Europe will see a cancer epidemic in the next decade if weaknesses in cancer health systems and cancer research are not urgently addressed, according to a new analysis from Lancet.
With an estimated one million cancer diagnoses missed across Europe in the last two years, the impact of the COVID-19 pandemic is predicted to set back European cancer outcomes by almost a decade, said the Lancet Commission “European Groundshot—addressing Europe’s cancer research challenges”.
The Lancet Oncology Commission’s analysis highlights the pivotal importance of cancer research in tackling the unprecedented challenges facing European cancer systems and makes key recommendations for how this can be achieved.
It also identified gaps in the European cancer research landscape and calls for a doubling of the European cancer research budget, as well as prioritisation of under-served cancer research areas, including prevention and early diagnosis, radiotherapy and surgery, implementation science, action on gender equality, and a deeper focus on survivorship .
The Lancet Oncology Commission also argues that Europe cancer research should have a more grounded patient-focused, rather than techno-centric, approach and therefore a ‘Cancer Groundshot’ is a more appropriate aim.
RESILIENT CANCER RESEARCH
“With the backdrop of the COVID-19 pandemic, Brexit, and the Russian invasion of Ukraine, it is more important than ever that Europe develops a resilient cancer research landscape to play a transformative role in improving prevention, diagnosis, treatment, and quality-of-life for current and future patients and those living beyond cancer,” says Professor Mark Lawler, Queen’s University Belfast, UK and Chair and lead author of the Commission.
“We estimate that approximately one million cancer diagnoses were missed across Europe during the COVID-19 pandemic. We are in a race against time to find those missing cancers. Additionally, we saw a chilling effect on cancer research with laboratories shut down and clinical trials delayed or cancelled in the first pandemic wave. We are concerned that Europe is heading towards a cancer epidemic in the next decade if cancer health systems and cancer research are not urgently prioritised. Our European Groundshot Commission provides crucial findings on the current landscape of cancer research, exposes the key gaps, and demands the prioritisation of European cancer research agendas over the next decade,” he said.
EUROPEAN CANCER RESEARCH FACES TRIPLE THREAT
About 1·5 million fewer patients with cancer were found in the first year of Covid 19 pandemic, with one in two patients with cancer not receiving surgery or chemotherapy in a timely manner. Additionally, 100 million cancer screening tests were missed. The commission said that up to one million European citizens might have an undiagnosed cancer due to the cancer backlog.
Considering these findings, one of the European Commission’s key recommendations is for the European cancer research community to accelerate the research response to the indirect impacts of the COVID-19 pandemic on cancer and that, now more than ever, there is a crucial need to ensure that cancer is appropriately protected and prioritised within current and future European research agendas.
It also said that Ukraine war was another huge challenge to cancer research in Europe. Russia and Ukraine are two of the largest contributors to clinical cancer research in the world, especially industry-sponsored clinical research.
Many Ukrainian cancer clinical trials include cancer centres in central and eastern European countries and the conflict will likely result in many of these major trials being delayed or failing to recruit. An additional danger is that industry might consider it too high risk to run cancer clinical research in countries bordering Ukraine—loss of private sector investment would be hugely damaging to cancer research in central and eastern Europe.
The Commission also predicts that Brexit will continue to negatively impact European cancer research. It called for mitigating the impact of Brexit and other political challenges by ensuring that the UK can continue to collaborate with European partners and contribute to European cancer research and innovation activities.
“UK cancer research in the post-Brexit world stands at a crossroads where strategic decisions will determine whether we continue to thrive and partner internationally or whether isolationism will reduce our world standing,” says Professor Richard Sullivan, co-lead for the Commission and Professor of Cancer & Global Health at Institute of Cancer Policy, King’s College London.
Professor Lawler adds, “If the UK is not involved in EU collaborative cancer research and not part of Horizon Europe’s research community, this will have an extremely detrimental effect on European cancer research activity. Ultimately, patients with cancer will the pay the price for this decision in terms of health-care outcomes.”
EUROPEAN CANCER RESEARCH GAPS IN FUNDING
The Commission Commission says that the total investment in cancer research in Europe in 2010–19 was about €20–22 billion, about €26 per head. The minimum equivalent figure for the USA over the same period was US $80·5 billion. Considering this dramatic gap in spend per head, the European Groundshot Commission calls for a doubling of the European cancer research budget to €50 per capita by 2030.
The authors argue that cancer prevention research in particular has not had the funding it deserves. A greater focus on preventing cancer would reduce the number of people who develop cancer and therefore allow more resources to be available for those who do require treatment. The report calls for a significant reprioritisation of cancer prevention, cancer screening, and early cancer detection research to reduce the burden of cancer for European citizens and enable those who do develop cancer access to more resources and the best treatments available. Gender equity in cancer research is another crucial gap identified in the Commission report, with senior female authors making up less than a third of all authors for those European countries contributing the most cancer research outputs.