National cancer planning instruments in Europe and their developments

National cancer plans (NCPs) saw a strong push with the recommendation of the European Commission from 2009, which called upon Member States to adopt NCPs or national cancer strategies. This process resulted in rapid adoption of NCPs. Joint Action EPAAC developed the European Guide for Quality National Cancer Control Programmes in support of their preparation. Europe's Beating Cancer Plan poses a new task and challenge in the need to transpose its recommendations into the national cancer documents.

3.N. Workshop: Toward Europe Beating Cancer Plan goal of 80% awareness of the European Code Against Cancer in 2025

Cancer cases continue rising worldwide and cancer remains a leading cause of death in Europe. Almost 4.4 million new cases of cancer were diagnosed in Europe in 2020 and almost 2 million deaths were due to cancer. These projections will increase to more than 5 million new cases and 2.5 million deaths in 2040, only taking demographic changes into account, and corresponding to around 100 million new cancer patients over the next 20 years. Studies in Europe and elsewhere estimate that around 40% of cancers could be prevented if current understanding of risk and protective factors would be translated into effective primary prevention, with further reductions in cancer incidence and mortality by early detection of cancer. By far tobacco represents the largest contributor to cancer, with studies showcasing its responsibility for around 20% of the cancer burden and thereby causing almost half of all preventable cancers. Other important risk factors include excess weight and unhealthy diet, alcohol, infections and other environmental and occupational exposures. Scientific evidence has been translated into a set of public health recommendations within the European Code against Cancer (ECAC). The ECAC informs the general public on the steps to take to reduce their cancer risk, and is Europe's key cancer prevention tool to improve health literacy on cancer risks and prevention measures. The recently launched Europe's Beating Cancer Plan announced that “The European Code against Cancer will be updated to take into account the latest scientific developments and will add new evidence-based recommendations to improve health literacy. The Cancer Plan will aim to make at least 80% of the population aware of the Code by 2025.” After over three decades of ECAC's promotion, we present the results from the first study assessing its impact in Europe at population and health promoters' level. This study serves as a baseline of the awareness of the ECAC in Europe and paves the way towards a scaled-up systematic evaluation. Also, the French Cancer Barometer has monitored changes in the perception of cancer risk factors over 10,000 people during a 10-year follow-up. Such a national case-study has the potential to be scaled-up at European level. Finally, the Eurobarometer is an Europe-wide tool that provides regular public opinion surveys, including on health, in all Member States. In this workshop we explore options including the Eurobarometer as a potential tool to measure progress towards the Cancer Plan aforementioned goal. The objectives of this workshop are: to provide the rationale for a standard, sustainable and Europe-wide tool to measure progress on awareness on the ECAC and its recommendations, in order to reach the goal of 80% awareness of the ECAC by 2025, to build upon national best practices on the assessment of population perceptions on cancer risk factors, to showcase and discuss with participants on available European tools and metrics towards a Cancer Barometer. Key messages “What gets measured, gets done”. We call for standard and sustained measuring tools at European level to measure progress towards the health literacy goal of 80% awareness of the Code by 2025. Current awareness of many cancer risk factors and the European Code across Europe is low. The French Cancer Barometer is presented as a country-case study with potential to be scaled-up EU wide.

Breast cancer treatment and survival differences in women in remote and socioeconomically disadvantaged areas, as demonstrated by linked data from New South Wales (NSW), Australia

Introduction Reducing variations in cancer treatment and survival is a key aim of the NSW Cancer Plan. Variations in breast cancer treatment and survival in NSW by remoteness and socioeconomic status of residence were investigated to determine benchmarks. Reducing variations in cancer treatment and survival is a key aim of the NSW Cancer Plan. Variations in breast cancer treatment and survival in NSW by remoteness and socioeconomic status of residence were investigated to determine benchmarks. Methods A retrospective cohort study used linked data for invasive breast cancers, diagnosed in May 2002 to December 2015 from the NSW Cancer Registry, with corresponding inpatient, and medical and pharmaceutical insurance data. Associations between treatment modalities, area socioeconomic status and residential remoteness were explored using logistic regression. Predictors of breast cancer survival were investigated using Kaplan–Meier product-limit estimates and multivariate competing risk regression. Results Results indicated a high 5-year disease-specific survival in NSW of 90%. Crude survival was equivalent by residential remoteness and marginally lower in lower socioeconomic areas. Competing risk regression showed equivalent outcomes by area socioeconomic status, except for the least disadvantaged quintile, which showed a higher survival. Higher sub-hazard ratios for death occurred for women with breast cancer aged 70 + years, and more advanced stage. Adjusted analyses indicated more advanced stage in lower socioeconomic areas, with less breast reconstruction and radiotherapy, and marginally less hormone therapy for women from these areas. Conversely, among these women who had breast conserving surgery, there was higher use of chemotherapy. Remoteness of residence was associated in adjusted analyses with less radiotherapy and less immediate breast reconstruction. In these short term data, remoteness of residence was not associated with lower survival. Conclusion This study provides benchmarks for monitoring future variations in treatment and survival.

