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Prostate Cancer in Europe

Submitted by on 18 May 2011 – 15:25

John Dalli mugshotJohn Dalli, European Commissioner for Health and Consumer Policy

Cancer represents great suffering and premature death to millions of Europeans and their families. Every year, close to 2,5 million EU citizens are diagnosed with cancer. Cancer remains the second most common cause of death in the EU, claiming 1,2 million lives every year.

At the same time, inequalities in cancer prevention, diagnosis and care across the EU are a cause for concern. This is why working together to combat cancer is one of the longest-standing areas of EU cooperation in health.

Following three successive Europe against Cancer action programmes starting back in 1987, the Commission launched the European Partnership for Action Against Cancer in 2009.

The Partnership aims to support Member States in their efforts to reduce new cases of cancer by half a million by 2020 and to develop integrated cancer plans by the end of the Partnership.  To this end, the Partnership provides a framework for identifying and sharing information, capacity and expertise in cancer prevention, control, research and care.

By engaging a wide range of stakeholders within this Partnership, the Commission is leading a collective effort with a common commitment to address cancer. Partners include non governmental organisations, researchers, patients’ groups, industry, organisations of health professionals and national authorities across the EU. This approach should help reduce inequalities by helping Member States to prevent and control cancer more efficiently across the EU.

One third of all cancers are preventable. Health promotion and early detection of cancer are therefore among the key areas on which the Partnership works. One specific cancer prevention activity is the European Code Against Cancer with two central messages: “Certain cancers may be avoided by adopting healthier lifestyles”, and “cancers may be cured, or the prospects of cure greatly increased, if they are detected at an early stage”.

When we speak about cancer, however, we need to take into account that cancer is not one disease but many. The most frequent types in the European Union are lung, colorectal and breast cancer, followed by prostate cancer.

Back in 2003, Member States adopted Council recommendations that foresee implementing national screening programmes for breast, cervical and colorectal cancer, with quality assurance, taking into account European Guidelines. Since then, the European Commission has developed guidelines on quality assurance in screening for these three types of cancer and supported Member States in their efforts to develop screening programmes.

In addition to these three types of cancer, prostate cancer is undeniably a common cancer among men particularly those aged over 65 years of age, even  though its death rates remain lower than for lung and colorectal cancer.  The increase in the incidence of prostate cancer in many countries during the 1990s and 2000s was largely attributable to the greater use of prostate-specific antigen (PSA) diagnostic tests.[1] The extent to which mortality has been affected by such early diagnosis and improved treatment has yet to be fully established, and the various possible causes of this disease still need to be fully determined.

Taking into account the insufficient evidence on whether or not the benefits of early detection could outweigh the risks, when the Council adopted its recommendation on screening back in 2003, it excluded prostate cancer screening from the recommendation.

Instead, it was decided that the case for prostate cancer should be reviewed at a later stage, building on the results of the still on-going European Randomized Study of Screening for Prostate Cancer and the US National Cancer Institute’s Prostate, Lung, Colorectal and Ovarian Cancer Trial. Both studies will need to continue for several years before they yield conclusive results. When they do, then the time will be ripe to re-examine evidence and consider possible recommendations on prostate cancer screening.  Until then, health professionals alone need to ascertain, how and in which cases to recommend testing for prostate cancer.

The European Partnership for Action Against Cancer goes beyond prevention and screening and also includes actions to identify and disseminate good practice in cancer-related health care, as well as coordination of cancer research and health information and data. In addition, through its mechanisms, the Partnership will also offer the opportunity for the cancer community to discuss new developments in cancer prevention and control.

In conclusion, action against cancer, regardless of the type, is a key component of European health policy.  The European Commission is keen to play its part in supporting efforts to prevent, diagnose and treat cancer.