Europe’s long-awaited Beating Cancer Plan was published on February 3, and like many in Europe’s cancer community, members of the European Head and Neck Society were waiting in anticipation for its publication.
The publication marks a much-welcomed shift by the current Commission to prioritise cancer as a major health issue facing Europe. Since the last European action plan against cancer was developed in the early 1990s, we have fortunately seen significant progress made for patients with cancer across Europe. Despite this, head and neck cancer remains a largely unknown disease, which in 2020 killed more than 70,000 people in Europe, and in our view requires much more attention.
At a pan-tumour level, it is safe to say that the Beating Cancer Plan is not a disappointment. In fact, it is a hugely encouraging proposition and represents a renewed commitment to cancer prevention, treatment, and care. For many this plan represents hope; hope that the publication of this Plan is a landmark moment in finally starting to turn the tide against cancer.
Indeed, when we review the Plan from a head and neck cancer perspective, there are many positive and promising elements, as well as some areas where we believe change or adaption is needed if we are to fully tackle the issues that head and neck cancer poses throughout Europe.
The flagship initiatives on prevention, specifically the actions around creating a ‘Tobacco-Free Generation’, and efforts to reduce harmful alcohol consumption are extremely welcome. It is well-documented that smokers have a higher risk than non-smokers of developing head and neck cancers: a person who smokes will be 15 times more likely to develop head and neck cancer than a non-smoker. Likewise, men who consume more than three units and women who consume more than two units of alcohol per day are at a significantly higher risk of developing head and neck cancer.
In addition to smoking and alcohol misuse, the human papillomavirus (HPV) is a known risk factor for head and neck cancers, and one which is driving an increase in cases, regardless of gender. Therefore, the objective to vaccinate at least 90% of the EU target population of girls and to significantly increase the vaccination of boys by 2030 is extremely timely. At present, however, the plan only refers to this vaccination programme as a means to eliminate ‘cervical cancer and other cancers’; we believe this language should be updated to include head and neck cancers specifically. Furthermore, we also urge the adoption of firmer targets for achieving vaccination of boys at a Member State level, as this will be crucial to lowering the incidence of HPV-related head and neck cancer.
Early detection of head and neck cancer remains a major challenge in Europe, with approximately 60% of people presenting at the late stage, when outcomes are poor. It is therefore encouraging to see the focus on early detection and intervention, for example through screening. That said, the Plan does not list head and neck cancer as a tumour type that is being considered for a Europe-wide screening programme; we strongly believe that given the growing incidence and severity of head and neck cancers, the creation of a head and neck cancer screening programme should be included in discussions.
Beyond the benefits of screening, awareness campaigns are an effective tool for early detection. It is our view that the European Commission should actively encourage and support these public-facing campaigns as invaluable education opportunities for the general public.
One such example is our Make Sense campaign and its annual head and neck cancer awareness week, which runs during the third week of September throughout Europe. Greater understanding and uptake of the Campaign’s central principle, the ‘1for3’ rule, is needed among the general public; by activating people to seek medical advice after experiencing one symptom of head and neck cancer (such as a lump in the neck, pain when swallowing, frequent nose bleeds, white/red patches in the mouth, a persistent blocked nose) for three weeks or longer, we could significantly improve earlier diagnosis rates and therefore greatly help the outlook for these patients.
High-quality care is of the utmost importance. Yet, for many people living in Europe with head and neck cancer, care is not optimal. Sadly, huge disparities exist and prognosis varies throughout Europe. For those living with the disease, care is best delivered as part of a multidisciplinary team in specialised centres, but access to these facilities remains an issue. The flagship initiative of establishing an EU Network linking recognised National Comprehensive Cancer Centres and the related aim of ensuring that 90% of eligible patients have access to such centres by 2030 is a significant step forward and progress in this direction will be closely followed. Furthermore, launching the Cancer Inequalities Registry to map trends in key cancer data identifying inequalities between Member States and regions will also be key to identify and therefore address discrepancies in care.
Finally, there is an urgent need to continue and accelerate improvements to the quality of life for patients, survivors and caregivers living with all types of cancer. Best survivorship practices are especially needed in head and neck cancer, where the effects of the disease can have profound and long-lasting impact on patients’ lives. We strongly welcome the Launch of the ‘Better Life for Cancer Patients Initiative’, including a ‘Cancer Survivor Smart-Card’ and the creation of a virtual ‘European Cancer Patient Digital Centre’ to support the exchange of patients’ data and monitoring of survivors’ health conditions, and hope these initiatives will have a tangible impact on the lives and care of survivors.
It is fair to say that cancer remains one of the biggest public health threats of our time, but to us, what this Beating Cancer Plan represents is the long-overdue possibility of a brighter future for the European cancer community, including patients with head and neck cancers.
About the Make Sense Campaign
The Make Sense campaign, initiated by the European Head and Neck Society (EHNS), aims to raise awareness of head and neck cancer and ultimately improve outcomes for patients with the disease. More information about the campaign is available at makesensecampaign.eu, on Twitter and on Facebook.
About the EHNS
The European Head and Neck Society (EHNS) is an international non-profit association based in Belgium. The EHNS is composed of individuals, national and multinational societies, and associated study groups oriented towards head and neck cancer research, training and treatment throughout Europe. For more information on the society, please visit: www.ehns.org.