Annexes to COM(2021)44 - Europe's Beating Cancer Plan - Main contents
Please note
This page contains a limited version of this dossier in the EU Monitor.
| dossier | COM(2021)44 - Europe's Beating Cancer Plan. |
|---|---|
| document | COM(2021)44  |
| date | February 3, 2021 |
Flagship initiatives on quality of life for cancer patients and carers
ØLaunch 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 – 2021-2023.
Other initiatives:
ØEnsure full implementation of the Directive on work-life balance for parents and carers – 2021-2022.
ØAddress fair access for cancer survivors to financial services (including insurance), via a code of conduct and a reflection on long-term solutions – 2021-2023.
7.Reducing cancer inequalities across the EU
A number of indicators show major differences in cancer prevention and care between and within Member States. These inequalities can be seen in access to prevention programmes, in rates of early cancer detection, diagnosis, treatment, survival and measures to improve quality of life of cancer patients and survivors. For instance, mortality rates from colorectal cancer are substantially higher among men than among women 68 . Differences in survivorship and access to care can be explained by gender differences, a combination of lower exposure to risk factors, better access to screening programmes and health services, and better capacity to absorb the social and financial consequences of cancer. Furthermore, persistent discrepancies can also be observed for women 69 , older people, persons with disabilities, and disadvantaged and marginalised groups, like people with a minority racial or ethnic background and people living in poverty.
These inequalities are unacceptable in a European Health Union that seeks to protect everyone. There should be no first- and second-class cancer patients in the EU. Europe’s Beating Cancer Plan aims to address these inequalities across the entire disease pathway. It will tackle these issues also in conjunction with the actions under the Pharmaceutical Strategy for Europe and the forthcoming EU Disability Rights Strategy.
Flagship 9: In 2021, the Commission will establish a Cancer Inequalities Registry. It will identify trends, disparities and inequalities between Member States and regions. Alongside regular qualitative assessments of the country-specific situation, the Registry will identify challenges and specific areas of action to guide investment and interventions at EU, national and regional level under Europe’s Beating Cancer Plan.
Several actions outlined in the Cancer Plan will address inequalities between and within EU Member States. The updated Council Recommendations on cancer screening will advise Member States on the latest approaches to cancer screening, coupled with quality assurance schemes and accreditation for screening and treatment of breast, colorectal and cervical cancer. The EU Network of Comprehensive Cancer Centres will support Member States in establishing at least one National Comprehensive Cancer Centre by 2025 70 , ensuring that 90% of eligible patients have access to such Centres by 2030.
To reduce inequalities in access to healthcare services, Member States can benefit from EU Cohesion Policy Funds, for instance through the use of mobile healthcare units for cancer screening, or laboratory diagnostics. This is particularly important for those living in the most deprived and isolated communities with restricted access to large urban centres. These projects aim to provide healthcare and cancer services, with an emphasis on disease prevention and early diagnosis. The mobile units, staffed with a multidisciplinary team, visit communities on a regular basis and connect with established health facilities. The Commission will also promote the use of advanced mobile technologies by healthcare providers through the future EU4Health and Digital Europe programmes. Digital Europe supports the deployment of fast connectivity in line with the Gigabit Society targets for 2025 71 . The EU will offer priority funding to projects involving health facilities with a public service mission. Finally, by supporting the delivery of affordable, accessible and fair mobility for all, the Smart and Sustainable Mobility Strategy will help to better connect people and patients in remote areas with hospitals and healthcare hubs.
The COVID-19 pandemic has even further hit the most disadvantaged groups in our society, including cancer patients. Isolation and containment measures due to the COVID-19 pandemic have affected their follow-up care and quality of life. The EU is working to ensure continued and equitable access to care, including in crisis situations, and Europe’s Beating Cancer Plan is a key part of these efforts.
