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.
The Council of the EU advised Member States to implement population-based cancer screening in its 2003 Recommendation on breast, colorectal and cervical cancer, stressing the need for European guidelines and quality assurance schemes. This framework was superseded in December 2022 when the Council adopted the new Recommendation that, among others, expands screening to include lung, prostate and, under certain conditions, gastric cancer. The Council reaffirmed the central role of up‑to‑date, evidence‑based guidelines and quality assurance schemes, to ensure that evidence based, up-to-date screening programmes and associated quality assurance schemes are implemented in the EU.
In 2008, the European Parliament and the Council invited the European Commission to support the development and update of guidelines based on latest evidence together with quality assurance schemes thereby reducing disparities 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), and on Gastric Cancer (EC-GaC), Lung Cancer (EC-LuC), 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, which provides scientific alignment, coordination and shared information platforms to strengthen EU capacities for prevention, early detection, treatment and care.
Background
The European Cancer Information System (ECIS) provides estimates of new cancer cases (incidence) and deaths due to cancer (mortality) for multiple cancers in individual EU-27 countries and for the EU-27 as a whole. The data also covers breast, cervical, colorectal, gastric, lung and prostate cancers, which represent over 50% of the burden of cancer in the EU terms of incidence and mortality, and are accessible from the ECIS factsheets.
The Cancer factsheets series is produced by the JRC and the European Network of Cancer Registries which provide an overview of the cancer burden in the EU-27.
In this context, 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 contribute to addressing 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 the six 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 initiatives on cervical and gastric cancers, the European Commission collaborates with IARC for the development of the European cancer guidelines and quality assurance scheme.
Within these initiatives, IARC coordinates the project EUCervScreen QA, co-funded by the EU4Health Programme - EU4H-2022-DGA-IO-IBA-2 and the project EU-GAINS co-funded by the EU4Health Programme - EU4H-2024-IO2-IBA-01. 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 in time limited small topic-specific groups are formed. Both are 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 annual Declarations of Interests.
Topic-specific groups are formed in relation to specific theme under discussion by the respective working groups of the initiatives and are dissolved once concluded.
Under the supervision of the JRC and collaborated with IARC, topic-specific groups propose recommendations and/or requirements to the working groups, which are the decision-making bodies.