The Employment, Social Policy, Health and
Consumer Affairs Council (EPSCO) adopted the new Council
Recommendations on Cancer Screening on 9 December. This gives the European
Union (EU) a new framework for the systematic detaction for early stage cancers.
The recommendation is not legally binding.
In five EPSCO meetings, the
European Commission's proposal text has been finalised. The amendments relate
both to the proposals to develop the established programmes on breast,
colorectal and cervical cancer and to transfer the screening approach to other
cancers such as prostate, lung and stomach cancer. What the ministers adopted in
EPSCO, with explicit reference to Article 168, paragraph 7 Treaty on the
Functioning of the European Union (TFEU) and their competence now leans more
towards what is practially feasible.
Major differences in cancer screening
This is because the Member States are at
different stages of implementation of organised cancer screening.
Population-based cancer screening programmes have neither been introduced nor
fully implemented in all Member States in 2020. There are also great
inequalities. For example, target group coverage for breast cancer screening
varied between 6 and 90 per cent and for cervical cancer screening between
about 25 and 80 per cent. This can be read in Europe’s
Beating Cancer Plan.
Considering available resources
Against this backdrop, negotiations have
been hard-fought over the target called for in the Beating Cancer Plan of offering
screening to at least 90 per cent of the target population for breast,
colorectal and cervical cancer by 2025. In the end, it was nevertheless
reflected in the Council recommendations. However, with regard to the
monitoring of their implementation, Member States have made it clear that this
can only be done taking into account capacities as well as financial and human
resources. Healthcare systems should not be unnecessarily burdened with
Checking cost-effectiveness by Member States
Furthermore, the cost-benefit ratio of any
programme must be balanced. The Member States have emphasised that cost-benefit
assessment must be carried out as an integral part of the implementation of
screening programmes at the national level. This would depend on a number of
factors, besides the epidemiology, also on the organisation and implementation
of the programmes as well as a sufficiently high participation of the target
group. In the implementation, the available diagnostic, treatment and aftercare
services should also be taken into account.
European Commission not entirely satisfied
The European Commission has welcomed in
principle the adoption of the Council Recommendations on cancer screening. But
it would have liked more. In a protocol
note , it criticises the fact that the scope of recommended preventive
medical check-ups has been restricted by the Member States. In particular, it
would have been better to retain the wider age range for breast cancer
screening and the reference to the level of effectiveness of lung and prostate
cancer screening. However, Member States could only agree to recommend the
applicable age range for women from 50 to 69 years of age for breast cancer
screening tests. The Member States are of the opinion that the necessary
evidence is limited for the effectiveness of screening for lung and prostate
cancer and, in certain circumstances, for stomach cancer.