Actions in this area include strengthening and integrating telemedicine and remote monitoring in health and care systems by supporting research, innovation and deployment actions with EU funds. This will help to protect immunosuppressed cancer patients from exposure to infectious diseases such as COVID-19. These developments can also support patients in remote or rural areas. Furthermore, the virtual consultation model of the European Reference Networks will be promoted to support knowledge-sharing among healthcare professionals. Through the EHDS, the Commission will work to remove barriers to cross-border provision of digital health services. Measures will also include training and continuous education for the cancer workforce.
Flagship initiative on inequalities
ØLaunch a Cancer Inequalities Registry to map trends in key cancer data identifying inequalities between Member States and regions– 2021-2022.
Other actions
ØStrengthen and integrate telemedicine and remote monitoring in health and care systems; promote the virtual consultation model of the ERNs – 2021-2023.
ØImprove the overall resilience, accessibility and effectiveness of European health systems to safeguard provision of cancer care in future health crises – 2021-2025.
ØMainstream equality action in other areas addressed by Europe’s Beating Cancer Plan such as screening and high-quality cancer care – 2021-2025.
8.Putting childhood cancer under the spotlight
The European Union can and should do more to protect our children from cancer. In 2020, over 15,500 children and adolescents were diagnosed with cancer, with over 2,000 young patients losing their lives to it 72 . In fact, cancer is the principal cause of death by disease in children beyond the age of one. However, important differences exist between childhood and adult cancers in terms of the type of cancer, how far it spreads, and how it is treated. For example, by the time they are diagnosed, 80% of paediatric cancers have already spread to other parts of the body, compared to about 20% of adult cancers.
Flagship 10: In 2021, the Commission will launch the ‘Helping Children with Cancer Initiative’ to ensure that children have access to rapid and optimal detection, diagnosis, treatment and care. This initiative will be funded under the future EU4Health programme to facilitate access to early diagnosis and quality treatment through the new Network of Comprehensive Cancer Centres. It will support training and enable the sharing of best practice and standards of care for children with cancer, complementing the actions implemented by the new European Reference Networks.
Up to 30% of children affected by cancer suffer severe long-term consequences. As the number of childhood cancer survivors continues to grow, comprehensive care, treatment and follow-up are essential to help young patients make a good recovery and enjoy an optimal quality of life 73 . The new ‘Cancer Survivor Smart-Card’ will also address the specificities of childhood cancer survivors, including long-term monitoring of outcomes and potential toxicity of treatments, rehabilitation, psychological support, educational modules, connectivity with healthcare staff, and information about past clinical history. The Card will also help tailor follow-up care for the child patients, with the input of carers and in agreement with the family. Beyond the individual level, the upgraded European Cancer Information System with a new section, specifically tailored and dedicated to childhood cancers will facilitate monitoring and further research. In addition, the revision of the Orphan and Paediatric Regulations will be reviewed to improve the conditions for studying and authorising new cancer medicines for use in children.
The Commission will establish in 2022 a new ‘EU Network of Youth Cancer Survivors’ to complement the actions under the ‘Helping Children with Cancer Initiative’, which will connect young cancer survivors and their families as well as informal and formal carers. The Network will help strengthen long-term follow-up in cancer care plans at national and regional level. Children, adolescents and young adult survivors will be nominated as Network representatives in Member States. Particular attention should be given to limit the disruptive impact of cancer on the education of children and young people affected by cancer, either as patients or carers.
Young cancer patients will also be supported under the foreseen Horizon Europe Cancer Mission. For example, the planned ‘Childhood cancers and cancers in adolescents and young adults: cure more and cure better’ initiative could increase understanding of cancer initiation and progression and boost the transformation of paediatric cancer care with evidence based information to advance diagnostics, treatment and survivorship support.
Flagship initiative on paediatric cancer
ØLaunch the ‘Helping Children with Cancer Initiative’ to ensure that children have access to rapid and optimal detection, diagnosis, treatment and care – 2021.
Other initiatives
ØEstablish an ‘EU Network of Youth Cancer Survivors’– 2021-2022.
