The Covid bill on cancer is a ‘time bomb’. A report published today in “The Lancet Oncology” warns of something that organizations such as the Spanish Society of Medical Oncology (SEOM) or the Spanish Association Against Cancer have been warning for some time. The impact of the Covid-19 pandemic may delay cancer outcomes in Europe by almost a decade as there have been one million missed cancer diagnoses across Europe in the last two years.
In Spain, as a consequence of the first wave, it was calculated that one in five people who have cancer is not being diagnosedeither due to fear of Covid-19 or simply due to the saturation of an increasingly stressed health system.
What the Covid-19 has caused has been a worsening of the reality of this silent pandemic that is cancer, assured Ramón Reyes, president of the Spanish Association against Cancer.
From lac AECC it is estimated that the lack of diagnosis or late diagnosis could have affected around 40,000 or 50,000 people at the end of 2020. Covid-19 has been “a blow to cancer patients, which can take its toll in the medium and long-term survival rates”, lamented Ramón Reyes, who denounced in particular that the primary care blockade and the stoppage of screening “causes there to be a pool of people who may have cancer and when they reach the system they do so in more advanced stages, which will pose serious problems.”
The document now published by “The Lancet Oncology” analyzes the impacts of the Covid-19 pandemic on treatment and, especially, on cancer research. In addition, it presents a series of recommendations to mitigate these problems.
The expert committee that produced the document identifies gaps in the European cancer research landscape and calls for a doubling of the European budget for cancer research, as well as for neglected areas of cancer research to be prioritized, including prevention and treatment. early diagnosis, radiotherapy and surgery, gender equality programs and a deeper focus on survival.
The Covid-19 pandemic has highlighted the weaknesses of cancer health systems and the cancer research landscape across Europe which, if not urgently addressed, will set cancer outcomes back by almost a decade, he argues.
The authors of the report bet that cancer research in Europe should have a more patient-centred approach, instead of a technocentric one.
Against the backdrop of the Covid-19 pandemic, Brexit and the Russian invasion of Ukraine, it is more important than ever for Europe to develop a research landscape resilient cancer to play a transformative role in improving prevention, diagnosis, treatment and quality of life for current and future patients and those living beyond cancer,” says Mark Lawler of Queen’s University Belfast, UK. Kingdom) and President of the Commission.
“We estimate that one million cancer diagnoses have been missed across Europe during the pandemic. In addition, we have detected a chilling effect in cancer research with the closure of laboratories and the delay or cancellation of clinical trials in the first wave of the pandemic. We are concerned that Europe is heading towards a cancer epidemic in the next decade if health systems and cancer research are not urgently prioritized.”
The Commission, which has analyzed data on the impact of the pandemic across Europe, has found that doctors saw 1.5 million fewer patients with cancer in the first year of the pandemic, and one in two cancer patients did not receive surgery or chemotherapy.
Furthermore, they estimate that 100 million cancer screening tests were missed and that up to a million Europeans could have undiagnosed cancer. Taking these findings into account, one of the key recommendations is that the European cancer research community accelerate the research response to the indirect impacts of the Covid-19 pandemic on cancer and that, now more than ever, cancer is duly protected and prioritized in current and future European research agendas.
The Russian invasion of the Ukraine represents another major challenge for cancer research in Europe. Russia and Ukraine are two of the largest contributors to clinical cancer research in the world, especially industry-sponsored clinical research. Many cancer clinical trials in Ukraine include cancer centers in Central and Eastern European countries, and the conflict will likely cause many of these major trials to be delayed or not carried out.
Russia and Ukraine are two of the largest contributors to cancer clinical research in the world, especially industry-sponsored clinical research.
To this is added that the industry could consider that carrying out clinical trials in cancer in countries bordering Ukraine is too high a risk: the loss of private sector investment would be very detrimental to cancer research.
“While there has been a lot of news coverage about the Russian invasion of the Ukraine, its profound and continuing impact on clinical research has not been reported of cancer. There is already a growing east-west gap in European cancer research and it is crucial that the war between Russia and Ukraine does not cause this gap to widen,” says Andreas Charalambous, President of the European Cancer Organization.
The report also predicts that Brexit will continue to have a negative impact on European cancer research. Analyzing data comparing research activity in the EU28 (including the UK) with research activity in the EU27 (excluding the UK) found a significant gap that is highly unlikely to be resolved by increased research activity of the remaining EU27.
“If the UK does not participate in the EU collaborative cancer research and is not part of the research community of the Programa Horizon Europe, this will have an extremely detrimental effect on European cancer research activity. Ultimately, cancer patients will pay the price for this decision in terms of health care outcomes,” said Richard Sullivan, co-director of the Commission on the King’s College de Londres (United Kingdom)
The analysis of investment in cancer research in Europe in 2010-19 further finds that the total amount of investment, excluding the private sector, was around 20 to 22 billion euros, around 26 euros per capita. The minimum equivalent figure for the US during the same period was US$80.5 billion (about €76 billion and €234 per capita). Given this dramatic gap in per capita spending, the Commission calls for the European budget for cancer research to be doubled to €50 per capita by 2030.
The Commission argues that the investigation for the cancer prevention in particular has not received the funding it deserves. A greater focus on cancer prevention would reduce the number of people who develop cancer and thus make more resources available to those who require treatment. The report calls for a significant change in the priorities of cancer prevention, cancer detection and early detection research to reduce the cancer burden for European citizens and allow those who develop cancer access to more resources and best treatments available.
It is estimated that 40% of cancers in Europe could be prevented
“It is estimated that 40% of cancers in Europe could be prevented if primary prevention strategies made better use of the current understanding of cancer risk factors. Evidence-based, cost-effective cancer preventive interventions are already available. Furthermore, up to a third of cancer cases in Europe are more likely to have a better outcome if detected early, but unfortunately we found that screening rates vary widely between different European countries. More research is needed to understand why people do not participate in screening programs of cancer across Europe,” says Anna Schmutz of the International Agency for Research on Cancer (France).
The gender equality in cancer research is another crucial gap identified in by this commission. Thus, the document determined the gender of the principal investigators in Europe for 22,291 cancer research projects: the majority of principal investigators were men and less than 33% were women, reflecting the gender inequality that exists.
Lawler believes that we are facing “an unparalleled opportunity to reimagining cancer research and its implementation to achieve our ambitious 70 Vision: 35, an average 70% 10-year survival for patients treated for cancer in Europe by 2035. Let us seize this opportunity.”