The main objective of the European Commission (EC) Initiatives on Breast, Colorectal and Cervical Cancer is to provide essential levels of quality care that are equally accessible across Europe, by:
- Developing evidence-based guidelines for (primary prevention), screening and diagnosis of cancer.
- Developing a voluntary quality assurance scheme for cancer services covering the entire care pathway from primary prevention, screening, diagnosis, follow-up to end-of-life care.
A role of the EU is to support national policies by helping Member States (MS) to tackle shared challenges, such as the burden of chronic diseases like cancer.
In 2003, the Council of the EU identified the adoption of European guidelines as key for ensuring the development of effective cancer screening programmes in the EU. Those Council Recommendations on cancer screening, in fact, invite national, population-based screening programmes for breast, colorectal and cervical cancer, along with other principles of best practice in their early detection. In 2008, the European Parliament and Council of the EU further reinforced the request to support MS in their efforts to fight cancer.
As such, the EC, namely the Directorate General for Health and Food Safety (DG SANTE) and the Joint Research Centre (JRC), have established the European Commission Initiatives on Breast Cancer (ECIBC), Colorectal Cancer (ECICC) and is progressing with Cervical Cancer (ECICvC) to provide evidence-based guidelines for cancer screening and diagnosis, reflecting the latest scientific developments, together with associated quality assurance schemes for implementation in healthcare settings.
These initiatives fall under the activities of the new European Commission Knowledge Centre on Cancer (KCC), one of the flagship initiatives of the Europe’s Beating Cancer Plan (launched in February 2021). Operated by the JRC, the overall vision of the KCC is to provide independent, scientific evidence base, as well as systems, portals, and platforms to support the EC’s actions on cancer seeking for alignments and synergies of EC activities on cancer.
In December 2022, following the EC's proposal to strengthen cancer prevention through early detection, the Council of the EU has 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.
The European Cancer Information System (ECIS) estimated almost 380 000 new breast cancer cases (in females as well as males) diagnosed in 202 for EU-27, 99% of these affecting women. For females, they account for more than 29% of all new cancer diagnoses in women.
New 2022 estimates for EU Member States report 356 000 new cases and 159 000 deaths due to colorectal cancer in the EU, accounting for 13% of all new cancer diagnoses and 12.3% of all cancer deaths.
The Cancer factsheets series produced by the JRC and the European Network of Cancer Registries provide an overview of the cancer disease burden in EU-27.
Moreover, data show differences in incidence and mortality rates between Member States, and even within Member States. The European Cancer Inequalities Registry (ECIR) shows the existing inequalities between Member States. In some cases, mortality can be higher than the European average despite lower incidence. This may depend on many factors including quality and readily access to care.
These European initiatives seek to improve the approach to breast, colorectal, and cervical cancer primary prevention, screening and care and to help to overcome inequalities in accessing care across Europe.
The EC initiatives are operated by the JRC and DG SANTE. The JRC coordinates the scientific and technical aspects ensuring its objectives are achieved. The JRC plans the overall activities of the initiatives, coordinates the working groups together with the chairs, and liaises with international partner organisations relevant for the initiatives. The JRC is furthermore responsible for the definition of preparatory discussion documents and the management of scientific activities in support to the projects.
The initiatives are taken forward in coordination with national contacts from the EU MS, as well as from outside EU (other European countries). These countries have nominated national contacts as focal points to provide feedback and advice based on their expertise regarding their national context and are consulted on selected topic areas.
For each initiative there are working groups and subgroups composed of experts selected through public open calls, issued by the EC. The experts have been selected to cover all needed expertise for the development of the guidelines and quality requirements. They act in their personal capacity, independently and in the public interest, and not representing any private, commercial or national interests. The experts fill in and sign declarations of confidentiality, commitment, as well as, a declaration of interests. Consequently, the working groups are composed by health care professionals with different expertise, scientists, and importantly also by patients' representatives participating in all discussions and decision making processes. Coordinated by the JRC, the members discuss and draft documents during in person or virtual meetings.