European Commission’s fight against cancer grows stronger
The European Commission aims to reduce the burden of cancer through the Joint Action CANCON (European Guide on Quality Improvement in Comprehensive Cancer Control), European Code Against Cancer and by heavily investing on research. Antoni Montserrat Moliner, Senior Expert for Cancer and Rare Diseases, Directorate of Public Health, European Commission, elaborates on the EU fight against cancer
Bladder cancer is the ninth most common cancer worldwide. Despite significant advances in the treatment of bladder cancer, it remains a growing problem in the European Union. Based on key statistics published in the International Agency for Research on Cancer for 2012, the crude annual incidence of bladder cancer in the European Union is 16.3 per 100,000 of population with 123,000 new cases per year. The mortality in the EU is 4.7 per 100,000, meaning that 40,300 people in the EU die from bladder cancer annually, nearly 30,000 men and 12,000 women respectively.
There are some differences in the occurrence of bladder cancer across Europe. Bladder cancer occurs mainly in older people. Roughly 9 out of 10 people with this cancer are over the age of 55. The average age at the time of diagnosis is 73. Men are about 3 to 4 times more likely to get bladder cancer during their lifetime than women. According to the American Cancer Society, the overall chances of men developing bladder cancer during their life is about 1 in 26. For women, the chance is about 1 in 88.
Action on cancer
The European Commission aims to reduce the burden of cancer in the EU in several ways. It aims to increase survival rates and reduce cancer mortality by improving quality of patient care, ensure better quality of life for cancer patients and helps reintegration and palliative care through two main tools, namely the Joint Action CANCON (European Guide on Quality Improvement in Comprehensive Cancer Control) and European Code Against Cancer.
The former serves as the official European guide on quality improvement in comprehensive cancer control, and facilitates discussion among member states. It provides an extraordinary opportunity to address all the topics directly related to bladder cancer, such as quality-based cancer screening programmes, comprehensive cancer network organisations, community-based cancer care and survivorship. The active participation of bladder cancer stakeholders in these discussions will constitute a remarkable input to respond to the needs of patients in a broad and cooperative European context, taking into account that a comprehensive cancer control policy should focus not only on the general aspects of cancer control but also on those that specifically correspond to different cancer sites, as is the case for bladder cancer.
The 4th version of the European Code Against Cancer, produced by the European Commission in close collaboration with the IARC (International Agency for Research on Cancer) in October 2014, provides essential recommendations for preventing cancer to the general public in a friendly, easy-to-read format. The Code is a key communication tool used in the prevention of all cancers, and constitutes the major tool for disseminating preventive measures and contributing to definitively change the perception of cancer around its two very clear messages: one, that certain cancers may be avoided and that health in general can be improved by adopting healthier lifestyles; and two, that cancers may be cured, or the prospects of being cured are high, if detected at an early stage. The messages of the Code are essential to prevent bladder cancer: avoid tobacco smoking and incriminated occupational exposure and regularly eat fresh fruit and vegetables. In addition, prevention and control of urinary tract infections should be recommended for bladder cancer prevention.The active involvement of bladder cancer stakeholders in the promotion and dissemination of the Code will be essential.
In May 2016, the European Commission proposed amending the overarching Occupational Safety and Health (OSH) Framework Directive 89/391/EEC and other Directives specifically dealing with chemical risks. Based on input from scientists, employers, workers, representatives from the different member states and labour inspectors, the Commission has proposed limit values for 13 priority chemical agents identified through the consultation process, including o-Toluidine, which is considered as a carcinogen provoking bladder cancer and primarily used in the manufacture of dyes.
Research is also essential in better understanding the mechanisms of bladder cancer. A total of 16 projects, with a total investment of 25 million euros, have been supported by EU Research Programmes. The European FP7 project DeCanbio brought together a consortium of clinicians and researchers in genomics, proteomics and bioinformatics to identify and validate biomarkers that hint at a recurring bladder cancer.
The Luxembourgish Centre de Recherche de la Santé (CRP-Santé) joined forces with researchers and clinicians from other member states to develop a simple test to detect this. The European Union Horizon 2020 Programme for research is supporting the project ‘Multimodal, Endoscopic Biophotonic Imaging of Bladder Cancer for Point-of-Care Diagnosis,’ led by the Technical University of Denmark and the Frederiksberg Hospital, which will provide robust, easy-to-use, cost-effective optical methods with superior sensitivity and specificity to enable a step-change in point-of-care diagnostics of bladder cancer.
Large and ambitious initiatives like these can only be implemented through the type of cooperation that the existing European programmes permit. It is a challenge to mobilise common resources and the expertise of European, national and regional authorities as well as scientific partners and patient organisations. It’s a big challenge indeed – but our commitment to organise the efficient and appropriate coordination of these efforts at a European level is even bigger