Council updates its recommendation to screen for cancer

The Council proposes a new recommendation on cancer screening to bring down the mortality of cancer and cut the incidence of invasive cancers. Cancer is a major disease and cause of death throughout Europe. In 2020, an estimated 2.7 million people in the Union were diagnosed with cancer.

Cancer is a terrible scourge but we must not lose hope to fight it. Screening programmes to detect cancers at an early stage, before people even develop symptoms, can be an effective instrument to offer the best available treatment. Vlastimil Válek, Czech deputy prime minister and minister of health

Screening of lung, prostate and gastric cancer

Whereas the previous cancer screening recommendation from 2003 was limited to breast, cervical and colorectal cancer, member states agreed to broaden the focus:

• lung cancer: countries should explore the feasibility and effectiveness of screening with use of low-dose computed tomography. Special attention should be given to the identification and targeting of high risk profiles
• prostate cancer: considering the current state of knowledge and the amount of opportunistic screening, countries should evaluate the feasibility and effectiveness of the implementation of organised programmes
• gastric cancer: those countries and regions with cases of high gastric incidence and death rates should consider cancer screening strategies

On cervical cancer, the recommendation stipulates that member states should consider adapting ages and intervals to individual risk based on the human papilloma virus (HPV) vaccination history of the individuals. HPV can cause cervical (and other) cancers.

As regards breast cancer the Council recommendation suggests a lower age limit of 45 years and an upper age limit of 74 years (in addition to the recommended screening for women aged 50 to 69 with mammography).

Focus on implementation

Screening for cancer being only one element, the Council also recommends to ensure adequate, timely and complementary diagnostic procedures and treatments for those individuals with a positive screening test. They should also consider the human and financial resources and their healthcare capacities when running cancer screening programmes.

This focus on the feasibility of rolling out cancer screening programmes comes against the backdrop of the COVID-19 pandemic which had disrupted health promotion and prevention programmes and negatively impacted access to early diagnosis and treatment of cancer.

Benefits and drawbacks of screening

Screening makes it possible to detect cancers at an early stage or possibly even before they appear or become invasive. Some lesions can then be treated more effectively with a greater chance that patients can be cured.

But there are also inherent limitations which can have negative effects for the screened population. These limitations include false positive or false negative results, overdiagnosis and subsequent overtreatment as well as risks originating from the screening and testing methods.

Background

The ‘Europe’s Beating Cancer Plan’ from 3 February 2021 announced support for member states to ensure that 90 % of the EU population who qualify for breast, cervical and colorectal cancer screenings are offered screening by 2025. The Plan also proclaimed the revision of the 2003 Council recommendation on cancer screening.

Based on the scientific opinion of its Group of Chief Scientific Advisors, the Commission – on 20 September 2022 – presented a proposal for a new cancer screening recommendation.

Next steps

On the basis of information provided by member states, the Commission will report on the implementation of cancer screening programmes, not later than the end of the fourth year after the date of adoption of this recommendation.

• A new approach on cancer screening (Council recommendation)
• Protecting workers: health and safety at work (background information)
• A cancer plan for Europe (European Commission)

Source by Redazione