Tag Archive for: Cancer

Wendy Yared at the Conference on cancer of the Swedish Presidency of the Council of the EU


There are high expectations that digital tools can contribute to a lower incidence of cancer, although we are still testing and evaluating many of them. What is certain, however, is that technology will not be enough if we do not change our lifestyle habits. We have already heard this with climate change, with the energy crisis, with our consumption patterns… and cancer is no stranger to this.

This idea is also advocated, among others, by Wendy Yared, Director of the Association of European Cancer Leagues (ECL) with more than 25 years of experience in public health and health policy. The organisation she leads brings together national and regional cancer societies that cooperate and exchange information to curb the impact of cancer at European level.

Question: In Europe, we are making great efforts to reduce the incidence of cancer, but how can we do even more?

Answer: We need to put more emphasis on cancer prevention so that we can save more lives. I am always surprised that many people are still not aware that up to 50% of all cancers are preventable. This means that not all cancers are inevitable, and we need to encourage everyone to understand it.

Why have not we paid more attention to prevention until now?

Only 3%, or even less, of health budgets are devoted to prevention. And I am not just talking about cancer prevention, but about prevention in general. When there are few resources and attention, there are not enough actions to reduce the incidence of these diseases.

Moreover, cancer takes decades to develop, so if there is a current improvement in its incidence, it is due to the efforts that were made decades ago. Maybe what we are doing now is very good and sufficient, but we will not be able to see numbers improve significantly for another twenty or thirty years. The good news is that now, at the EU level, there is a lot more attention towards cancer control and policymakers are being convinced about of its importance.

Considering the available data about the growing incidence of cancer, how is ECL looking at the future?

First, it is important to know how reliable the data and the sources are, but it is certain that the ageing of Europeans plays an important role. For our part, we are trying to maintain cancer high on the EU agenda, because this has not always been the case.

We must be patient, but there are reasons for hope, such as increased budgets for cancer control and a bigger awareness in Europe. I am confident that we will see a decrease in cancer incidence soon, especially with the increased EU support in recent years.

“I am confident that we will see a decrease in cancer incidence soon, especially with the increased EU support in recent years”.

Nowadays, it is known that our habits and the risk of suffering cancer are linked. Why is it so difficult to raise awareness of this idea among people?

Each risk factor responds to specific behaviours and, as a result, there are different challenges in each of them. For some risk factors, such as tobacco use, we have more information on why it is so hard to modify our habits, but we also know actions that work, such as taxation. If there are high prices, it will be more difficult for people, especially youth, to get hooked.

Cancer leagues need the support of governments to improve policies and raise awareness, considering that we do our best with fewer resources than industry, which widely promotes its unhealthy products (tobacco, alcohol, sugary drinks, sunbeds, etc.).

How can we convince them to lead healthier lifestyles?

The International Agency for Research on Cancer (IARC) is now in the process of updating the European Code Against Cancer. They are evaluating what works and what does not in each cancer area while considering the most updated evidence. It is important to keep renewing the messages regularly so that people are reminded of them. And finally, as mentioned before, it is important to have policies that encourage citizens to make the healthiest choices.

Can you give us some insight into the upcoming fifth version of the European Code Against Cancer and how do you plan to increase its dissemination?

There will likely be new recommendations that will be added to the current fourth edition.  Discussions are ongoing to align with current evidence, such as including boys for the Human Papilloma Virus (HPV) vaccinations.

Regarding the dissemination, we will continue to engage the member leagues of the ECL and other partner international organisations to spread the word about the ECAC, since they have direct contact with patients and civil society.

The ECAC and other initiatives focus on what we can do as individuals to reduce cancer risks, but do we ask the same commitment from producers (alcohol and tobacco companies, food industry…)?

We can ask but I have little confidence that they will have any significant level of commitment. While some companies may show that they try to make a difference, not all of them do what they promise. It is simple: it is not their job and they want to sell and make a profit. We have different priorities and that forces us to seek a balance between all the actors involved.

If producers truly wish to help, they could give a portion of their profit to support healthcare systems, because if they are going to make people sick, at least help them get better too.

