There is a strong scientific basis for introducing life-saving screening programmes in EU member states for both lung cancer and prostate cancer, according to experts advising the European Commission ahead of an expected update to the Council’s cancer screening guidelines.
In a comprehensive evidence review published today (2 March), SAPEA – part of the Commission’s Scientific Advice Mechanism – also evaluates improvements to existing screening programmes for cervical cancer, breast cancer and colorectal cancer — by adopting new technologies, expanding the age range of screening, and optimising how frequently people are screened depending on age, sex and previous test results.
Indeed, in the case of cervical cancer, a combination of improved screening and widespread HPV vaccination may even allow Europe to eradicate the disease entirely in coming years.
A comprehensive review of the evidence conducted by SAPEA, the consortium of European academies, also concludes that:
- There has been rapid progress in minimally invasive, novel screening technologies for detecting cancer at an early stage. For example, there is growing interest in the use of ‘liquid biopsy’ blood tests to detect multiple different types of cancer from the same sample. These are not yet ready for rollout, but they are evolving rapidly, so we should be ready to implement them when they are ready.
- Clinical trials are valuable, but they cannot tell us exactly what will happen when a nationwide screening programme is implemented in the real world. So any new programme should be rolled out gradually, using local small-scale pilots.
- The EU has a role in supporting public awareness campaigns, and in creating large-scale biobanks to improve future research.
- Once a programme is running, it needs to be continually monitored and adjusted to maintain quality. Standards, guidelines and screening criteria should be continually updated to take advantage of emerging evidence and new technologies, and the EU has a role in coordinating this. This would also allow countries to share experience and data, and to optimise the use of resources.
- Meanwhile, offering opportunistic screening tests outside of organised programmes — and to people with no symptoms — leads to poor quality and unequal access. This should be avoided.
Leading cancer experts from across the world discussed the latest scientific progress in a series of three full-day scientific meetings held at the end of 2021, chaired jointly by Professors Rebecca Fitzgerald (University of Cambridge) and Harry de Koning (Erasmus MC Medical Centre, Rotterdam), under the auspices of FEAM, one of the five academy networks that make up SAPEA.
The experts’ conclusions, supported by a review of the scientific literature conducted by Cardiff University, are detailed in the latest SAPEA Evidence Review Report. And this evidence in turn informs the Scientific Opinion of the Group of Chief Scientific Advisors, also published today (2 March).
Professor Fitzgerald, one of the chairs of the SAPEA project, said:
“Organised cancer screening programmes save lives. The earlier a cancer is diagnosed, the greater the chances of treating it successfully and straightforwardly.
“Although many European countries already have screening programmes for cervical, breast and colorectal cancer, the latest evidence indicates some ways in which these existing screening programmes can be improved — and also points to introducing new screening programmes for lung and prostate cancer.”
Most health policy, including cancer screening programmes, are led by individual EU member states. But the EU has a role in coordinating and promoting best practice, including through guidelines agreed by the Council in 2017 and due to be updated later in 2022.
And Commission President Ursula von der Leyen made the fight against cancer one of her top priorities when she published the EU Beating Cancer Plan.
Notes for editors
The SAPEA Evidence Review Report, together with supporting reviews and documents and the Scientific Opinion of the Group of Chief Scientific Advisors, will be available to download from 12:00 on 2 March at www.sapea.info/topic/cancer-screening/.