About the European Commission initiatives on cancer screening and care

Objective

The European Commission initiatives on cancer screening and care aim to ensure that essential quality care is provided across Europe and is equally accessible regardless of where a person lives or is treated, or their financial resources.

To achieve this goal, the initiatives support Member States in the implementation and monitoring of high-quality cancer services within the context of organised, population-based screening programmes by integrated development of:

• evidence-based guidelines for primary prevention, screening and diagnosis of cancer,
• quality assurance schemes for cancer services covering the entire care pathway comprising screening and diagnosis, as well as treatment, follow-up and supportive care.

Legal Base

One of the European Union’s (EU) roles is to support national policies by helping Member States to tackle shared challenges. Among these is the burden of non-communicable diseases such as cancer. Over the past few decades, significant steps have been taken to address the growing cancer burden.

In 2003, the Council of the EU formally targeted the development of effective population-based cancer screening programmes in the EU. The Council Recommendation focused on Member State implementation of high-quality population-wide screening programmes for breast, colorectal and cervical cancer, along with other principles of best practice in early detection. They identified the adoption of European guidelines as essential to this process. 

In 2008, the European Parliament and Council of the EU further reinforced this, asking the European Commission to develop new guidelines based on scientific evidence together with quality assurance schemes to support Member States in their efforts to fight cancer and address discrepancies in cancer screening and care across Europe. 

In response, the Commission, namely the Directorate-General for Health and Food Safety (DG SANTE) and the Joint Research Centre (JRC), established the European Commission Initiatives on Breast Cancer (ECIBC), Colorectal Cancer (ECICC), Cervical Cancer (EC-CvC), Lung Cancer (EC-LuC), and Gastric Cancer (EC-GaC) and Prostate Cancer (EC-PrC).

These initiatives fall under the activities of the European Commission Knowledge Centre on Cancer, one of the flagship initiatives of the Europe’s Beating Cancer Plan (launched in February 2021). Operated by the JRC, the Knowledge Centre on Cancer fosters independent scientific alignment, coordination and support to European Commission cancer-related policies and activities while expanding the EU’s capacities and systems for prevention, early detection, treatment and care. It also provides information systems, portals and platforms, facilitating alignment and synergies across European Commission cancer-related activities.

In December 2022, following the European Commission's proposal to strengthen cancer prevention through early detection, the Council of the EU adopted a new approach on cancer screening. In addition to cancer screening for breast, colorectal and cervical cancer, the new Council recommendation suggests screening for lung, prostate, and under certain conditions, gastric cancer.

The European guidelines and quality assurance schemes are given centre stage as instruments to ensure that evidence-based up-to-date screening programmes and associated quality assurance schemes are implemented in the EU.

Background

The European Cancer Information System (ECIS) has estimated new cancer cases (incidence) and deaths due to cancer (mortality) for multiple cancers in individual EU-27 countries and in the EU-27 on average. The data for breast, cervical, colorectal, gastric, lung and prostate cancers are summarised below.

The Cancer factsheets series produced by the JRC and the European Network of Cancer Registries provides an overview of the cancer disease burden in the EU-27.

The European Cancer Inequalities Registry (ECIR) shows the existing inequalities, including in incidence and mortality rates, between Member States and regions. These inequalities may depend on many factors including disparities among countries and regions in access to and/or quality of care. They may also be related to age, sex and socioeconomic disparities, such as educational attainment and income level, and disparities between urban and rural areas.

The European Commission initiatives on cancer seek to address these issues. They are improving the approach to cancer primary prevention, screening and care to support Europe in overcoming inequalities in access to quality care and to improve cancer outcomes.

Governance

European Commission

The European Commission Initiatives on Cancer Screening and Care are operated by the JRC and DG SANTE. DG SANTE is responsible for the policy leadership of the initiatives, while the JRC coordinates the scientific and technical aspects, ensuring the initiatives’ objectives are achieved. 

The JRC defines the scope of the initiatives, plans and manages the scientific activities, and coordinates the working groups in collaboration with their chairs. It also liaises with international partner organisations and EU-funded projects and joint actions relevant to the initiatives.

The JRC is furthermore responsible for defining the methodology for developing the European cancer guidelines and quality assurance schemes, ensuring alignment across all European Commission initiatives on cancer.

The European Commission, as the funding body of the initiatives, does not influence the content of the guidelines or the quality assurance scheme. The prioritisation of topics and issuing of recommendations and/or requirements fall under the responsibility of the working groups.

International Agency for Research on Cancer (IARC/WHO)

For the EC initiative on cervical cancer, the European Commission collaborates with IARC for the development of the European cancer guidelines and quality assurance scheme.

Within the initiative, IARC coordinates the project European Cervical Screening Quality Assurance Update (EUCervScreen QA), co-funded by the EU4Health Programme - EU4H-2022-DGA-IO-IBA-2 (EU Funding & Tenders Portal). IARC establishes and manages a steering group, a working group, and a pool of experts to assist in the development of the guidelines’ recommendations and quality assurance scheme requirements following the established methodologies for the EC initiatives on cancer.

Working groups and topic-specific groups 

For each initiative, working groups and topic-specific groups are formed, composed of experts selected through public open calls issued by the European Commission or IARC. The experts include healthcare professionals, scientists, and, importantly, also patients/caregivers. They are selected to cover all needed expertise for the development of the guidelines and quality assurance schemes. 

Expert professionals and patients/caregivers act in their personal capacity, independently and in the public interest. They do not represent any private, commercial or national interests. To ensure this, in addition to their official declarations of confidentiality and commitment, all experts must submit an annual Declaration of Interests form. 

The working groups and topic-specific groups are formed based on their specific expertise related to individual topics of the initiatives. Coordinated by the JRC and/or IARC, the working group and topic-specific group members discuss and draft documents during in person or virtual meetings. All group members participate equally. Topic-specific groups propose recommendations and/or requirements to the working groups, which are the decision-making bodies.