Implementation of Cancer Plans in the United States: A Review

State cancer plans facilitate prioritization and stakeholder engagement in preventing and controlling cancer. Implementation plans further help stakeholders prioritize efforts, reduce redundancy, and find opportunities for work synergies. A review of cancer plan implementations plans was performed in the development of an implementation plan for the Florida Cancer Plan. This review sought to identify, characterize, and summarize the use of implementation plans that support comprehensive cancer control activities. Although 100% of states and territories published a cancer plan and 78% of states provided funding for implementing their state cancer plans, only 32% published an implementation plan. Commonalities and unique features of state cancer plan implementations are presented and discussed. An example implementation plan is provided for states without a plan to model.

The Lack of Coherence in the European Union’s Approach to Noncommunicable Disease Prevention

This chapter focuses on the extent to which the European Union's (EU) and its Member States have addressed the growing rates of non–communicable diseases (NCDs) through the development and implementation of effective prevention policies. After discussing the powers that the EU derives from the EU Treaties to address the main commercial determinants of health through the adoption of EU–wide harmonizing rules, it compares the EU regulatory response to tobacco on the one hand, and unhealthy diets and alcohol on the other. It then reflects on the role that the EU Court of Justice has played in the prevention of NCDs in Europe, before concluding with a few remarks on what the future may hold in this policy area now that the new EU Commission in post has announced its ‘Beating Cancer Plan’ and its ‘Farm to Fork Strategy’.

NURS-03. DEVELOPMENT OF A PATIENT-HELD TREATMENT SUMMARY FOR PAEDIATRIC CNS TUMOUR PATIENTS

BACKGROUND Following the Scottish Government Cancer Plan 2012–15(1) ‘End of Treatment’ summaries for paediatric oncology patients treated in SE Scotland have been successfully implemented. However, it became evident that the particular needs of patients with CNS tumours were not adequately captured on the standardised documentation. METHODS In view of these difficulties an alternative document was prepared specifically for this patient cohort by the multi-disciplinary team, including Nurse Specialists, Paediatric Neuro-oncology and Neuro-psychology. This was designed to be a flexible, fluid summary to be used for all such patients regardless of tumour grade or treatment modality and included those undergoing surveillance only. OUTCOMES: The document is primarily completed by the Neuro-Oncology Nurse Specialist alongside the patient and family, usually following initial treatment and is used alongside their holistic needs assessment. The document is circulated to all involved professionals, including Primary Care, and a copy is retained by the patient. This then provides a concise source of information detailing diagnosis and treatment, any specific ongoing sequelae and details of red flag symptoms to alert patients and health professionals to the potential of relapse or other associated significant health problems. These treatment summaries are currently being piloted and have been well received thus far. They will be formally audited in due course with the aim to use nationally throughout Scotland in future.

The Roadmap for Action on AMR

The speaker will present the perspective of civil society, as well as its extensive work to raise awareness and bring together stakeholders committed to tackling AMR across Europe. The Stakeholder Network on AMR, hosted within the European Commission's Healthcare Policy Platform, along with the resulting Roadmap for Action on AMR will be presented. The speaker will explain how the Roadmap and the key strategies and targets identified encompass a 'One-Health' approach, emphasising that AMR can only be addressed through concerted cross-sectoral actions, ranging from infection prevention, better diagnostics and supporting Member States in implementing National Action Plans. The links between AMR and other EU initiatives such as the emerging Cancer Plan, the Farm to Fork Strategy and the European Green Deal will also be elaborated on. Finally, the role of the European Parliament in ensuring that AMR stays high on the agenda and mobilising Member States to act, will be discussed in the context of a newly established MEP Interest Group on AMR with an ambitious strategic work programme for the Parliamentary term 2019 - 2024.