The implementation of Europe’s Beating Cancer Plan and the EU Mission on Cancer will go far beyond research and innovation to develop new solutions and improve the lives of Europeans, says Joanna Drake, deputy director-general, DG Research and Innovation (DG R&I). 

Joanna Drake, deputy director-general, DG Research and Innovation 

More Europeans are surviving cancer than ever before, and those affected by the disease have a better quality of life. Despite the substantial improvements in reducing the cancer burden, the incidence of cancer is expected to rise due to ageing populations, unhealthy lifestyles, unfavourable health factors, and environmental and working conditions.

The Covid-19 pandemic has worsened the situation by halting or delaying regular check-up screening programmes, treatments and clinical trials. It has also exposed inequalities in access to healthcare due to uneven geographical availability of services and other problems in health systems. These developments will have long-lasting effects on prevention and cancer control.

To fight cancer, it’s crucial to detect and treat as early and precisely as possible. Technology is changing the cancer care landscape, presenting new opportunities – from digital health records to real-world patient data for research purposes.

There is good news on the horizon. The EU’s Mission on Cancer launched in September 2021, together with Europe’s Beating Cancer Plan adopted in February 2021, aims at improving the lives of more than three million people by 2030 through prevention and cure, and helping those affected by cancer, including their families, to live longer and better.

Europe's Beating Cancer Plan is a key pillar of the European Health Union, presented by European Commission president Ursula von der Leyen in November 2020, calling for a more secure, resilient and better-prepared European Union. It reflects the EU’s political commitment to steward the strategy, taking action against cancer and leaving no stone unturned.

Joanna Drake, mission manager for the EU Mission on Cancer and deputy director-general at Directorate-General for Research and Innovation (DG R&I), outlines the European Commission’s commitment to defeating this disease.

How will the EU Mission on Cancer improve the diagnosis and treatment of cancer for Europe's citizens and remove the disparity within and among the member states?

If we look at what's happening within the member states, we can see there is currently no real equality in accessing knowledge on cancer or its prevention, diagnosis and treatment, or quality of life for cancer patients and their caregivers. So, what we want is a levelling up through the Cancer Mission actions.

We propose that by 2023, there will be a blueprint for a federated digital platform supported by and for patients and cancer survivors to exchange real-world health data.

Once fully operational, they could access hands-on information on guidelines, clinical trials, possible side effects, and personalised care. It will also provide information on cross-border healthcare, psychosocial and legal support, guidance on returning to work, financial issues, and legal rights as a cancer survivor. In addition, scientists will be able to access this aggregated real-world patient data for research purposes.

Second, we have started with establishing a blueprint for a database known as the UNCAN.eu platform. This is also a question of putting data together which has not hitherto been combined, but it also includes data on sources outside the health domain.

Examples include geographical observation data, climate and environmental exposure, and information concerning the social sciences. By making this data available on a platform, researchers can access it and inform decision-makers about any proposed policy action that needs to be taken.

Our third priority involves working towards a Network of Comprehensive Cancer Infrastructures by 2025. It's an objective that would level up – at least to a certain minimum level –information provision and efficiency for national cancer infrastructures to make sure that all European regions in the member states are covered.

'We propose that by 2023 there will be a blueprint for a federated digital platform, supported by and for patients and cancer survivors to exchange real-world health data.' Joanna Drake, deputy director-general, DG Research and Innovation (DG R&I)

In terms of overcoming this disparity, what will be the role of the Network of Comprehensive Cancer Infrastructures and the European Reference Networks on cancer?

They will enable scientists to benefit from a state-of-the-art research infrastructure and participate in international clinical studies. Most importantly, creating this network will benefit cancer patients because they will ultimately have better access to prevention, screening, diagnostics and treatments, and improved care pathways.

The European Reference Networks will also be involved in designing clinical studies and care pathways, which we believe will ultimately lead to a levelling up on a European scale for cancer infrastructures, care, prevention, diagnostics, analysis, and quality of life.

This obviously demands close cooperation between the Horizon Europe Cancer Mission, Europe’s Beating Cancer Plan, member states, as well as regions and local communities, and likewise joining up different levels of governance.

How would you describe this to a patient or a doctor?

What we envision is something that produces high quality care and good research results that inform policy and leads to an improvement in access to care. The relevant ministries and governance structures, which are already in place, will manage a comprehensive network of cancer infrastructures across the member states that share data among themselves.

The network will provide access to researchers, who will gain insights into the policy, care, prevention measures and tools necessary for any member state or even patients to seek better information about their condition, or where best practices have been established.

But at the end of the day, you need a truly joined-up structure that works together much closer than is the case now. There are already a lot of exchanges and conferences taking place, and operational collaboration too, but this will be more visible and organised to enable a patient to be more informed at a European level (for example cross-border healthcare) rather than just at the local, regional or national level.

In time, I believe this can also evolve into a better collaboration over health policy, which is something Covid-19 caused to happen between member states with a lot of success. Look at the vaccination programme! It wouldn't have happened so quickly if the health authorities and research communities had not collaborated very closely at European level.

How will the EU Mission on Cancer and Europe’s Beating Cancer Plan enhance EU research efforts and inform future policies?

You can't inform only with policies. You also need to mobilise support and financial resources. We need greater mixing of existing legal instruments and funding programmes to create better outcomes for cancer patients and those who are at risk or living beyond cancer. So now, we are creating the building blocks with the Mission and Europe’s Beating Cancer Plan, which are designed to complement each other.

This also involves the use of financial incentives and inducements through different legal instruments across the EU institutions to help member states conduct their own programmes. This is on top of funding from the European budget, and will help mobilise even more financial support for what can be deemed to be a European initiative to deliver European added value.

You can do this both with public money and attracting private investment for innovation and startups with ready-for-market solutions and through implementation research. This could be research on primary prevention programmes, which can then attract further investment for other research and innovation programmes that can contribute to diagnosis, care and quality of life.

For example, a risk-based screening programme, using cheaper and faster screening technology that could be targeting regions with limited resources, or at the other end of the spectrum, new and tailored palliative end-of-life care solutions for advanced cancer patients.

We need to incentivise even closer, joined-up cooperation between the research ministries, health ministries and stakeholders, researchers, innovators and policymakers.

If we can do this, Europe will look like the region where it makes sense to invest money, including private money, to ensure these innovative solutions and in some cases already available technology can be made available and cheaper to those regions with limited resources.

'…a risk-based screening programme, using cheaper and faster screening technology that could be targeting regions with limited resources, or at the other end of the spectrum, new and tailored palliative end-of-life care solutions for advanced cancer patients.' Joanna Drake, deputy director-general, DG Research and Innovation 

The Covid-19 pandemic has had a negative impact on cancer control activities, how will the Cancer Mission make up the lost ground?

I agree, Covid-19 has had a negative effect on cancer control in all member states, whether it is prevention, screening, detection, treatment or care, but it has also exacerbated health inequalities.

In fact, cancer diagnoses dropped by 40% in 2020, with far more than one million undiagnosed cases. Scientists predict that there will be an increase in diagnoses of late-stage tumours, reducing the chances of survival, affecting quality of life, and increasing costs to the healthcare system for the years to come.

So how will the Cancer Mission help? First, it's now on the map as a truly European objective, and we know President von der Leyen is giving it her personal attention. Second, this high profile will ramp up communication and awareness of the risk factors and symptoms of cancer, encouraging people to attend cancer prevention programmes.

The Cancer Mission supports home screening solutions like self-testing for cervical cancer and colorectal cancer. It also supports clinical trial designs that require patients to travel less, plus medication and follow-up from home, and different care pathways.