The OECD Forum Network is a space for experts and thought leaders—from around the world and all parts of society—to exchange expertise and perspectives across sectors. Opinions expressed do not necessarily represent the views of the OECD.

As part of an OECD Forum series, the virtual event Closing the Cancer Gap: Towards Better Screening and Treatment took on place 8 December 2022. This event has ended but don't worry, you can still ► watch the replay!

We have reached a crucial inflection point for cancer research and cancer care in Europe. The COVID-19 pandemic, national lockdowns, the war in Ukraine and the cost-of-living crisis have created a perfect storm which, if not addressed as a matter of urgency, threatens to precipitate a cancer epidemic, unravelling our progress on cancer survival and setting us back at least a decade, and probably much more. The picture is undoubtedly bleak, but we also have a significant opportunity to reimagine cancer research and its implementation across Europe. The ambitious but achievable goal? An average of 70% ten-year survival rates for all European patients with cancer by 2035.

This “70:35” vision is central to a report released in November 2022 by The Lancet Oncology European Cancer Groundshot Commission, containing the most comprehensive evaluation of cancer research in Europe to date. Over the last three and a half years, I have had, with my colleague Professor Richard Sullivan from King’s College London, the privilege to lead this Europe-wide expert panel of scientists, clinicians and patients as we sought to identify and prioritise the cancer challenges. But most importantly, we are also developing patient-relevant solutions, articulated through a Call for Action and a series of 12 Recommendations which, if acted upon, will deliver our 70:35 Vision for the whole of Europe.

This Groundshot will empower a more person-centred, data-informed cancer research agenda and, most crucially, its implementation across Europe.

The European Cancer Groundshot Commission echoes the US Cancer Moonshot that then Vice President Joe Biden championed during the Obama presidency, and which he re-ignited in 2022 on World Cancer Day. But does Europe really need a Cancer Moonshot? In developing our Lancet Oncology European Groundshot Commission on cancer research and its implementation for better patient care, we argued that a more citizen-centred, patient-focused and less techno-centric approach is more appropriate to the challenges that cancer poses for Europe. Rather than shooting for the moon, cancer research and its prioritisation for Europe must reflect what is happening on the ground (hence, the European Groundshot). This Groundshot will empower a more person-centred, data-informed cancer research agenda and, most crucially, its implementation across Europe.

Our findings are in many ways a significant wake-up call for Europe. The impact of COVID-19 on cancer services and cancer patients has been alarming.

Approximately 100 million cancer screening tests have not been performed, while almost one million cancer diagnoses have been missed—we are in a race against time to find these missing diagnoses. Impacts on treatment have also been severe, with one-in-two cancer patients missing their chemotherapy or surgery at the pandemic’s nadir. The herculean efforts of the cancer workforce in supporting what was essentially an infection control health service have also taken their toll: four-out-of-ten staff are burned out, with three out of ten showing signs of clinical depression.

But our work has revealed other challenges that need to be addressed—cancer research in western Europe has doubled in the last 12 years, whereas in Eastern Europe it has stagnated.

Reproduced with permission from The Lancet Oncology / © Elsevier Ltd

The cancer research spend in Europe is €26 per head, almost tenfold less than the equivalent spend in the United States. And its not only what we spend: it’s how we spend it. Our findings show that for a disease like lung cancer, which constitutes 21% of the European cancer burden, we only devote 4% of our research efforts and resources.

Reproduced with permission from The Lancet Oncology / © Elsevier Ltd

Common cancer killers such as colorectal and pancreatic cancers are also underresearched. The focus of our research is also too narrow; we need to include more on prevention, early detection and survivorship to address the significant challenges that the 20 million European citizens living beyond a cancer diagnosis experience, some of which manifest themselves every day of their lives.

Cancer research is not a luxury but a necessity, and an integral part of 21^st century cancer medicine.

Crucially, we must deliver. Europe has been good at breakthroughs, with our strong cancer science base making really significant discoveries; mRNA technology, originally developed for cancer research applications but now the lifesaving lynchpin of the COVID vaccine effort, being a case in point. What we are not as good at is the follow-through: translating this excellent science into tangible benefit for patients. We need to invest more in health services research and implementation science (currently our investment is less than 4%), so that our best discoveries are rapidly translated to the clinic.

Our work has also revealed that patients who are treated in research-active hospitals have better outcomes than those who are not. Thus, cancer research is not a luxury but a necessity, and an integral part of 21^st century cancer medicine. Our Lancet Oncology European Cancer Groundshot Commission, with its Call to Action and 12 Recommendations, are firmly based on and empowered by comprehensive data intelligence, and not opinion or conjecture. 

Reproduced with permission from The Lancet Oncology / © Elsevier Ltd

They provide an opportunity to reimagine cancer research, but more importantly to direct its implementaion across Europe for the benefit of its citizens. Let’s grasp that opportunity.

As part of an OECD Forum series, the virtual event Closing the Cancer Gap: Towards Better Screening and Treatment took on place 8 December 2022. This event has ended but don't worry, you can still ► watch the replay!