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Opinion Number: CDR 2072/2021
Rapporteur: SACRÉDEUS Birgitta
Commission: NAT
Status: Adopted
Date: 01/12/2021
 
to ensure that both the legislative and non-legislative framework related to the future European Health Union and more specifically the Europe's Beating Cancer Plan reflects the responsibilities of local and regional authorities in public health, given that 19 of the 27 Member States have opted to give LRAs primary responsibility for healthcare
to continue to prioritise health at European level and to support regional and local authorities in the fight against cancer and epidemics of diseases in cross-border health cooperation and in the modernisation of health systems
The rapporteur an opportunity to discuss with the European Parliament the Cancer Plan and the position of the CoR at the Interparliamentary Committee Meeting of the BECA Committee on “Turning the tide on cancer: the view of national parliaments on Europe's Beating Cancer Plan" as well as with the Chair of BECA Committee at the CoR NAT meeting in the context of the adoption of the draft opinion.

EP BECA Committee adopted the draft report on 9 December 2021. The draft report echoes the calls and recommendations in the CoR Opinion in multiple areas, such as, inter alia, recommending to facilitate access to cross-border health care and clinical trials for cancer patients, extend the use of joint procurement to manage shortages of cancer medicines, guarantee the 'Right to be Forgotten' to prevent discrimination and improve the access of cancer survivors to financial services, ensure equal access to innovative cancer drugs and treatments for all patients. It calls for stronger measures to address key risk factors, such as smoking and alcohol consumption (including labelling, etc.) and to extend the screening schemes, calling on the Commission to include other cancers (besides breast, cervical and colorectal cancer), based on latest scientific evidence, into the new EU-supported Cancer Screening Scheme, and recommends the creation of at least one cancer registry in each EU region.

On 16 February 2022, the Parliament adopted its final recommendations for a comprehensive and coordinated EU strategy to fight cancer, focusing on cancer prevention, equal access to cancer care across borders and a European approach addressing medicine shortage.

On 11 May 2022, the European Commission published its follow-up to the CoR opinion. The Commission largely echoed the CoR's calls and suggestions highlighting some initiatives that have since been implemented or being planned while also giving some insight as to what is in the pipeline.
On the health literacy and health awareness of the population, the Commission has launched the European Code Against Cancer and, e.g. the HealthyLifestyel4All initiative which the LRAs will be invited to help promote. The Commission is also launching actions to improve health literacy including training for professionals working in the health and social care sector. Additionally, several actions have been developed to motivate citizens towards a healthy and active lifestyle, take part in vaccination and screening programmes, and improve their overall health literacy (update the European Code against Cancer with the aim that at least 80% of the population is aware of the Code by 2025; an EU Mobile App for Cancer Prevention; a new project on Health Literacy for Cancer Prevention and Care, etc.).
On extending targeted screening, the Commission confirms that the revision of the Council recommendation on Cancer screening is in the EC work programme 2022 and that new evidence exists to consider extending screening recommendations also to other types, such as lung, prostate and gastric cancer.
On the large differences in cancer incidence and mortality between and within Member States (including lack of data), the Commission launched a European Cancer Inequalities Registry in February 2022 that will identify trends, disparities and inequalities between Member States from geographical and regional perspective but also due to age or gender, educational attainment income level, as well as disparities between urban and rural areas. Under cancer prevention, environmental factors like exposure to air pollution, various carcinogenic chemicals and radiation will be included. At a later stage, the Registry will also show disparities in the access to high-quality cancer care, particularly for timely diagnosis and treatment. To monitor cancer trends and progress with the plan, the Commission will regularly collect and publish relevant cancer data through the European Cancer Information System, which will feed also into the newly established Cancer Inequalities Registry.
On equal access to medicines, with the Pharmaceutical Strategy for Europe, the Commission committed to ensure that authorised medicines are accessible and affordable at all times for all EU patients. The strategy aims to support innovation in unmet medical needs and secure a steady supply of affordable, high-quality, safe and effective medicines in the EU.
On the potential of personalised medicine, the Cancer Plan and the EU Mission on Cancer will help to ensure further developments and access to innovative approaches to precision and personalised medicine, including personalised risk assessment for stratified prevention of cancers in high-risk patients. These actions are already planned to be supported under the EU4Health Programme and the Horizon Europe EU Mission on Cancer.
On joint procurement for cancer medicines, the Commission has launched the Big Buyers initiative as a support mechanism for Member States to facilitate joint public procurement. To publicise the initiative, the Commission intends to launch a major communication campaign.
On the "right to be forgotten", the Commission points out that stakeholder dialogue to develop a code of conduct will be launched to ensure that only necessary and proportionate information is used when assessing the eligibility of applicants for financial products. Additionally, the Mortgage Credit Directive already seeks to ensure that consumers are treated fairly and transparently, and also, the proposal for a new Directive on consumer credits refers to the European Banking Authority Guidelines on loan origination and monitoring, pointing out that health data, including cancer data, should not be used for the assessment of consumer creditworthiness.

On 20 September 2022, the European Commission published the proposal for the new Recommendation on cancer screening which echoes CoR calls with regard to:
• setting up a knowledge centre on cancer to facilitate coordination of scientific and technological initiatives against the disease at EU level, such as the collection of data through national cancer registries and the use of artificial intelligence (AI) to improve the quality of cancer screening;
• stepping up vaccination campaigns against the human papillomavirus;
• targeted screening for breast, intestinal and cervical cancer, and if the scientific evidence and cost-benefit analyses so warrant, extending this targeted screening to other cancers, such as prostate and lung cancer;
• need for data on cancer incidence and mortality to identify trends and/or address inequalities in cancer screening and treatment;
• rapid advances in research and innovation that enable bespoke innovative diagnostics and treatments and cancer prevention strategies that are better tailored to individual patients and types of cancer.

THE EUROPEAN COMMITTEE OF THE REGIONS



 calls on the EU institutions to ensure that the legal framework for the envisaged European Health Union factors in local and regional authorities' responsibility for public health, given that 19 of the 27 Member States have opted to give LRAs primary responsibility for healthcare;

 welcomes the aim to make the most of the opportunities for sharing medical and scientific data and digitalisation, and the fact that the envisaged European Health Data Space will make it possible to safely retrieve and share electronic health data for prevention and treatment across borders in the EU;

 stresses that cancer screening and early diagnosis must be at the heart of Europe's Beating Cancer Plan and thought should be given to extending targeted screening to other types of cancer, such as prostate and lung cancer;

 draws attention to the large differences in cancer incidence and mortality between and within Member States and criticises the lack of regionally disaggregated data needed to identify trends and/or address inequalities in cancer screening and treatment; calls on the Commission to launch the planned Cancer Inequalities Registry as soon as possible;

 draws attention to the system of "standardised treatment" that has been introduced as a best practice in some Member States to expedite diagnosis and start treatment;

 calls on the Member States to promote the accreditation of at least one cancer centre per Member State and establish an EU network of centres of excellence that makes cross-border cooperation and patient mobility easier; suggests that the Cross-Border Healthcare Directive should provide standards for cross-border screening, imaging and treatment of cancer;

 points to an urgent need for measures to promote the availability of generic and biosimilar medicines; suggests exploring the possibility of extending the EU's common procurement system, conducting joint price negotiations and creating a strategic reserve for cancer medicines.
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