ØLaunch the Childhood cancers and cancers in adolescents and young adults’ initiative to increase understanding of paediatric cancer – 2022-2025.
9.Funding
Europe’s Beating Cancer Plan will be implemented, enabled and supported using the whole range of Commission funding instruments with a total of €4 billion being earmarked for actions addressing cancer. A substantial share of the future EU4Health programme, totalling €1.25 billion, will be used to support actions and initiatives outlined in the Cancer Plan. For instance, major initiatives that will receive support include the ‘EU Mobile App for Cancer Prevention’, the ‘EU Network of Comprehensive Cancer Centres’, ‘Helping Children with Cancer’, ‘Better Life for Cancer Patients’, the ‘Knowledge Centre on Cancer’ and the ‘EU Inter-specialty Training’.
Financial support will also be provided through other EU funding instruments, reflecting the whole-of-government approach and diversity of actions coming under Europe’s Beating Cancer Plan. For example, the Horizon Europe Framework Programme for Research and Innovation 74 could provide a total of up to €2 billion to support the foreseen Mission on Cancer and other cancer related research projects including for research infrastructures and the Partnerships. Erasmus+, the European Institute for Technology and Marie Skłodowska-Curie actions could provide up to a total of €500 million for projects in education, training and research in the field of cancer 75 . The Digital Europe programme will provide financial support of up to €250 million for cancer-related project, and support wider digital investments, such as relating to electronic data, cybersecurity and digital skills from which the health sector will benefit.
The Cohesion Policy Funds (European Regional Development Fund, Cohesion Fund and European Social Fund Plus) will provide support to Member States and their regions to improve their health systems’ resilience, accessibility and effectiveness. In this context, funding will support actions ranging from health promotion and disease prevention, improving access to prevention, early detection and screening, and treatment, as well as research and development projects relating to oncology. The funds could, for example, invest in equipment and infrastructure in oncology wards and prevention centres, in the development and implementation of telemedicine, eHealth applications and tools, or in health workforce skills for cancer care. While most interventions will be implemented in national or regional programmes, in line with state aid rules, the Interreg programmes under the European Regional Development Fund also offer cross-border or transnational funding possibilities 76 .
As Cohesion Policy Funds are under shared management, Member States and their national and regional authorities will be responsible for setting priorities on the basis of existing needs, and carrying out these investments. Member States are strongly encouraged to make full use of all options to implement the measures included in the Cancer Plan.
Under the ‘Next Generation EU’ EU budget and recovery plan, an unprecedented Recovery and Resilience Facility, with a budget of €672.5 billion in non-repayable support and loans, is being created to finance reforms and investments. The Facility will support the recovery from the COVID-19 pandemic and help overcome its economic and social impact. Member States are prompted to identify investments that may include health infrastructure, equipment, digital transformation of healthcare, manufacturing capacity for medicines and medical devices, in particular if they are linked to addressing the Country Specific Recommendations, which guide the reforms and investment to be supported by the Facility, including in cancer care.
In addition, the Commission has put forward a proposal for a Technical Support Instrument 77 , to provide practical support to all EU Member States who express interest in institutional, administrative and growth-enhancing reforms.
Cancer-related investments by Member States and public and private entities could also be mobilised through EU budget guarantees, for instance through the InvestEU programme. It will offer loans and equity financing for investments in hospitals, primary care and community care facilities, eHealth, the healthcare workforce, and in innovative health products, services and care models. To facilitate the use of EU funding instruments for cancer investment, the Commission will set up a knowledge sharing mechanism to inform Member States about the different EU funding mechanisms and how they can be utilised.
10.International collaboration and coordination
The Commission has a longstanding collaboration with international organisations such as WHO and OECD on health issues including on cancer. This cooperation will continue to be pursued for instance with WHO within the recently agreed framework of collaboration on non-Communicable diseases 78 , which has a key focus on cancer. In addition the Commission will re-inforce its work with specialised agencies and actors such as WHO’s International Agency for Research on Cancer 79 , or the European Network of Cancer Registries 80 to facilitate collaboration to take action against cancer also beyond the borders of the EU. Furthermore, continued EU support to strengthening health systems in partner countries and advancing universal health coverage including primary health care, directly contributes to improving prevention, detection, treatment and care of cancer.
