Strengthening prevention through early detection: A new EU approach on cancer screening - Main contents

EN

Official Journal of the European Union

C 473/1

Pursuant to Article 168(1) of the Treaty on the Functioning of the European Union, a high level of human health protection is to be ensured in the definition and implementation of all Union policies and activities. Union action, which is to complement national policies, is to be directed towards improving public health, preventing physical and mental illnesses and diseases, and obviating sources of danger to physical and mental health. Such action shall cover the fight against the major health scourges, by promoting research into their causes, their transmission and their prevention, as well as health information, education and monitoring.

Further development of cancer screening programmes should be implemented in accordance with national law and national and regional responsibilities for the organisation and delivery of health services and medical care in line with Article 168(7) of the Treaty on the Functioning of the European Union.

Cancer is a major disease and cause of death throughout Europe. In 2020, an estimated 2.7 million people in the Union were diagnosed with cancer. Extrapolating from the figures for 2020, it is estimated that one in two Union citizens will develop cancer during their lifetime, with long-lasting consequences for their quality of life, and only half of all cancer patients will survive.

Council Recommendation 2003/878/EC (1) sets out recommendations for cancer screening in the Union. It encourages EU Member States to implement population-based, quality-assured screening programmes, and it has been instrumental in improving cancer screening and ensuring that the vast majority of people in the target age ranges, from all socio-economic groups and throughout the territory, have access to organised screenings.

Additionally, the governance, organisational requirements and evaluation of cancer screening have been discussed and information has been shared at Union level, together with the experience acquired through the actions on cancer screening supported under the EU Health Programme (2).

Screening makes it possible to detect cancers at an early stage, or possibly even before they become invasive. Some lesions can then be treated more effectively, with a greater chance that patients can be cured. The main indicator of the effectiveness of screening is a reduction in disease-specific mortality or in incidence of invasive cancers.

Evidence shows the efficacy of screening for breast, colorectal, cervical, (to a limited extent) lung and prostate cancers, and gastric cancer in certain circumstances. All of Wilson and Jungner’s criteria (3) for responsible screening, as well as the additional criteria set out by the WHO (4), should be used to assess the feasibility of a screening programme.

Screening is the process of testing for diseases in people in whom no symptoms have been detected. In addition to its beneficial effect on disease-specific mortality and on incidence of invasive cancers, the screening process also has inherent limitations, which can have negative effects for the screened population. These include false positive results, which can cause anxiety and may require additional testing that may pose potential risks, false negative results, which provide false...