“While some companies may show that they try to make a difference to reduce cancer incidence, not all of them do what they promise. It is simple: it is not their job and they want to sell and make a profit”.

In terms of digital tools for cancer care, it is very common to mention mobile apps, but can you give other examples of these tools? Is there one that stands out above the rest?

When we talk about digital tools, we also include smartwatches, the Internet of Things, robotic surgery, pathologists… but none of them stand out among the other tools for now. We have to wait for the results that all of them are promising and bringing. The internet and websites, if we count them as digital tools, are the most promising because of their accessibility, durability and reach.

How can digital tools help us to deliver cancer services more efficiently and reduce existing gaps?

The patient must be well-informed to be able to choose which option he or she prefers and to have flexibility in this regard. Beyond highlighting the benefits of these tools, such as reduced travel time and the guarantee that the doctor is always there, even if not physically, what is really important is to give the patient the possibility to choose between virtual or face-to-face care for their particular needs.

What are the barriers that healthcare professionals need to overcome?

The pandemic has shown that there is a new way of working in healthcare and has helped professionals change their mind-set on the value of digital health. Not everyone was trained with these technologies when they were studying, like surgeons, for example, so their learning curve has been steep and fast. They also have had to learn how to talk to patients through the screen when there are difficult things to tell. Professionals need to be convinced that this adaptation can be useful to them and make their work easier.

And regarding the management of health information?

Hospitals use different systems to manage their data, so harmonisation of information and platforms across healthcare institutions remains a challenge. We need to ensure that these systems are interoperable within and across our borders.

Patients can be nervous about sharing their data, because sensitive information can be grounds for discrimination if it gets out or is leaked, so these systems need to be secure and the patient needs to be assured of the confidentiality of their information.

What added value can eCAN bring in the context of digital tools?

eCAN aims to put on the table some recommendations on teleconsultation and telemonitoring at European level, which I believe is vital to clear up doubts and ensure that everyone interprets the regulations in a harmonised way. But for this to happen, it is first necessary to raise awareness among policymakers, which is also what eCAN is trying to do.

The first Country Cancer Profiles under the European Cancer Inequalities Registry state significant inequalities in cancer mortality rates between and within EU member states. These reports reveal that varying exposure to risk factors for cancer and the different capacity of healthcare systems to provide timely and free access to early diagnosis, as well as high-quality cancer care and treatment, partly explain these inequalities. 

The Country Cancer Profiles consist of a concise yet comprehensive analysis of cancer burden and policies in the 27 EU states, plus Norway and Iceland. The documents were launched last 1st of February 2023 at the ‘Cancer – Equity, excellence and innovation: modern cancer care for all’ conference, co-organised by the European Commission and the Swedish Presidency of the Council of the European Union.  

During the event, the Head of the Health Division at the Organisation for Economic Co-Operation and Development (OECD), Francesca Colombo, highlighted some of the report’s key messages. All of them rely on the idea that “there are large and unacceptable inequalities across the European Union. No matter what indicator you look at, you will find differences across countries, differences across population groups; and much of these is something on we can act”, emphasised Colombo. 

Inequalities across the European Union

The difference in mortality rates becomes substantial when comparing central and eastern European countries to the remaining EU countries. Even within the same state, relevant inequalities across population groups are visible. According to Caroline Brechet and other OECD representatives, “cancer mortality rates are 75% higher among men than women across EU countries”, while “less educated individuals have higher mortality rates for nearly all types of cancer than their more highly educated counterparts”.  

Addressing these disparities requires national and international efforts to identify the EU’s main challenges regarding cancer continuum care, targeting population groups, sharing best practices between member states and boosting comprehensive prevention policies. 

As Colombo mentioned, policies on alcohol consumption are real examples that take a comprehensive approach and can be translated to the cancer field. In the case of alcohol, there is the PPPP approach, which combines Police enforcement to limit alcohol-related injuries, Protecting children from alcohol promotion, Primary health care and Pricing policies. 

The gender gap is still visible 

Looking at the report’s graphics and numbers, Francesca Colombo explained that cancer mortality rates have decreased over time in almost all member states. However, there are countries in which the efforts for reducing cancer mortality are not enough and where the gender gap is still visible. 

