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Cancer UpdatesResults Policy and ProgrammesReport provided by Jan Foubert, Executive Director EONSCONCORD Study shows Large Differences in Cancer SurvivalWorldwideThe CONCORD study ‘Cancer survival in five continents: aworldwide population-based study’ by Prof. Michel Coleman et aland the CONCORD Working Group was published online in LancetOncology on 17 July 2008. It is claimed that it is the first worldwidestudy designed to quantify international differences in populationbasedrelative survival by age, sex, country and region for patientsdiagnosed during 1990-94 with breast, colon, rectum or prostatecancer. The study provides data on 1.9 million adult cancer patients(aged between 15 and 99) from 101 cancer registries in 31 countrieson 5 continents.Key points from the study include:5-year survival for breast, colorectal and prostate cancers wasgenerally higher in North America, Australia, Japan, and northern,western and southern Europe, and lower in Algeria, Brazil, andeastern Europe.For colorectal cancer, 5-year survival for patients ranged from around60% in North America, Japan, Australia and France and down to40% in Algeria, Brazil, Czech Republic, Estonia, Poland, Slovenia andWales. Pooled 5-year survival for Europe ranged from 45% for womenand 48% for men. Almost 11% of patients with colorectal cancer diewithin the first month after diagnosis.For breast cancer, 5- year survival for patients ranged from 80% ormore in North America, Sweden, Japan and Australia to less than60% in Brazil and Slovakia, and below 40% in Algeria. Pooled 5-yearsurvival in Europe was 73%. About 2.3% of patients with breastcancer die within the first month after diagnosis.Survival from cancers of the breast, colorectal and prostate variedwith the type of health insurance in a population based study. Survivalwas highest with patients who had insurance (private or otherwise)and lowest with no insurance.Most of the wide variations in survival are likely to be due todifferences in access to diagnostic and treatment services.For further reference, please consult http://www.thelancet.com/journals/eopCurrent Trends on Cancer Incidence, Mortality and Survival inEuropeThe European Journal of Cancer (EJC) published a special editionon ‘Cancer control in Europe, state of the art in 2008’ on 2 July2008. The issue features ten articles on the cancer burden and onrecent trends in cancer survival. In an overall analysis of the papers,co-editors Prof. Jan Willem Coebergh (The Netherlands) and Dr. TitAlbreht (Slovenia) conclude that cancer prevention and managementin Europe is moving in the right direction. Differences betweencountries in policies for mass screening, access to healthcare andtreatment, however, are reflected in varying cancer rates. The mainconclusions of the articles include the following:• In the more prosperous countries of Northern and Western Europe,cancer incidence shows a downward trend, with the exceptionof obesity-related cancers (such as colorectal cancer), and fortobacco-related cancers in women;• Due to better access to specialised diagnostics, earlier detectionand better treatment, EU-wide survival rates for most cancers haveimproved;• The highest incidence rates of breast, prostate, testicular cancerand melanomas were observed in Northern and Western Europe,while lung, stomach and cervical cancer were more common inSouthern and Central Europe.• Cancer prevention efforts must be improved, in particular withregard to female smoking and the emerging obesity epidemic.Prof. Coebergh and Dr. Albreht expect the special issue to providerelevant input to the drawing up of the European Commission’sforthcoming Action Plan on cancer. For further information, also seethe press release from the European CanCer Organisation (ECCO)and on the website http://www.ecco-org.eu:80/News/News/In-the-news and on http://www.sciencedirect.com/science/journal/09598049.EUROPA DONNA to launch Breast Health Day in Europe on 15October 2008The European Breast Cancer Coalition (EUROPA DONNA) willlaunch a Breast Health Day in Europe on 15 October 2008. A pressconference featuring expert speakers will take place in Milan in thelate afternoon.The aim of this initiative is to start a public education campaign toensure that women and girls across Europe have correct informationon the early detection and prevention of breast cancer. The ultimategoal is to reduce incidence rates as a result of immediate actionon breast cancer. To increase public awareness, EUROPA DONNAis preparing a short public service TV announcement, which will beaired in 41 countries in October. Representatives of the 41 membercountries of EUROPA DONNA, including all 27 EU countries, willbe present at the launch. The new “Short Guide to Breast Health”which covers lifestyle factors influencing breast cancer, as well asthe “Short Guide to the European guidelines for quality assurance inbreast cancer screening and diagnosis” (see www.cancerworld.org),will be discussed at the event.EU Health Ministers adopt Council Conclusions on CancerThe EU Health Ministers adopted Council Conclusions on reducingthe burden of cancer at the Employment, Social Policy, Health andConsumer Affairs Council (EPSCO).While highlighting the cancer burden and the expected increase incancer incidence in an ageing population, the Conclusions call fora patient-centered, comprehensive and interdisciplinary approachto cancer control. They further point at the existing inequalitieswithin and between Member States with regard to cancer incidenceand survival rates. As a key element, the Conclusions stress theimportance of cancer registries and cancer control strategies, as- newsletter fall 200812
