Europe faces a “cancer epidemic” unless urgent action is taken to boost treatment and research, after an estimated 1m diagnoses were missed during the pandemic and which could retard cancer outcomes by almost a decade if not addressed, say experts.
Leading specialists say COVID-19’s impact and the focus on it has exposed “weaknesses” in cancer health systems and research landscape across the continent, reports The Guardian.
A recent report, European Groundshot – Addressing Europe’s Cancer Research Challenges: a Lancet Oncology Commission, brought together a wide range of patient, scientific and healthcare experts with detailed knowledge of cancer across Europe.
They said one unintended consequence of the pandemic was the adverse effects that the rapid repurposing of health services and national lockdowns, and their continuing legacy, have had on cancer services, on cancer research and on patients with cancer.
“To emphasise the scale of this problem, we estimate that about 1m cancer diagnoses might have been missed across Europe during the pandemic,” they wrote in The Lancet Oncology. “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates as a result of substantial delays in diagnosis and treatment. This will continue to stress European cancer systems for years to come.”
They said these issues will ultimately compromise survival and contribute to inferior quality of life for many European patients with cancer.
The report analysed data and found clinicians saw 1.5m fewer patients with cancer in the first year of the pandemic, with one in two patients with cancer not receiving surgery or chemotherapy in a timely manner.
About 100m screenings were missed, and it is estimated that as many as 1m European citizens may have an undiagnosed cancer as a result of the backlog, said Professor Mark Lawler, of Queen’s University Belfast, the chair and lead author of the commission. “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.”
The Russia invasion of Ukraine represents another huge challenge to cancer research in Europe, the report says. Russia and Ukraine are two of the largest contributors to clinical cancer research in the world. The commission also predicts Brexit will negatively affect European cancer research.
“With the backdrop of the pandemic, Brexit, and the Russian-Ukraine situation, 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,” said Lawler.
The report also argues that cancer prevention efforts and research, in particular, have not had the funding they deserve. A greater focus on preventing cancer would reduce the number of people who develop cancer and allow more resources to be available for those who do require treatment, it says.
“It is estimated that 40% of cancers in Europe could be prevented if primary prevention strategies made better use of our current understanding of cancer risk factors,” said Anna Schmütz, of the International Agency for Research on Cancer.
Commission details
European Groundshot—addressing Europe's cancer research challenges: a Lancet Oncology Commission
Prof Mark Lawler, Lynne Davies, Simon Oberst, Kathy Oliver, Prof Alexander Eggermont, Anna Schmutz, et al.
Published in The Lancet on 15 November 2022
Summary
Cancer research is a crucial pillar for countries to deliver more affordable, higher quality, and more equitable cancer care. Patients treated in research-active hospitals have better outcomes than patients who are not treated in these settings. However, cancer in Europe is at a crossroads. Cancer was already a leading cause of premature death before the COVID-19 pandemic, and the disastrous effects of the pandemic on early diagnosis and treatment will probably set back cancer outcomes in Europe by almost a decade. Recognising the pivotal importance of research not just to mitigate the pandemic today, but to build better European cancer services and systems for patients tomorrow, the Lancet Oncology European Groundshot Commission on cancer research brings together a wide range of experts, together with detailed new data on cancer research activity across Europe during the past 12 years.
We have deployed this knowledge to help inform Europe's Beating Cancer Plan and the EU Cancer Mission, and to set out an evidence-driven, patient-centred cancer research roadmap for Europe. The high-resolution cancer research data we have generated show current activities, captured through different metrics, including by region, disease burden, research domain, and effect on outcomes. We have also included granular data on research collaboration, gender of researchers, and research funding. The inclusion of granular data has facilitated the identification of areas that are perhaps overemphasised in current cancer research in Europe, while also highlighting domains that are underserved. Our detailed data emphasise the need for more information-driven and data-driven cancer research strategies and planning going forward. A particular focus must be on central and eastern Europe, because our findings emphasise the widening gap in cancer research activity, and capacity and outcomes, compared with the rest of Europe. Citizens and patients, no matter where they are, must benefit from advances in cancer research.
This Commission also highlights that the narrow focus on discovery science and biopharmaceutical research in Europe needs to be widened to include such areas as prevention and early diagnosis; treatment modalities such as radiotherapy and surgery; and a larger concentration on developing a research and innovation strategy for the 20 million Europeans living beyond a cancer diagnosis.
Our data highlight the important role of comprehensive cancer centres in driving the European cancer research agenda.
Crucial to a functioning cancer research strategy and its translation into patient benefit is the need for a greater emphasis on health policy and systems research, including implementation science, so that the innovative technological outputs from cancer research have a clear pathway to delivery. This European cancer research Commission has identified 12 key recommendations within a call to action to reimagine cancer research and its implementation in Europe. We hope this call to action will help to achieve our ambitious 70:35 target: 70% average survival for all European cancer patients by 2035.
The Lancet European Groundshot and comments (Restricted access)
See more from MedicalBrief archives:
Cancer claims shoot up as COVID focus takes eye off other deadly diseases
COVID-19 causes million-women backlog in UK screening for breast cancer
COVID-19 fears lead to decrease in Groote Schuur cancer patient referrals