Third countries will benefit from the work and actions under the Europe’s Beating Cancer Plan, notably through collaborative research within the framework of Horizon Europe. To effectively tackle global challenges such as cancer, international cooperation will be significantly strengthened within Horizon Europe to ensure access to talent, knowledge, know-how, peer to peer experts, facilities and markets worldwide. In addition, outputs and evidence generated by the Cancer Plan, notably best practices, lessons learnt, guidelines or screening programmes, will be made available and can be implemented and adapted to the national contexts of third countries. Accompanying partner countries in cancer campaigns and outreach associating EU Delegations, international actors and UN agencies on the ground is key for an effective impact. For example, the guidelines, or systematic reviews produced through the European Commission Initiative on Breast Cancer 81 are already, or will be used in several countries outside of the EU 82 .
11.Implementation and governance: delivering together
The Commission will establish the EU Cancer Plan Implementation Group, to align actions and policies across the European Commission and other EU institutions. The group will meet regularly to discuss and review implementation of the Cancer Plan and of the foreseen Horizon Europe Mission on Cancer. It will work closely with:
·the European Parliament committees that deal with cancer-related issues;
·Member States (through the Steering Group on Health Promotion, Disease Prevention and the Management of Non-Communicable Diseases);
·the Cancer Mission Board functioning as a scientific advisory group; and
·a stakeholder contact group, in particular consisting of patient groups, established under the Commission’s Health Policy Platform.
The Commission will be meeting with representatives of these institutions and stakeholder groups in regular intervals, at least twice per year. This approach will enable EU institutions and stakeholders to work together more consistently and make ownership of Europe’s Beating Cancer Plan fully inclusive.
The implementation of the Cancer Plan will be monitored through an implementation roadmap and progress indicators. The roadmap and indicators will reflect the actions included in the Cancer Plan and will undergo regular review by the Implementation Group. Building on the augmented European Cancer Information System, the Commission will also regularly collect and publish relevant data to monitor trends and feed into the Cancer Inequalities Registry. This will also help monitor progress for all actions in the Cancer Plan, including their impact on competitiveness, the environment, and health beyond cancer.
Europe’s Beating Cancer Plan will be reviewed by the end of 2024. The review will assess whether the action taken is sufficient to achieve the objectives, or whether additional measures are necessary.
12.Conclusion
Europe can collectively do more. In a strong European Health Union, addressing cancer needs to become a shared political, operational and scientific priority. Europeans expect and deserve to live in a society that protects them from avoidable cancers, that ensures early detection, and that provides equitable, affordable, high-quality and sustainable cancer care to those who need it. Europe’s Beating Cancer Plan is an ambitious strategy that offers specific solutions to meet these expectations. It aims, first and foremost, to prevent cancer, and to ensure cancer patients, survivors, their families and carers can enjoy a high quality of life.
The COVID-19 pandemic has challenged the EU, its Member States and the population in unprecedented ways. However, of all the lessons learned in 2020, the clearest is that citizens have put health first among their priorities, and that they expect Europe to do more to protect it. The pandemic has shown that there is enormous strength in collaboration, solidarity and unity of purpose. This lesson also applies strongly to cancer prevention, treatment and care. The success of Europe’s Beating Cancer Plan requires a whole-of-society effort that follows the ‘Health in All Policies’ approach.
Cancer care is no longer the responsibility of the health sector alone. It requires engagement and buy-in from a wide range of sectors and stakeholders. With ten flagship initiatives and multiple supporting actions that address the entire disease pathway, this is a plan for Europe. It is inclusive, giving everyone concerned a stake in its success; and, above all, it is people-centred, focusing on patients’ needs throughout.
