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by | October 14, 2014 | Uncategorized

New cancer expert group: cancer is on the EU public health agenda

On the first meeting of the new expert group on cancer, which was held on 22-23 September, the Commission presented an overview of the EU priorities for cancer and an implementation report on previous work done in the field. It gave also an update on the ongoing CANCON Joint Action (European Guide on Quality Improvement in Comprehensive Cancer Control) and progress towards a European Cancer Information System. Finally, the International Agency for Research on Cancer presented the 4th edition of the European Code Against Cancer, and the Expert Group discussed its dissemination. EPHA is among the selected NGOs which represents the voice of the European public health society. EPHA is among the selected NGOs to represent the voice of European public health society on a new cancer expert group.

The group has been established by a Commission Decision dated 3 June 2014, and is composed of

  • EU, EFTA and EU candidate Member States representatives;
  • 3 representatives of patients’ organisations in the field of cancer;
  • 2 representatives of European associations acting in the field of cancer prevention;
  • 3 representatives of European professional associations or scientific societies acting in the field of cancer;
  • 1 representative of producers of products or service providers in the field of cancer;
  • and the representative of the International Agency for Research on cancer.

The full DG SANCO statement is on-line.

Cancer puts a heavy burden on Europe

In 2008, 2.5 million people were diagnosed with cancer in the European Union (EU27). Cancer is the second most common cause of death in the Union (29% of deaths for men or 3 out of 10 deaths, 23% for women or 1 out of 5 deaths) – a figure that is expected to rise due to the ageing European population. [[http://ec.europa.eu/health/major_chronic_diseases/diseases/cancer/index_en.htm]]

Link between cancer and other chronic diseases

Cancer puts a considerable burden on society, but when we measure the public health impacts, we have to take into consideration the links with other chronic diseases, such as diabetes, cardiovascular diseases, respiratory diseases, like asthma or chronic obstructive pulmonary disease (COPD,) etc.:

  • Both chronic diseases and certain types of cancer have common risk factors, co-morbidities and epidemiology. (e.g. nutrition, tobacco, alcohol, environmental exposure)
  • Both chronic diseases and cancer require costly healthcare
  • They both have a time bomb effect , which means that for most common cancers in the early stage there are no tangible symptoms and fatalities happen after a long period of time when treatment is more difficult.

This common characteristic may mean there might be a common solution. The use of the European Cancer Information System (ECIS) is a good example that could be a model replicated for other chronic diseases.

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See more information on cancer registries here: [->5961]
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Alcohol, as a key risk factor for cancer

Alcohol consumption causes cancers of the oral cavity, pharynx, larynx, oesophagus, coorectum, liver, and female breast. The relative risk of breast cancer rises with increasing alcohol intake by about 10% per 10 g pure alcohol per day.” [[Lancet Oncol. 2009 Nov;10(11):1033-4. A review of human carcinogens–Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. Secretan B et al,]]

The risks tend to increase with the amount of ethanol drunk, in the absence of any clearly defined threshold below which no effect is evident. [[Ann Oncol. 2003 Jul;14(7):973-1005. European Code Against Cancer and scientific justification: third version (2003). Boyle P et al,]]

Alcohol was the second largest risk factor for cancer in France in 2000, according to an IARC report Alcohol was attributable to 8.1 % of all cancer cases and tobacco 18.2 %. Infectious agents were third place with 3.3 %. For cancer deaths, the figures are respectively 23.9, 6,9 and 3.7 %. [[see page 108 in Attributable Causes Of Cancer. The French data from 2000 can be downloaded from http://www.iarc.fr/en/publications/pdfs-online/wrk/wrk3/]]

10% of all cancers in men and 3% in women are estimated to be caused by alcohol in eight European countries. [[BMJ. 2011 Apr 7;342:d1584. Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. Schütze M et al]]

EPHA’s work on cancer

Health determinants remain the primary focus of activity for many of EPHA’s members. EPHA adds value to the work of members in the health determinants stream with its broad public health perspective. Social inequalities are a key driver of cancer incidence, prevalence and mortality and they are an important thread that runs through all of EPHA’s work.

The first aim of EPHA’s five year (2011-2015) strategic plan is “to improve overall population health and healthy life years, through tackling determinants of health including inequalities” and by exchanging knowledge and good practices which could improve the health of the entire population; allowing people to live better and longer. Within its activities, EPHA focuses on key risk factors of different cancer types, such as tobacco and alcohol consumption.

EPHA will continue its work in the expert group and rely on the wide expertise of EPHA members working in the cancer field and on determinants of cancer which are relevant for other chronic diseases

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