“Is it acceptable that for every Elsa in Sweden with 86% chance of survival following treatment for breast cancer there exists just across the Baltic Sea, in Lithuania, an Elze whose chance of survival plummets to 66%?"

"Or for every Luca in Italy with an almost 90% chance of being alive 5 years after a diagnosis of prostate cancer, there is a Luka a few kilometres away across the Adriatic in Croatia whose 5 year survival chances have shrunk to 71%?”, questioned Prof. Mark Lawler, European Cancer Concord and Queen’s University Belfast, at the launch of the Europe of Disparities Policy Paper at the European Cancer Congress organised by the European Cancer Organisation (ECCO) in Vienna.

Francesco de Lorenzo, President of the European Cancer Patient Coalition (ECPC) denounced that “it is not acceptable, the situation in which many European citizens and their families experience these healthcare inequalities”.

He recalled that “cancer has no boundaries and the ECPC and its patients want to shed light on policy responses which can be employed to overcome this situation”.

The paper highlights shocking figures recounting disparities across Europe.

In Poland for example, lung cancer mortality is 83% (EU Average 56.4%) while in Romania, the mortality rate for cervical cancer is 14.2%, compared with an EU average of 3.7%.

And these inequalities are not just confined to Eastern Europe.

The United Kingdom and Denmark have significantly poorer survival rates, particularly for lung, colorectal and ovarian cancers, when compared with Norway and Sweden, while many European countries have insufficient capacity to deliver optimal radiotherapy services.

The document explores the patient care pathway, from diagnosis to recovery after treatment, to identify key indicators for these disparities. Like in most conditions, prevention and early detection are important elements to improve the chances of surviving for patients.

The high mortality rate for cervical cancer in Romania is a direct consequence of its fragmented screening programme and for de Lorenzo, “a policy response to underpin appropriate screening services is critical”.

€102 is the average cancer cost per citizen in the EU but disparities range from €16 in Bulgaria to €184 in Luxembourg.

Massive inequalities in access to optimal care exist, including access to radiotherapy, surgery, medicines and innovative treatments.

The paper details that healthcare budgets underpin certain inequalities but that an increased spend does not always correlate with improved patient care.

Members of the Europe of Disparities in Cancer Working Group warn about the additional negative impact of austerity and cost-containment measures in a number of European countries.

For example Greece, against EU recommendations, has reduced its screening programmes for breast and cervical cancer, risking an increase in undetected cancers that may lead to increases in mortality.

“Inequality can, and will, neutralize the advances we make in Europe in cancer control without serious attention from policymakers."

"We have quietly tolerated too narrow a focus on cancer control, one that is almost entirely built on personalised medicine, without addressing this foundational problem" added Prof. Richard Sullivan, Institute of Cancer Policy.

Solutions of the paper include the issuing of guidelines on optimal radiotherapy capacity; providing patients with accurate surgical oncology activity data to allow informed decision-making on choice of accredited hospital/cancer center; addressing shortage and facilitating access to life-preserving and life-enhancing medicines with the support of a harmonized assessment for therapeutic interventions at EU level.

In 17 countries of the European Union, cancer has overtaken cardiovascular disease as the leading cause for premature death.

“In 17 countries of the European Union, cancer has overtaken cardiovascular disease as the leading cause for premature death. In Europe in 2012, there were 3.75 million new cases of cancer, with 1.75 million deaths, equivalent to a cancer death every 20 seconds. Upward pressure on appropriate health spending and the needs of ageing populations need to be factored in, otherwise by 2050 we will face an epidemic of such proportions that in certain countries, a European citizen will die from cancer every 5 seconds”, argued Prof Lawler, Chair of the Working Group.

“We can no longer tolerate these disparities. The time to act is now”, concluded Prof. Mark Lawler.

Source: ECPC