The European Commission invites all Member States, stakeholders and citizens across the EU to come together and ensure that Europe’s Beating Cancer Plan delivers. Together, we can reverse the rising trend of cancer across the EU and secure a healthier, fairer and more sustainable future for all, in line with the United Nations Sustainable Development Goals. Together, we can strip away the fear and uncertainty that come with a cancer diagnosis – and replace them with knowledge, determination, dignity and hope. Together, we can make a difference and defeat cancer.
(1) Most recent estimates from the European Cancer Information System (ECIS) for the EU-27 countries. New diagnoses cover all types of cancer, apart from non-melanoma skin cancer.
(2) https://gco.iarc.fr/tomorrow/en/ .
(3) mRNA (messenger Ribonucleic acid) is the molecule that direct cells in the body to make proteins. It can be used to make vaccines to prevent or treat specific diseases, such as certain types of cancer or viruses like COVID-19.
(4) See Article 168 of the Treaty on the Functioning of the European Union.
(5) The Cancer Mission Board, an independent expert group of the Commission, has prepared an outline with 13 recommendations for consideration which will serve as basis for the implementation of the Cancer Mission, https://ec.europa.eu/info/publications/conquering-cancer-mission-possible_en .
(6) https://ec.europa.eu/research/eic/index.cfm .
(7) https://eit.europa.eu .
(8) The Marie Skłodowska-Curie Actions (MSCA) are the EU flagship programme for researchers’ mobility and training through the development of excellent doctoral programmes, collaborative research and fellowship schemes, and contribute to excellent research, https://ec.europa.eu/research/mariecurieactions/node_en .
(9) OECD (2019), Health in the 21st Century: Putting Data to Work for Stronger Health Systems, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/e3b23f8e-en .
(10) https://ec.europa.eu/digital-single-market/en/content/european-digital-strategy .
(11) Real-world data is health-related data derived from a diverse human population in real-life settings. Such data can include medical health records, registries, biobanks, administrative data, health surveys, observational studies, health insurance data, data generated from mobile applications etc.
(12) Also known as supercomputing, this refers to computing systems with extremely high computational power that are able to solve hugely complex and demanding problems. https://ec.europa.eu/digital-single-market/en/policies/high-performance-computing .
(13) In this respect the European Interoperability Framework will underpin these efforts, https://eur-lex.europa.eu/legal-content/en/TXT/?uri=CELEX:52017DC0134 .
(14) Couespel, N., et al., Strengthening Europe in the fight against cancer, study for the Committee on Environment, Public Health and Food Safety, Policy Department for Economic, Scientific and Quality of Life Policies, European Parliament, Luxembourg, 2020.
(15) https://eur-lex.europa.eu/eli/reg/2016/679/oj .
(16) An electronic health record is a collection of longitudinal medical records or similar documentation of an individual, in digital form (Commission Recommendation (EU) 2019/243 of 6 February 2019 on a European Electronic Health Record exchange format).
(17) Agarwala, V. et al. (2018), Real-World Evidence In Support Of Precision Medicine: Clinico-Genomic Cancer Data As A Case Study, Health Affairs, Vol. 37/5, pp. 765-772.
(18) The European Cancer Information System (ECIS) will become a part of the Knowledge Centre on Cancer, https://ecis.jrc.ec.europa.eu/ .
(19) Cancer staging describes the extension of a tumour, and takes into account its size, the invasion of adjacent organs, and the presence in other more distant organs (metastatic cancer).
(20) For example with data from the Human Biomonitoring for EU programme ( https://www.hbm4eu.eu/ ) or environmental data available via the Information Platform for Chemical Monitoring ( https://ipchem.jrc.ec.europa.eu /).
(21) World Health Organization, Regional Office for Europe, 18.02.2020 at https://www.euro.who.int/en/health-topics/disease-prevention/tobacco/news/news/2020/2/tobacco-use-causes-almost-one-third-of-cancer-deaths-in-the-who-european-region .
(22) For instance: novel tobacco products, e-cigarettes, herbal products for smoking.
