Reducing the Burden of Cancer in the EU

1
Reducing the Burden of Cancer in the EU

• Policy Dialogue in preparation of the Slovenian
  Presidency over the Council of the EU
• Brussels, 12 and 13 November 2007, 1000 - 1630

2
Agenda

• Welcome
• Objectives of the meeting (Marija Seljak)
• Setting the Scene - Differences in the Outcome in
  Cancer Care across Europe Prof. Michel Coleman
• Workshops
• Lunch between 12.30 - 13.30

3
Initiatives of the Slovenian Presidency

• Health Promotion and Disease Prevention
• Priority CANCER
• Alcohol related harm injury prevention
• Nutrition and physical activity
• Antimicrobial Resistance
• Innovation
• E-health
• Pricing and reimbursement of pharmaceuticals - EU
  networking
• Access to Health Care
• Addressed within above mentioned priorities

4
Background and rationale

• Vision /goals
• Mapping inequalities in incidence/mortality/surviv
  al
• Room for improvement (public health justice,
  community added value and subsidiarity)
• The importance of an integrated approach
• Identify areas which have an EU added value
• Possibilities for policy development at the EU
  level ?

5
Objectives of the policy dialogue

• To present the evidence on the burden of cancer
  and the need for the overarching approach
• To exchange on national practices and
  international action in 4 policy areas
• primary prevention
• cancer screening and early detection
• treatment and integrated care
• cancer research
• To explore and discuss EU added value and debate
  possible policy developments under the Slovenian
  EU Presidency

6
Workshops

• Primary prevention and health promotion
• Cancer screening
• facilitatorsVesna Kerstin Petric, prof. Jose M
  Martin-Moreno
• Tratment and integrated care
• Cancer research
• facilitators Tit Albreht, Willy Palm

7
Primary prevention and health promotionIssues

• Majority of cancers are life-style or environment
  related (use of tobacco and alcohol, healthy
  nutrition, physical activity, occupational risks,
  etc.)
• Cancer and other NCDs share several determinants
• Differences in equity in access to prevention and
  promotion
• Variable effectiveness of translating knowledge
  into outcomes

8
Primary prevention and health promotion
International policies and instruments

• General
• Europe Code against Cancer (2003 being updated)
• Alcohol
• WHO Resolution on framework for alcohol policy
• EU Alcohol strategy
• European Alcohol and Health Forum
• Nutrition
• WHO food and nutrition action plan
• Global Strategy on Diet and Physical Activity
• EU White Paper on Strategy for Europe on
  nutrition overweight and Obesity
• EU Platform for action on Diet, Physical Activity
  and Health

• Tobacco
• EU Directives on advertising and product
  regulation
• Green Paper on Smoke-free environment
• WHO Framework Convention on Tobacco Control
• HELP campaign
• Environment
• European Environment and Health Strategy
• European Environment and Health Action plan
  2004-2010
• Health and safety at work strategy
• Other policies and instruments
• Free movement and pricing of unhealthy products,
  consumer protection, environmental policy, etc.

9
Primary prevention and health promotionQuestions

• What do you see as a top priority in this area ?
• What are the greatest obstacles on progress ?
• What do you see as an EU added value ?

10
Cancer screeningIssues

• For many malignant tumors the earlier a cancer is
  detected, the higher survival chances.
• Different kinds of screening opportunistic,
  selective, organised
• (Variety of approaches throughout the EU, not all
  of them are equally effective!)

11
Cancer screening International policies and
instruments

• Council Recommendation on cancer screening (2003)
• EU-funded projects to develop specific cancer
  screening guidelines (cervical, breast,
  colorectal cancer)
• Report on the implementation of cancer screening
  (anounced for 2008)

12
Cancer screeningQuestions

• What has been achieved after the adoption of the
  Council Recommendation on cancer screening (2003)
  ?
• What could be done to improve the implementation
  of cancer screening programmes ?
• What do you see as an EU added value

13
Treatment and integrated careIssues

• Optimal care contributes to survival rates and
  quality of life
• Increasing numbers but also changing treatment
  patterns (management of chronic condition
  involving a range of providers)
• Wide disparity in the level of care available to
  cancer patients in different parts of EU but
  also inequalities within countries
• Alocation of resources to cancer care
  (Evidence-based and integrated)
• Quality of cancer care ( Common standards and
  guidelines,HTA)
• Information needs health records, e-health,
  quality information to patients

14
Treatment and integrated care International
policies and instruments

• Sharing of best practice
• European HTA network
• High level group (Cross-border cooperation and
  reference centers on rare diseases)
• Cross-border care
• OMC in the area of Social Protection
• Proposal for a Directive on safe, high-quality
  and efficient cross-border care

15
Treatment and integrated careQuestions

• What could be the contribution of different
  centres of expertise networking at the EU level ?
  
• How can we encourage the exchange of best
  practices in integrated care at the EU level ?
• Participation?
• Patient involvement? Patient information and
  rights? Social networks?
• Links with lobbies (pharmaceutical industry)
• Other EU dimensions? coordination, support,
  legislation etc.

16
Cancer researchIssues

• Research is needed to improve our knowledge about
  the nature of the disease, the risk factors, as
  well as the effectiveness of different
  interventions ( different kinds of research risk
  factors, genomics, screening, clinical
  management, rehabiliation and palliation )
• Fragmentation and diversity of cancer research
• The need for increased academic research

17
Cancer research International policies and
instruments

• Instrument
• EU Research policy (FP6, FP7)

18
Cancer researchQuestions

• What are the challenges in cancer research and
  what can we do to encourage better structured
  (less fragmented) cancer research in EU ?
• How to improve public funding for cancer research
  at the national as well as EU level ?
• What type of cancer research (basic,
  translational, clinical, public health oriented)
  do you consider as a priority for EU ?
• How can EU encourage more research into cancer to
  improve the outcome and quality of life for
  cancer survivors ?

19
Overall governance of cancer policies

• Cancer policy requires an integrated approach
• Role of the national cancer plan ?
• Monitoring quality of policies and outcomes
• Cancer information systems (cancer registries)
• Essential tool for prioritising allocation of
  resources and assessing policy impact