by Member States at the informal EPSCO videoconference on 16 March 2021.
The European Cancer Inequalities Registry was set up with this purpose in mind. As one of the 10 flagship initiatives of Europe’s Beating Cancer Plan, it will help Member States address inequalities in cancer care by helping them to better understand their strengths and weaknesses.
This new tool aims to identify trends, disparities and inequalities between Member States and regions. Alongside regular qualitative assessments of the country-specific situation, the Registry will identify challenges and specific areas of action to guide investment and interventions at EU, national and regional level under Europe’s Beating Cancer Plan.
It provides a regular reporting mechanism based on quantitative cancer indicators covering the whole cancer control continuum and complemented by analytical reports providing contextual information and qualitative assessments. The quantitative indicators are currently derived from the European Statistical System (EUROSTAT) and will draw on other national data sources and from international organisations in due course.
In addition to looking at geographical and regional differences, the European Cancer Inequalities Registry will look at inequalities due to age or sex, inequalities associated with socio-economic factors, such as educational attainment and income level, and disparities between urban and rural areas.
The European Cancer Inequalities Registry puts forward an EU-wide framework to monitor disparities and report on trends in key cancer prevention and care at regional, national and EU level. Since the aim of the Registry is to monitor the whole continuum of the cancer pathway, the four pillars of Europe’s Beating Cancer Plan – prevention; early detection; diagnosis and treatment; quality of life – are at the core of the assessment framework. Additionally, epidemiological measures of cancer burden are included.
These thematic dimensions are assessed from the perspective of different inequalities, ranging from disparities between countries and regions, to inequalities due to age, sex, income, education or even the level of urbanization.
The European Cancer Inequalities Registry is governed by Commission services, the Directorate-General for Health and Food Safety (DG SANTE) and Directorate-General of the Joint Research Centre (DG JRC), together with the Organization for Economic Cooperation and Development (OECD).
Several other international organisations, research partners and European Commission services will be key players in the years to come. Their data and findings will feed into the data tool and the analytical reports, complementing and enhancing the initial dataset and closing data gaps.
Member States will guide the development of the initiative beyond its initial stages and along the course of its reporting cycles. Member States will be consulted on their country’s policies in cancer prevention, diagnosis and care and on the availability of national data sources, and will be involved in validating the data presented in the reports. They may also suggest new thematic areas and ways to improve the data tool and analytical reports.
Cancer Stakeholder Groups are also important partners for the implementation of the project. They will be involved in the process and encouraged to contribute to the initiative with relevant data. In particular, cancer networks, organisations representing patients, healthcare professionals, vulnerable groups, or other players directly affected by cancer prevention and care will be able to enhance the database for the European Cancer Inequalities Registry with their expertise and networks. Their collaboration and active participation will help disseminate the results widely, raising the initiative’s impact.
Between 30% and 50% of cancer cases in the EU are preventable, according to the World Health Organisation. The risk of cancer can be reduced by following healthy lifestyles, maintaining a healthy diet, being physically active and refraining from alcohol and tobacco consumption. Environmental factors like exposure to air pollution, various carcinogenic chemicals and radiation, as well as some infections, also play an important role in cancer development.
Early detection through screening offers the best chance of beating cancer and saving lives. However, progress in implementing population-based screening programmes and participation in those programmes differ across Europe and population groups.
Diagnosis and treatment
Disparities in the access to high-quality cancer care, particularly for timely diagnosis and treatment, persist across the EU. Various factors impact the quality of cancer care a patient receives, as well as their chances of survival, including their age, sex, stage at which the cancer was diagnosed, place of residence and level of education and income.
Quality of life
Thanks to early detection and new technologies for cancer treatment, survival rates have greatly increased in the EU. However, people from lower socio-economic backgrounds are still more likely to die from cancer or less likely to enjoy a good quality of life as cancer survivors.
In 2020, 1.3 million people are estimated to have lost their lives to cancer. There are important disparities in mortality rates across Europe and across different population groups. It is one of the main aims of all policy interventions to reduce these inequalities and to lower the overall mortality rates.