(23) According to Eurobarometer data, the trend has reversed for youth smoking rates (age 15-24) which went down to 20% in 2020, from 25% in 2014, following a peak of 29% in 2017.
(24) Council Directive 2011/64/EU.
(25) Article 32 of Directive 2008/118/EC.
(26) WHO Framework Convention on Tobacco Control, Article 5(3), https://www.who.int/fctc/text_download/en/ .
(27) https://ec.europa.eu/transparencyregister/public/homePage.do .
(28) For the EU Member States, UK, Norway, and Switzerland: https://www.euro.who.int/__data/assets/pdf_file/0009/386577/fs-alcohol-eng.pdf
(29) Between 2010 and 2016 in the European Union only a 1.5% reduction in total consumption has been reached: WHO fact sheet on the SDGs: Alcohol consumption and sustainable development (2020).
(30) https://ec.europa.eu/taxation_customs/sites/taxation/files/ study_assessing_articles_32_and_36_of_council_directive_2008118ec_concerning_the_general_arrangements_for_excise_duty.pdf .
(31) Brief interventions (BI) for alcohol have been shown to be effective in the management of alcohol consumption for harmful alcohol drinkers, who are not seeking treatment. BI is a discussion aimed at raising an individual's awareness of their risky behaviour as a way of motivating them to change it.
(32) Wild CP, Weiderpass E, Stewart BW, editors (2020). World Cancer Report: Cancer Research for Cancer Prevention, Lyon, France: International Agency for Research on Cancer. http://publications.iarc.fr/586 .
(33) https://ec.europa.eu/food/farm2fork_en
(34) Commission initiative to review promotion policy for EU agricultural food products, Regulation (EU) 1144/2014 https://ec.europa.eu/info/law/better-regulation/have-your-say/initiatives/12782-Information-and-promotion-measures-for-agricultural-and-food-products-in-the-internal-market-and-in-non-EU-countries .
(35) https://monographs.iarc.fr/wp-content/uploads/2018/06/mono114.pdf .
(36) https://www.eltis.org/sites/default/files/linking_transport_and_health_in_sumps.pdf .
(37) Mortality data for the year 2012 and the WHO European Region high income group of countries; see https://www.eea.europa.eu/publications/healthy-environment-healthy-lives.
(38) https://www.eea.europa.eu/publications/healthy-environment-healthy-lives.
(39) At least one in eight European deaths is caused by environmental pollution and in particular poor air quality, EEA Report No 21/2019.
(40) Erickson, BE: Linking pollution and infectious disease (2019), c&en – Chemical & Engineering News, Volume 97, Issue 11.
(41) Substances such as perfluorooctane sulfonate and perfluorooctanoic acid are associated with reduced antibody response to vaccination; EFSA, Scientific opinion on PFAS.
(42) Fitness check of the Ambient Air Quality Directives SWD(2019) 427.
(43) https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health .
(44) https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A52020PC0571 .
(45) https://osha.europa.eu/en/facts-and-figures/workers-exposure-survey-cancer-risk-factors-europe .
(46) Council Directive 2013/59/Euratom laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation.
(47) COM(2020) 667 final. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions on a “Chemicals Strategy for Sustainability Towards a Toxic-Free Environment”.
(48) Based on the three key pillars of the global strategy, the WHO recommends a set of targets or milestones that each country should meet by 2030 to get on the path to eliminating cervical cancer within the century: https://www.who.int/news/item/19-08-2020-world-health-assembly-adopts-global-strategy-to-accelerate-cervical-cancer-elimination .
(49) https://ec.europa.eu/health/sites/health/files/state/docs/2018_healthatglance_rep_en.pdf .
(50) https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX:32003H0878 .
(51) The three types of cancer addressed by the Council Recommendation on cancer screening which, in 2003, were the only ones to have the prerequisite to be addressed by population based screening.
(52) https://ec.europa.eu/info/research-and-innovation/strategy/support-policy-making/scientific-support-eu-policies/group-chief-scientific-advisors_en .
