EU institutions should engage more politically to induce change in HIV awareness
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Nearly 122,000 are unaware of their HIV infection in Europe. To decrease the number of people who are diagnosed late or are unaware of their infection, new strategies are required to expand targeted HIV testing …

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Home » Breast Cancer, EU Health, Health

Tackling breast cancer: Prevention, diagnosis, treatment and collaboration

Submitted by on 14 Jul 2017 – 10:05

Despite several medical advancements in the last decade, the mortality rate of breast cancer remains high across Europe. Alexander Roediger, Policy Lead – Oncology for Europe, Middle East, Africa and Canada (EMEAC) and Dr Christian Hosius, Regional Director Medical Affairs, Oncology, Europe and Canada (EuCan) from MSD, detail the role of collaboration in tackling the disease

Breast cancer is the most commonly diagnosed cancer in women and the most likely reason for cancer-associated death in women (1) With nearly 400 clinical trials underway in more than 30 tumor types, MSD is investing significant resources to develop innovative oncology medicines to help people living with cancer worldwide. (2)

Cancer remains one of the most devastating diseases, with 2.6 million people diagnosed with the disease across Europe in 1995, rising to 3.4 million people in 2012 – a staggering increase of 30%, mainly driven by demographic change. (3). What is more, cancer incidence is expected to continue its upward trajectory, rising again by over a third, by 2030. But, there is hope. Over the same period, cancer mortality decreased in nearly every single country. The central factors that drove a wedge between the trends in incidence and mortality are advances in diagnostics, medical treatment, and screening. (4).  Despite these improvements over the last decades in the field of breast cancer the mortality rate associated with this tumor type remains very high in Europe. In 2012 the incidence of breast cancer was 71.1 and the mortality rate 16.1. (5)

Screening and Diagnostic Tools – for better outcomes and better use of healthcare resources

Breast cancer can be divided into 3 main subtypes (although recent work suggests that these categories can be further subdivided): Hormone receptor positive (HR+, which may include estrogen and/or progesterone), HER2 positive (presence of the human epidermal growth factor receptor2 gene) and triple negative (absence of aforementioned receptors/gene). The disease is heterogeneous.

Of equal importance as new treatments is also the improvement of the diagnostic tools and screening methods to identify patients at an earlier stage of the disease. Screening and diagnosis should be at the forefront of breast cancer management. Screening of high-risk patients could include younger women based on their family history, BRCA mutation status and other genetic alterations. (6) Individual European member states have local guidelines which are not necessarily identical and therefore the standard screening may differ across Europe.

As part of this commitment, MSD is striving to determine biomarker relevance for immunotherapies  in breast cancer, as well as other tumor types by including prospective biomarker testing in our clinical program.

The study of biomarkers will help develop a better understanding of the biology of the individual tumour. This knowledge may allow for better selection of treatment and a more accurate understanding of the potential for response. Targeted or personalised healthcare may lead not only to better outcomes but also more efficient health resources use. (7)

 

We must work together

Finally, the role of prevention is also very important: better education is needed to support the individuals in making well informed choices about lifestyle and health. Patients with higher health literacy levels manage better to navigate and access the health system, understand the importance of cancer prevention, and seek earlier diagnosis or adhere better to treatment. (8) Patient empowerment and education are key to achieve this.

The cancer challenge cannot be tackled by a single stakeholder nor resolved by simple solutions. Dialogue is critical to understanding the priorities and needs of each partner in the access equation, physicians, nurses, patients, payers and governments, in order to support and drive the rapidly advancing science and deliver access to innovative medicines across Europe.

About MSD

For 125 years, MSD has been a global health care leader working to help the world be well. MSD is known as Merck in the United States and Canada. Through our prescription medicines, vaccines, biologic therapies, and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to health care through far-reaching policies, programs and partnerships.

1. Jönsson B et al. (2016), The cost and burden of cancer in the European Union 1995-2014; European Journal of Cancer 66: 162-170

2. See http://www.merck.com/index.html (11/12/2016)

3. Jönsson B et al. (2016), The cost and burden of cancer in the European Union 1995-2014; European Journal of Cancer 66: 162-170

4. Jönsson B et al. (2016), Comparator Report on Patient Access to Cancer Medicines in Europe Revisited; IHE Report 2016:4; http://www.ihe.se/access-to-cancer-medicines-in-europe.aspx

5. Zagouri et al. (2014) Breast cancer in Europe; J Thorac Dis 2014;6(6):589-590

6. http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs

7. Godman B et al. (2014), Personalizing health care: feasibility and future implications; BMC Medicine 11: 179

8. WHO Europe (2013), Health Literacy. The solid facts; edited by Ilona Kickbusch, Jürgen M. Pelikan, Franklin Apfel and Agis D. Tsouros