Brexit and COVID could cause European cancer epidemic

With an estimated one million cancer diagnoses missed across Europe in the last two years, the impact of the COVID-19 pandemic is predicted to set back European cancer outcomes by almost a decade, finds a new report published today by The Lancet Oncology.

Following a major re-examination of the present state of European cancer research and its future, a Lancet Oncology Commission: 'European Groundshot—addressing Europe's cancer research challenges', co-led by Professor Richard Sullivan at King's College London, provides a "sobering sense check" of the significant challenges that need to be urgently addressed to improve cancer survival rates in Europe.

The COVID-19 pandemic has exposed weaknesses in the European cancer research landscape, with clinicians seeing 1.5 million fewer cancer patients in the first year of the pandemic and one-in-two cancer patients failing to receive surgery or chemotherapy in a timely manner. Additionally, 100 million cancer screening tests were missed.

The study also finds Brexit will continue to negatively impact European cancer research unless European funders/research community and the UK government/research community find a way for continued collaboration.

"UK cancer research in the post-Brexit world stands at a crossroads where strategic decisions will determine whether we continue to thrive and partner internationally or whether isolationism will reduce our world standing," says Sullivan.

"If the UK is not involved in EU collaborative cancer research and not part of Horizon Europe's research community, this will have an extremely detrimental effect on European cancer research activity. Ultimately, patients with cancer will pay the price for this decision in terms of health-care outcomes."

The Lancet Oncology Commission identifies gaps in the European cancer research landscape and calls for a doubling of the European cancer research budget, as well as prioritization of underserved cancer research areas, including prevention and early diagnosis, radiotherapy and surgery, implementation science, action on gender equality, and a deeper focus on survivorship.

Experts say that prioritizing cancer research is crucial for European countries to deliver more affordable, higher quality, and more equitable cancer care, with patients treated in research-active hospitals having better outcomes than those who are not.

Professor Sullivan continued, "Despite significant investment in public cancer research over the last decade, research portfolios remain over-focused on discovery science and biopharmaceutical research. There has been a lack of funding and research in many key areas such as prevention, palliative care, surgery, and especially health services and systems. How to translate innovations into the real world is a key missing area and the Commission calls on all European countries to change strategies to address this."

"The Commission provides clear evidence that research is not an add-on luxury but an essential pillar for countries to build their national cancer control programs to deliver high quality, affordable and equitable outcomes."

The report also outlines how Russia's invasion of Ukraine represents another huge challenge to 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 Ukrainian cancer clinical trials include cancer centers in central and eastern European countries and the conflict will likely result in many of these major trials being delayed or failing to recruit.

Authors recommend that, as a matter of extreme urgency, the European cancer community must gather data on the impact of the conflict on patients, cancer services, medicines and other shortages, and workforce gaps, in Ukraine and in neighboring countries, as well as developing a plan to mitigate the impact of the war on cancer research.

Lead author and Chair of the Commission, Professor Mark Lawler at Queen's University Belfast, said, "With the backdrop of the COVID-19 pandemic, Brexit, and the Russian invasion of Ukraine, it is more important than ever that Europe develops a resilient cancer research landscape to play a transformative role in improving prevention, diagnosis, treatment, and quality-of-life for current and future patients and those living beyond cancer.

"We estimate that approximately one million cancer diagnoses were missed across Europe during the COVID-19 pandemic. We are in a race against time to find those missing cancers. Additionally, we saw a chilling effect on cancer research with laboratories shut down and clinical trials delayed or canceled in the first pandemic wave."

"We are concerned that Europe is heading towards a cancer epidemic in the next decade if cancer health systems and cancer research are not urgently prioritized. Our European Groundshot Commission provides crucial findings on the current landscape of cancer research, exposes the key gaps, and demands the prioritization of European cancer research agendas over the next decade."

More information:
Mark Lawler et al, European Groundshot—addressing Europe's cancer research challenges: a Lancet Oncology Commission, The Lancet Oncology (2022). DOI: 10.1016/S1470-2045(22)00540-X

Provided by King's College London