(53) The action is expected to help increase the five-year net survival rate of patients with cervical, breast and colorectal cancer by 2025. It will also reduce existing inequalities in survival rates between EU Member States.
(54) Principle 16 of the European Pillar of Social Rights.
(55) https://ec.europa.eu/health/sites/health/files/state/docs/2018_healthatglance_rep_en.pdf .
(56) The establishment of national Comprehensive Cancer Centres and their networking at EU level are being recommended by the Horizon Europe Cancer Mission Board and the EU Joint Action CanCon, https://cancercontrol.eu/ .
(57) https://ec.europa.eu/health/ern_en .
(58) https://ec.europa.eu/social/main.jsp?catId=1223&langId=en .
(59) https://ec.europa.eu/digital-single-market/en/news/using-european-supercomputing-treat-coronavirus .
(60) https://ec.europa.eu/digital-single-market/en/european-1-million-genomes-initiative .
(61) Policy Paper on Public Health Genomics in Cancer, https://cancercontrol.eu/archived/uploads/PolicyPapers27032017/Policy_Paper_1_Genomics.pdf .
(62) Cancer is a disease that can be affected by changes in either one or many genes, frequently coupled with environmental factors. A ‘polygenic risk score’ can inform people about their risk of developing a disease, based on the total number of genetic changes related to specific diseases, including some types of cancers.
(63) https://ec.europa.eu/info/research-and-innovation/strategy/goals-research-and-innovation-policy/open-science/eosc_en .
(64) Cancer Control Joint Action (CanCon ): https://cancercontrol.eu/archived/uploads/images/Guide/042017/CanCon_Guide_7_Survivorship_LR.pdf .
(65) Patient organisations refer to this issue as so called “Right to be forgotten”, which however should not be confused with the same terminology used in the context of the General Data Protection Regulation .
(66) https://ec.europa.eu/info/european-pillar-social-rights-0/european-pillar-social-rights-20-principles_en .
(67) COM (2021) 50 final, 27.01.2021.
(68) https://ec.europa.eu/health/sites/health/files/state/docs/2020_healthatglance_rep_en.pdf.
(69) This is for instance due to comparatively lower financial resources women have at their disposal to absorb the monetary consequences of cancer and less time resources for treatment and recovery, due to the persistent gender pay, earnings, and pension gaps and women’s disproportionate caring responsibilities, https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A52020DC0152.
(70) For larger Member States, one Centre per 5 million inhabitants is recommended.
(71) ‘Connectivity for a Competitive Digital Single Market - Towards a European Gigabit Society’ (COM(2016) 587 final).
(72) Most recent estimates from the European Cancer Information System (ECIS) for the EU-27 countries.
(73) https://siope.eu/media/wp-content/uploads/2013/09/European_Standards_final_2011.pdf .
(74) Beside the proposed Cancer Mission, Horizon Europe finances research and pilot projects under the thematic areas in the “Health” cluster with a EUR 8.2 billion budget.
(75) Due to the bottom-up nature of these programmes the funding cannot be provided through dedicated calls. Therefore this indicative amount reflects the budget of previous cancer-related projects in the period 2014-2020.
(76) E.g. under the cross-border cooperation Interreg programme for the Euregio Meuse-Rhine (Aachen-Maastricht-Liège), the university hospitals cooperate on cancer treatment: https://www.oncocare.eu/ or on rare diseases: https://www.emradi.eu/en/about-emradi .
(77) The Technical Support Instrument (TSI) is the successor to the Structural Reform Support Programme (SRSP)
(78) Joint Statement of the European Commission and the WHO Regional Office for Europe “A deeper and result oriented partnership for health in Europe” of 14 September 2020.
(79) https://www.iarc.who.int/ .
(80) https://www.encr.eu/ .
(81) https://healthcare-quality.jrc.ec.europa.eu/european-breast-cancer-guidelines
(82) Bahrain, Chile, China, Mexico, Tunisia.