well as the need for greater cooperation between care services atdifferent stages of the cancer cycle.Underlining prevention as the most effective long-term strategyto reduce the burden of cancer, the Conclusions reiterate theimportance of healthy lifestyles and the reduction of occupationaland environmental carcinogens.The document also welcomes the involvement of civil society, inparticular patient groups, in shaping cancer policies and developingservices to better address patient needs.Among other actions, the Conclusions invite Member States to:- Develop and implement cancer strategies or plans;- Continue the implementation of cancer screening programmes inline with the Council’s Cancer Screening Recommendation (2003);- Provide the best possible evidence-based treatment for cancerpatients within the framework of national health priorities andfinancial resources;- Ensure population-based cancer registration as an important toolfor the development and monitoring of policies to prevent and treatcancer;- Take advantage of existing financial mechanisms to improve cancerprevention and control and also exchange best practices in thesetwo fields.The Conclusions further invite the European Commission to:• Present an EU Action Plan on Cancer addressing cancer controlfrom prevention to palliative care;• Facilitate the exchange of best practice and encouragecooperation in the evaluation, monitoring and assessment of healthactions;• Support Member States in the implementation of the Council’sCancer Screening Recommendation;• Support the networking of cancer registries;• Extend the knowledge of cancer, e.g. with regard to risk factors,early detection and treatment.Finally, Health Ministers encourage representatives of civil society toactively participate in raising awareness of cancer risk factors and ofscreening and prevention programmes. The Member States and theCommission should also promote the empowerment of civil society;these should contribute to the development and implementation ofcancer strategies or plans.At the Health Council meeting Slovenian Health Minister Zofija MazejKukovič outlined the main elements of the Conclusions, emphasisingthe growing cancer burden despite progress made in preventionand treatment to date. EU Health Commissioner Androulla Vassilioureiterated that the Commission will put forward an EU Action Plan onCancer in 2009, which will be accompanied by an impact assessmentof the human, social and economic costs of cancer. She also saidthat much remains to be done to implement the Council’s ScreeningRecommendation from 2003.In the national speeches, national and/or regional cancer strategiesand plans emerged as the most common topic of interest. Forinstance, Portugal called for cooperation between the MemberStates in developing national cancer strategies while Spain stressedthat regions must have an input in European cancer strategies. TheHealth Ministers also outlined national screening and preventionpolicies, with an emphasis on lifestyle-related initiatives. Finally, theyhighlighted the importance of cooperation on research and exchangeof best practices.Endorsed by the Health Ministers of all Member States, theCouncil Conclusions on cancer reflect broad political support offurther action to reduce the cancer burden and the existing cancerinequalities across Europe. Together with recent European Parliamentinitiatives on cancer, such as the Resolution on combating cancerin the enlarged EU, the Council Conclusions pave the way for acomprehensive EU Action Plan on cancer to be introduced by theCommission in 2009.PREVENTPrediction, Recognition, Evaluation and eradication of normal tissueeffects of radiotherapy11-12 th January 2009 Brussels, BelgiumThis ESTRO conference, in collaboration with EONS, explores thescience and clinical knowledge of radiotherapy side effects. This twoday conference brings together scientists, clinicians and nurses tofocus on the important issues of radiation toxicity and explores theimpact and future management for patients. The plenary speakerswill present the latest radiotherapy research and discuss the clinicaland scientific issues facing clinicians in the management of patientsundergoing radiotherapy including acute and late effects. Thisconference is aimed at health practitioners working in the field ofradiotherapy or caring for patients who receive or have receivedradiotherapy.Mains sessions explore radiation induced cancers, radiation biologyand mechanisms of normal tissue damageParallel clinical sessions will explore:• Impact of toxicity on patients• Measurement of toxicities• Managing toxicitiesSpeakers include both nurses and clinicians researching this fieldand providing the evidence base for radiotherapy management anddiscussion of where our gaps in knowledge exist.For further information of the scientific programme and registration:http://www.estro.be/estro/index.cfm or contact the ESTRO officeon 0032 2 775 93 40.newsletter fall 2008 -13
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