Even before Covid-19 struck, cancer was a leading cause of premature death, but the impact of the pandemic on early diagnosis and treatment is likely to set back cancer outcomes in Europe by almost a decade.

That’s the stark message from a Lancet Oncology Commission report, ‘The European Groundshot – addressing Europe’s cancer research challenges’, published yesterday (15 November).

The Commission on cancer research, led by Prof Mark Lawler, from Queen’s University Belfast, saw a wide range of experts analyse new data on cancer research activity across Europe over the past 12 years. Insights from the data have helped inform Europe’s ‘Beating Cancer Plan’ and the EU Cancer Mission, while the researchers have also set out a patient-centred cancer research roadmap for Europe. 

Among the most significant findings, the research shows that 100 million screening tests were not performed during the pandemic, while more than 1 million cancer diagnoses were missed. Against this backdrop, there is a warning that cancer must not become “the forgotten C” in the fight against Covid, and lung cancer should receive greater research attention than is currently the case.

The Commission also highlights limitations with discovery science and biopharmaceutical research in Europe. It advocates a widening of research focus to include such areas as disease prevention and early diagnosis; treatment approaches such as radiotherapy and surgery; and greater effort on developing a research and innovation strategy for the millions of Europeans living with cancer.

Additionally, the data highlight the key role of comprehensive cancer centres in driving the European cancer research agenda. There is a need, says the Commission, for a stronger emphasis on health policy and systems research, including implementation science. This would enable innovative technological outputs from cancer research to have a clear pathway to delivery, the researchers argue.

Disparities between and within European countries are analysed, in relation to survival, and research activity, output, and funding. A specific focus, concludes the Commission, should be on central and eastern Europe, since the data underlines a widening gap in cancer research activity, capacity and outcomes compared with the rest of Europe. The Commission proposes a pan-European approach to overcome this issue, and this forms part of a dozen key recommendations within a call to action on cancer research and its implementation in Europe. The aim is to achieve a 70:35 target: 70 per cent average survival for all European cancer patients by 2035.

Recommendations outlined in the report include: doubling implementation science and health services research activity by 2024; doubling cancer research funding in Europe to €50 per head by 2030; enhancing gender equality in cancer research; delivering a data dashboard by 2023 to capture and mitigate in real time the impact of Covid-19 on cancer; establishing a European Cancer Survivorship Research Plan by 2023; and deploying comprehensive cancer centres to advance cancer research and its translation into clinical care.

Geopolitical events and tensions are also seen as an impediment to cancer research. The war in Ukraine, for example, is significant because both Russia and Ukraine are described as two of the world’s largest contributors to clinical cancer research. Brexit is also identified as likely to have a negative impact on European cancer research.

Writing in The Lancet Oncology, the researchers say: “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates, as a result of substantial delays in cancer diagnosis and treatment. This cancer stage shift will continue to stress European cancer systems for years to come.

“These issues will ultimately compromise survival and contribute to inferior quality of life for many European patients with cancer.”

The report ‘European Groundshot – addressing Europe’s cancer research challenges: A Lancet Oncology Commission’ can be viewed on The Lancet’s website.