The state of the art of cancer control in 30 European countries in 2008

Abstract

Inequalities in cancer incidence, mortality and survival represent a major challenge for public health. Addressing this challenge requires complex and multidisciplinary approaches. Sharing successful experiences from across Europe may therefore be of benefit. We describe the state of the art of cancer control structures in the 27 European Union countries, plus Iceland, Norway and Switzerland, at the beginning of 2008. Information on cancer plans, cancer registries, cancer screening, Human Papillomavirus (HPV) vaccination and smoking restrictions in each country was identified through PubMed, the official websites of national and international organizations and Google TM searches. Experts and/or health authorities from each country completed and validated the information. Sixteen countries had implemented national cancer plans in 2008. Twenty four countries had population-based cancer registries with 100% coverage. The exceptions were Greece and Luxembourg (no population-based registry yet), France, Italy and Spain (<50%), and Switzerland (62%). In 9 countries, population coverage of breast cancer screening was 100% with participation ranging from 26 to 87%; 8 countries did not have organized programmes. Seven countries had cervical cancer screening programmes with 100% coverage with participation ranging from 10 to 80%; 8 countries had no organized programme. Nine countries had announced national HPV vaccination policies by early 2008. Six countries had organized colorectal cancer screening programmes. Five countries had complete bans on smoking in public places. There is wide international heterogeneity in cancer control structures in Europe. This provides considerable scope and motivation for cooperation and sharing of experience.Considerable progress in cancer control has been made in the European Union (EU) in recent decades, but cancer continues to affect millions of individuals, their families and society in general, and it is a growing concern for health care systems, because of the human and material resources required to manage it. Inequalities in cancer incidence, mortality and survival, both between and within EU Member States, represent a major challenge for public health. Most of the 10 Member States that joined the EU in 2004 have higher cancer mortality 1 and less favorable survival trends 2 than the rest of the EU.The prevention and control of oncological diseases requires complex multidisciplinary approaches, from the promotion of healthy lifestyles and prevention to screening, diagnosis, treatment, rehabilitation and palliative care. Further improvement of cancer control in Europe requires a continuous dialogue between all stakeholders, and the sharing of experience and good practices. Better coordination of health policies between European countries is desirable. Cancer prevention and control must be recognized as a priority in European public health strategy, focused on the reduction of inequalities in access to early detection and treatment in all European countries.The range of strategies a...

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