The covid-19 pandemic has exposed the weaknesses of health systems in the treatment of cancer, as well as the shortcomings of cancer research throughout Europe. “Urgent improvements are needed in these areas because otherwise progress against this disease will be delayed by almost a decade.” This is the warning of a report prepared by a group of experts from the Oncology Commission of The Lancet.
The authors underline that “prioritizing research is crucial for European countries to offer more affordable, higher quality and more equitable cancer care, since patients treated in hospitals with research activity have better results than those who are not. ”.
Against the backdrop of the coronavirus pandemic, Brexit and the Russian invasion of Ukraine, it is more important than ever for Europe to develop a cancer research environment capable of playing a transformative role in improving prevention, diagnosis, treatment. patients’ treatment and quality of life,” says Professor Mark Lawler, Queen’s University Belfast, Northern Ireland, UK, and chair and lead author of the report.
According to Lawler, “it is estimated that during the covid-19 pandemic around one million cases of cancer remained undiagnosed in Europe. In addition —he adds— we have observed a chilling effect on research on this disease, with the closure of laboratories and the delay or cancellation of clinical trials in the first wave of the pandemic.
Effects of the pandemic, the invasion of Ukraine and Brexit
The Lancet Commission on Oncology has analyzed data on the impact of covid-19 across Europe and found that doctors treated between one and five million fewer cancer patients during the first year of the pandemic, and that one of every two patients did not receive surgery or chemotherapy on time.
In addition, 100 million screening tests were missed, and it is estimated that up to one million European citizens could have undiagnosed cancer due to delayed diagnosis.
For this reason, the report recommends that the response to the indirect repercussions that the pandemic has had on the diagnosis and treatment of this disease be accelerated. “Now more than ever, it is crucial to ensure that this area of research is duly protected and has priority within current and future European agendas,” the experts stress.
The authors explain that the Russian invasion of the Ukraine represents another huge challenge for research in this area in Europe, since these two countries “are two of the largest contributors to clinical cancer research in the world, especially that sponsored by the industry”.
They also stress that “many clinical trials in Ukraine include cancer centers in Central and Eastern European countries, and the conflict will likely cause many of these large trials to be delayed or fail to recruit volunteers.”
An additional danger “is that the industry might find it too risky to carry out cancer clinical research in countries bordering Ukraine. The loss of private investment would be hugely detrimental to disease research in Central and Eastern Europe.”
The report calls for the “gathering of data on the impact of the conflict on patients, cancer services, drug and other shortages, and staff shortages, in Ukraine and neighboring countries, as well as like developing a plan to mitigate the impact of the war on cancer research.”
The authors also predict that Brexit will continue to negatively affect European cancer research. They underline the need for funders and the European research community to mitigate the impact of Brexit and other policy challenges so that the UK can continue to engage with European partners and contribute to progress against this disease.
Gaps in research and its funding
The commission’s analysis has found that the total amount of investment, excluding the private sector, was around €20-22 billion, €26 per head. The minimum equivalent figure for the United States in the same period was about €76 billion (€234 per head). Given this dramatic difference in per capita spending, experts call for the European cancer research budget to be doubled to €50 per capita by 2030.
The group argues that prevention research has not received the funding it deserves. Greater attention to prevention would reduce the number of people who develop it and, therefore, would allow more resources to be available for those who do require treatment.
The report calls for a new priority to be given to research on the prevention, screening and early detection of cancer to reduce the burden it places on European citizens and allow those who develop cancer to have access to more resources and the best available treatments. .
Anna Schmutz of the International Agency for Research on Cancer (France) notes that “an estimated 40% of tumors in Europe could be prevented if primary prevention strategies made better use of current knowledge of risk factors.” . Evidence-based and cost-effective preventive interventions already exist, and we want to see more effective implementation and communication of them across Europe,” says the expert.
Gender gap in research
Gender equity in cancer research is another crucial gap identified in the report. In this sense, it indicates that the main authors represent less than a third of the research studies in this area in Europe.
“It is necessary to further investigate the reasons why some European countries or regions have greater gender inequality in cancer research than others. We hope that strategies based on this data will improve the balance,” says Professor Yolande Lievens, from the University Hospital Ghent in Belgium.
The commissioners hope that the conclusions and recommendations of this report will help the oncology research community in Europe to work towards a more equitable agenda in which all citizens and patients, regardless of their place of residence, benefit equally from advances. in this ambit.