Arming for the European battle against lung cancer
Addressing the risk factors of cancer is the European Commission’s first line of attack in the battle against cancer. In this article, Vytenis Andriukaitis, European Commissioner for Health and Food Safety, focuses on the two major tools which add value to the prevention and treatment of lung cancer
We often speak about cancer in violent metaphors – ‘fighting’, ‘waging war’, ‘winning the battle’, etc. Is this appropriate? Significant increases in survival rates of breast cancer, for example, thanks to advances in detection and treatment, may make this sort of language outdated as we turn our focus more towards survivorship and rehabilitation.
For lung cancer, on the other hand – which is responsible for the most cancer-related deaths in the EU, this type of language may be more fitting in the sense that we need powerful tools to fight a formidable battle.
In this article, I would like to focus on two EU-level tools which can add value in the prevention of lung cancer and in its treatment: EU tobacco control policy and European Reference Networks respectively.
First some statistics: in 2013 alone 270 000 people in the EU died from lung cancer, representing 21% of deaths due to cancer and making it the greatest source of cancer-related death in Europe.(1) There is a high variation between EU countries – the highest proportion of lung cancer among all cancer deaths was recorded in Hungary (26%), followed by Belgium, Denmark, Greece and Poland (all 24%), and the lowest in Portugal (15%) and Sweden (16%). There is also a gender gap. Lung cancer accounted for 26% of all male fatal cancer (185 600 deaths), compared with 15% for female (83 500 deaths). This can partly be explained by the greater prevalence of risk factors among men, notably smoking rates.
Addressing the risk factors of cancer is the Commission’s first line of attack, and as smoking is the greatest risk factor for lung cancer, I am particularly proud of the EU Tobacco Products Directive (2), which has recently become applicable to member states (20 May 2016). Through rules intended to make tobacco products look and taste like tobacco products – and not cosmetics, sweets or toys this piece of legislation aims to reduce smoking rates by two percentage points by 2021.
Some particular rules are mandatory – large picture warnings covering the front and back of cigarette and roll-your-own packages; bans on products with characterising flavours; small packs; ‘lipstick-style’ packs and misleading elements on packaging, which entice children and teenagers into starting to smoke. Few people can argue with measures that protect young people from the harmful effects of tobacco, and the Eurobarometer conducted in 2012 (3), just before the Commission put forward its proposal, illustrates this. Indeed, its results show that: “around three respondents in five support measures banning advertising at sales points (64%), banning flavours (63%), banning Internet sales of tobacco (62%) and keeping tobacco products out of sight in shops (58%)”.
It seems that the anti-tobacco sentiment in the EU is gaining momentum both at individual and government level. Evidence pointing to this includes falling smoking rates, especially in the 16-25 year age group, and the introduction of plain packaging and stricter laws on smoking in public places in some Member States. I am delighted with this trend and convinced that it will continue, so that in twenty, thirty years’ time, we will see a significant reduction in lung cancer deaths in the EU thanks to lower smoking rates.
Another line of attack facilitated by the EU lies in bringing together expertise and maximising synergies between Member States in their common effort to fight diseases. The value of EU collaboration is especially apparent in the case of rare diseases and conditions where knowledge and resources are scarce and fragmented across individual EU countries. Lung cancer is always serious, but rare forms of lung cancer are particularly hard to treat, and patients face real challenges with diagnosis and accessing expertise and appropriate treatment. This is where future European Reference Networks (ERNs) can help. ERNs are unique and innovative cross-border networks that will help diagnose and treat rare and complex diseases, including rare forms of cancer. They will become operational in early 2017.
No country alone has the knowledge and capacity to treat all these diseases, but by cooperating and exchanging life-saving knowledge at European level through ERNs, patients across the EU will have access to the best expertise available.
I sincerely believe that we are turning a corner in the fight against lung cancer, and that EU tobacco policy and ERNs are part of the solution, alongside other EU actions to support member states such as research funding and Joint Actions on rare cancers and comprehensive cancer control. (4)
I will do my utmost to ensure correct transposition of the Tobacco Products Directive by Member States so that the positive effects on public health in the EU are felt as soon as possible. With regard to ERNs, my services are developing a state-of-the-art IT platform and tools. We will also ensure that ERNs receive adequate support via EU funding mechanisms such as the Health Programme, the Connecting Europe Facility (CEF) and Horizon 2020, so that they can reach their full potential.
1. Eurostat Press Release 4 February 2016: http://ec.europa.eu/eurostat/documents/2995521/7149996/3-03022016-BP-EN.pdf/0bbc3389-8c0d-44a0-9b0c-2a0bff49f466
2. Directive 2014/40/EU of the European Parliament and the Council, adopted on 3 April 2014: http://ec.europa.eu/health/tobacco/docs/dir_201440_en.pdf
3. Eurobarometer on Attitudes of Europeans towards tobacco: http://ec.europa.eu/health/tobacco/docs/eurobaro_attitudes_towards_tobacco_2012_en.pdf
4. See factsheet on EU action on cancer: http://ec.europa.eu/health/major_chronic_diseases/docs/30years_euaction_cancer_en.pdf