Download 6.5 Cancer

6.5
Cancer
See Background Chapter 6.5
Cancer (a term comprising over 100 types of malignancy) is one of the major burdens
of chronic disease in Europe and the world. In 2000, malignant tumours were
responsible for 12% of the nearly 56 million deaths worldwide from all causes. In many
countries, more than one-quarter of all deaths are attributable to cancer. In 2000,
5.3 million men and 4.7 million women developed a malignant tumour and there were
6.2 million cancer deaths. It is predicted that cancer rates could increase by 50% to
15 million new cases in the year 2020.1
Although Europe comprises only about one-eighth of the world’s population, it
accounts for over one-quarter of the global burden of cancer incidence. Standardized
mortality rates for all cancers among all age groups in Europe reveal steady or
decreasing rates in the EU15 countries and increasing mortality rates in some, but not
all, EU10 countries.2
Barring major therapeutic breakthroughs in the short term, cancers are still a major
public health concern, in large part because of the preventable nature of some of the
most common cancers.3 Of these, tobacco consumption remains the most important
avoidable cancer risk. In the twentieth century, approximately 100 million people
worldwide died from tobacco-associated diseases (cancer, chronic obstructive lung
disease, heart disease and stroke).
The pharmaceutical industry has invested heavily in finding new pharmaceutical
treatment options for cancer, and analysis of cancer medicines in clinical development
suggests that its present level of effort is appropriate, based on the relative burden of
different cancer types. Yet, despite this major input by the private sector, many cancers
are still resistant to treatment and the struggle to find effective medicines is ongoing.
Europe does not at present match the private or public funding levels of the USA with
regard to cancer therapeutic research and development. It is recommended that the EU
should expand its capacity (infrastructure and human resources) and strengthen
coordination to conduct comparative Phase II/III clinical trials and continue to invest in
basic research into cancer biology.
The EU should continue to pursue excellence in cancer research within the existing
financing structures. There is a need for an increase in the level of basic research into
cancer biology. Global funding for cancer research appears overwhelmingly to be
concentrated in the USA. For Europe, improving the efficiency of the cancer R&D
process is important.
1
World cancer report 2003. Geneva: World Health Organization, International Agency
for Research on Cancer; 2003 Available from: http://www.iarc.fr/WCR
2
Bray F, Sankila R, Ferlay J, Parkin DM. Estimates of cancer incidence and mortality in
Europe in 1995. Eur J Cancer 2002;38(1):99-166.
3
National Cancer Control Programmes: Policies and management guidelines. Geneva:
World Health Organization; 1995.