Joint statement: Prevention at the heart of Europe’s Beating Cancer Plan

Prevention is the foundation of public health policy and central to protecting and improving people’s health and well-being. Europe’s Beating Cancer Plan is a key opportunity to put prevention where it belongs – at the heart of the European Union’s (EU) health agenda.

As a major chronic non-communicable disease (NCD), cancer shares many features with other NCDs, such as cardiovascular disease, respiratory diseases and type 2 diabetes, among others. What connects these diseases is that they are driven by a number of common, modifiable risk factors, especially tobacco and alcohol use, unhealthy diet, insufficient physical activity and air pollution.1 Moreover, NCDs share a high degree of preventability and are exacerbated by socio-economic inequities across the life span.

Many of the main risk factors for NCDs are shaped by social, environmental and commercial determinants which can be addressed through cross-sectoral policies and legislation. Using policies and legislation to create health-enabling environments answers the aspirations of Europeans for a healthy, equitable and ecologically thriving continent for current and future generations.2

Over half a million people under the age of 65 die of NCDs in the EU each year,3 while up to 80% of healthcare spending goes towards treating NCDs.4 The EU has vast potential to deliver human, social and economic added value by adopting a strong prevention agenda and by empowering Member States to develop, implement and enforce ambitious disease prevention and health promotion policies. However, this EU potential remains equally vastly underused.

Therefore, the undersigned organisations urge that a thorough prevention pillar should be included in Europe’s Beating Cancer Plan with special attention to tackling challenges common to all NCDs, and to initiate a process towards a wider EU strategic approach to the prevention of chronic diseases, including mental ill-health.

Especially, we call on the European Commission, European Parliament and national governments to:

Tackle common issues

Europe’s Beating Cancer Plan should affirm the need to effectively tackle the common risk factors for NCDS, including cancers, and strengthen national and, where relevant, European capacity to implement the World Health Organization (WHO) ‘Best Buys’ and other recommended policies,5 by:

• Producing an analysis of the gaps in the European response to NCD prevention and developing EU-level policies in its areas of competence to implement the WHO ‘Best Buys’ and other recommended interventions.
  Developing policy toolkits to support the implementation of the WHO ‘Best Buys’ which fall under national competence.
  Identifying and adjusting EU-level policies that may dissuade Member States from pursuing national NCD prevention strategies.
  Ensuring that the EU’s research framework addresses the need for public health policy development, impact assessment, monitoring and evaluation

Put health at the centre of EU policies

Different policy areas affect health and Europe’s Beating Cancer Plan should adopt a proactive approach to the ‘health in all policies’ obligation in the EU treaties6 to ensure that action to prevent cancers and other NCDs is meaningfully integrated into the European Green Deal, the Farm to Fork and Zero-Pollution strategies, the Economy of Well-Being, the Sustainable Development Goals (SDGs), and other relevant EU activities, by:

Strengthening the quality and scope of health and health equity impact assessment for relevant policies and legislation, using improved and continuously updated methodologies.
Establishing a reporting process, overseen at a high level in the European Commission, to ensure that all Directorates-General show their contribution to preventing cancers and other NCDs.

Support early detection

While effective, population-based primary prevention policies create a long-term, sustainable framework for reducing the incidence of cancers and other NCDs, historic exposures to risk factors will continue to generate new cases. Europe’s Beating Cancer Plan should support Member States in implementing appropriate, cost-effective and evidence-based solutions for early diagnosis and screening.7

Ensure governance fit to deliver

To deliver on its big promise, Europe’s Beating Cancer Plan needs to establish a goal-oriented, inclusive and transparent governance process, by:

Setting time-bound, EU-relevant targets related to developments in risk factors, funding and key prevention policies.
Establishing an inclusive process to ensure the participation of key health and civil society organisations, including youth.
Implementing checks to prevent conflicts of interest and enhance the transparency of decision-making to maximise the integrity and effectiveness of policy outcomes.
The undersigned organisations look forward to contributing to a bold EU response to prevention in Europe’s Beating Cancer Plan to advance the vision of a Europe free from avoidable NCDs.