EAU pushes for the inclusion of early detection of prostate cancer in the EU Cancer Plan

In its constant devotion to improving patient care, the EAU has become increasingly active in the European political landscape. Prof. Hein Van Poppel (Leuven, BE), Adjunct Secretary General responsible for education, is the driving force behind the EAU’s activities in Brussels, in close collaboration with EAU policy coordinator Mrs. Sarah Collen (Brussels, BE). One of their current priorities is getting prostate cancer, the most common male cancer in Europe, on the EU political agenda. The goal is to get early detection and diagnosis of prostate cancer included in Europe’s Beating Cancer Plan (EU Cancer Plan).

With the EU Cancer Plan, the European Commission aims to reduce the cancer burden for patients, their families and health systems. Prof. Van Poppel explains: “The EU Cancer Plan will be the first comprehensive EU strategy on cancer in thirty years, covering the whole continuum of cancer care: from prevention and early detection, through to treatment and care, and on to survivorship and quality of life. It will support, coordinate and complement EU member states’ efforts to fight cancer.”

Since the announcement of a new EU Cancer Plan after the 2019 European Parliament election, the EAU has taken several actions. Prof. Van Poppel: “In April 2020, we updated our white paper on prostate cancer to respond to the EU Cancer Plan in partnership with Movember, the European Cancer Patient Coalition (ECPC), Europa Uomo, and the European Alliance for Personalised Medicine (EAPM). We want the EU Cancer Plan to provide funding for an EU-wide awareness-raising campaign on prostate cancer and to mandate and endorse clinical guidelines, such as the EAU Guidelines on Prostate Cancer, on early detection and diagnosis of prostate cancer. These guidelines can be taken up by EU member states in their national cancer plans. The EU already provides guidance on screening for breast, cervical and colorectal cancer. We are asking for prostate cancer to be added to the list. Multiple studies provide robust evidence confirming that early detection of prostate cancer saves lives and improves quality of life, and prostate cancer has been overlooked by the EU far too long.”

“The EAU is well positioned to provide these clinical guidelines. We already have the scientific evidence and guidance available with our guidelines, so it is only a matter of endorsing them. To make this happen, we are working in partnership with our strategic partners such as patient organisations, research foundations, and industry partners, but also with the EU’s Joint Research Centre (JRC) and the Innovative Partnership for Action Against Cancer (iPAAC), within which we are working together with EU member states toward a joint EU action on cancer. PIONEER, the big data platform to enhance prostate cancer diagnosis and treatment, serves as a great example for our potential role in this specific part of the EU Cancer Plan; PIONEER is funded by the EU’s Innovative Medicines Initiative, and the non-industry consortium is led by our EAU Guidelines Office.”

Progress achieved

“As a result of our clear, targeted strategy on prostate cancer in relation to the EU Cancer Plan, Sarah and I were invited for a virtual meeting with leading members of the European Commission as they draft the EU Cancer Plan. We met with a variety of high-level officials, including project leader Matthias Schuppe and John F. Ryan, the Directorate-General for Health and Food Safety (DG SANTE), who has the overall responsibility for the EU Cancer Plan. We were given the opportunity to present the white paper and our call for the EU to include guidance on early detection of prostate cancer. We have already produced an algorithm for what will be a potential way forward for risk-stratified early detection of prostate cancer in well informed men. This algorithm is at the time of writing [mid-August – Ed.] under review for publication in European Urology.”

“We have also organised a number of European Prostate Cancer Awareness Days (EPADs) in the European Parliament to raise awareness among Members of the European Parliament (MEPs), European Commissioners, EU officials, and civil servants from across the EU. Besides EPADs, we have met with multiple MEPs to keep calling attention to our goals. For instance, we have met the two chairs of the MEPs Against Cancer (MAC) Interest Group: Veronique Trillet-Lenoir from France and Loucas Fourlas from Cyprus. Petra De Sutter from Belgium, vice-chair of MAC, signed up for our prostate cancer campaign. And we have a long-standing relationship with Cristian Busoi from Romania, whom I first met in Romania during its EU Presidency. He is the new chair of the European Parliament Challenge Cancer Intergroup and the spokesperson for the European Parliament on the new EU4Health Programme, which will be one of the vehicles for the funding of the EU Cancer Plan. Although COVID-19 has made it impossible to meet her in person, we have also been corresponding with Commissioner Stella Kyriakides and her cabinet.”

A draft of the EU Cancer Plan is planned for release in the fourth quarter of 2020. Prof. Van Poppel: "As a result of our successful campaign, we see from the results of the European Commission's public consultation on the EU Cancer Plan that there is strong support for the addition of prostate cancer to the list of cancers that need pan-European guidelines for screening. Prostate Cancer came second only to ovarian cancer on the list of priorities. This is a first significant success of our joint campaign work with national societies, which will allow us to approach the European Commission with more proof that this issue is a shared concern for citizens across the EU."

“In anticipation of the draft of the EU Cancer Plan, we are organising the 2020 edition of EPAD (EPAD20). The programme for EPAD20 involves a meeting with key European parliamentarians. It will take place on Tuesday, 17 November, on the eve of the European Cancer Organisation’s annual summit,” Prof. Van Poppel says. “This summit brings together oncology specialists, patient advocates, politicians and policymakers both online and in Brussels. The day before, we want to promote scientific guidance on risk-stratified early detection of prostate cancer and to push for more EU action on this. MEPs Tomislav Sokol from Croatia and Tiemo Wölken from Germany will co-chair our meeting. It will be helpful to have a German MEP chairing and to involve Germany in some way as Germany holds the EU Presidency from July to December 2020, which means they chair the meetings and try to steer the EU agenda.” Portugal (January-June 2021), Slovenia (July-December 2021), and France (January-June 2022) are up next to hold the EU presidencies.

Patient advocacy

All EAU’s political activities share the same ultimate goal: improving patient outcomes. Another factor in achieving this is patient involvement. Empowering patients to take co-responsibility for the management of their condition enhances medical outcomes. This is done by, among other things, transferring knowledge. For this reason, the EAU established the EAU Patient Advocacy Group (EPAG) in 2019 to help disseminate knowledge to patient advocacy groups, patient organisations, and caregivers. EPAG consists of healthcare professionals and patient representatives from five patient organisations: ECPC, Europa Uomo, the World Bladder Cancer Patient Coalition (WBCPC), the International Kidney Cancer Coalition (IKCC), and the Association of European Cancer Leagues (ECL).

Prof. Van Poppel: “Whatever we are doing in Brussels needs to make sense to patients and bring value to them. We want to achieve better outcomes for those who are impacted by cancer. That means that we need to be working hand-in-hand with those whose lives are impacted by cancer. For example, working with EPAG has helped us produce a leaflet on PSA testing that lists the pros and cons of going for a test.”

“For our recommendations for the EU Cancer Plan, we have been working in partnership with patient advocacy groups to identify the main issues around prostate cancer for patients and to give recommendations that ensure patient outcomes will be as positive as possible. Not only is it the EAU’s ambition to increase patient involvement, but we also want to act as a united front with patient advocacy groups at the European political stage. Through this united front, we will be able to reach our goals in Brussels.”