Although male mortality levels have decreased more than women over time, some countries present significant gaps. In this sense, Nordic countries perform better, showing more gender equity. 

Graphs on cancer mortality rates by country and gender indicate that female mortality levels among countries tend to be shorter than those we can find in data on men’s mortality. This fact suggests that efforts to reduce mortality among men need to be done in order to reduce the overall mortality rates. 

Graphic from OECD

Cancer mortality rates of men and women across EU countries. / OECD

Low social economic groups suffer higher cancer mortality rates 

The profiles also ratified how determinant socio-economic inequalities are in cancer mortality. The Head of the Health Division at the OECD suggested that prevention policies and interventions need to focus on social-economic disadvantaged groups and lower-educated groups.  

In this sense, the OECD representative explained that a large part of gender and socio-economic gaps are linked to modifiable risks factors for cancer, such as poor lifestyle, smoking, obesity or alcohol consumption. Colombo reiterated that addressing those inequalities “is probably where we can make the further gain”. 


Berchet, Caroline, Dedet, Guillaume, Klazinga, Niek, and Colombo, Francesca. Inequalities in cancer prevention and care across Europe. The Lancet Oncology. 24,1: 10-11. (2023)  

OECD. “EU Country Cancer Profiles“. OECD Publishing. (2023) 

This 4th of February, World Cancer Day, the eCAN Joint Action joins the three-year campaign #CloseTheCareGap and advocates for providing access to health prevention and care all over the world. Within its frame of work, as a European research project, eCAN is committed to closing the current care gap among EU countries by strengthening eHealth in cancer.

According to the European Beating Cancer Plan, “a number of indicators show major differences in cancer prevention and care between and within Member States”. As well known, early detection through different means (such as screening) is the best way to increase the chances of beating cancer. However, access to these prevention programmes varies considerably among countries. For example, national cancer programmes’ coverage of the target population ranges from 6% to 90% for breast cancer screening. The inequalities in access to prevention programmes evidence there is much work to provide equal access to health prevention and care.

Such difficulty does not only affect screening access but the entire disease pathway. eCAN aims to contribute to the cancer control continuum by boosting preparedness among the cancer care workforce in the virtual consultation and monitoring, improving healthcare workforces’ response in light of pandemics and crises, enabling cross-border cooperation, and reducing cancer care inequalities between rural and urban areas. Counting with the support of technological tools will enable to close the care gap in terms of prevention, early-detection, timely treatment and recovering.

Taking action is essential to respond to near-future projections on cancer incidence. According to estimated data, 2.7 million cases were diagnosed in the EU in 2020, which is expected to grow by a fourth by 2035. This means that in only 12 years, over 10 million people in the EU will be diagnosed with cancer each year.

The sheer scale of these numbers shows the dimensions of the problem. That is why the Europe’s Beating Cancer Plan is a key pillar for the European healthcare systems, since it also guides the development of national strategies focused on precision health, early-detection and the creation of a comprehensive health data space.

Reimagining healthcare systems 

The 35 organisations involved in this Joint Action believe the sooner cancer is detected, the better the access to adequate treatment. Reimagining the healthcare system and harnessing the new digital tools at people’s disposal for developing new ways of receiving medical assistance and monitoring is the vision this joint action follows and will work until September 2024.

The use of these digital tools will play a key role in strengthening healthcare systems before possible pandemic outbreaks. COVID-19 has evidenced the need of telemedicine in order to not only preserve cancer control continuum, but to also help cancer patients’ mental health. According to a Dutch study, almost one in three breast cancer patients and survivors reported that their emotional functioning and mental health declined from pre-pandemic levels.



Bargon, Claudia, et al. Impact of the COVID-19 Pandemic on Patient-Reported Outcomes of Breast Cancer Patients and Survivors. NCI Cancer Spectrum, Volume 5, Issue 1. (2021)

OECD/European Union, Health at a Glance: Europe 2022: State of Health in the EU Cycle, OECD Publishing. (2020)