Highlights of the Slovenian EU Presidency Cancer Conference - The Burden of Cancer – How Can it be Reduced?  

February 7-8, 2008 -  Brdo, Slovenia

 

Colette D. Lukan, MD, FRCPC
EORTC Communications Manager

The Republic of Slovenia, which assumed the Presidency of the European Union on January 1st 2008, designated cancer as a leading health priority for its six month term in office. Calling for closer cooperation between EU Member States to help combat the disease, Slovenia hosted a major conference on “The Burden of Cancer – How Can it be Reduced?” [1] on February 7-8, 2008, in Brdo, Slovenia. The gathering, which was attended by European policymakers, NGOs, leading health experts, researchers and patient advocates, aimed to highlight the magnitude of the problem and stimulate the exchange of information and experiences in the fields of cancer prevention, screening, integrated care and research. A further objective was to explore comprehensive strategies to tackle the disease at the national as well as regional level.

The Slovenian Minister of Health, Zofija Mazej Kukovic, was passionate in her support for the fight against cancer in her opening speech recognizing that one in three EU citizens will suffer from cancer and one in four will die from cancer. The increasing life expectancy and ageing of the EU population will result in a rise in the number of cancer patients, leading to an even greater future healthcare burden. The Minister remarked, that although much had already been achieved, more work lie ahead. She also noted that the time had come to look ahead and to examine how to strengthen those aspects that have proven useful and to search for new forms of mutual cooperation and assistance. The significant gaps among and within individual Member States, as reflected by different morbidity and mortality rates for cancer patients cannot be ignored. These gaps are partly the consequence of differences in the provision of a comprehensive approach to cancer control which includes prevention, early detection, treatment, rehabilitation, palliative care and research. The Minister encouraged and underscored the importance of sharing experiences, peer learning and cooperation for future progress in the field which will help reduce the burden of cancer for patients, their families and friends as well as society as a whole [2].

Several keynote speeches, addressing a broad range of highly relevant current topics, were delivered by an impressive representation of policymakers and leading cancer experts [3]. Four parallel thematic workshops served as a platform for discussion, debate and recommendations on: Primary Prevention and Health Promotion; Cancer Screening – Implementation of Proven Strategies; Integrated Cancer Care; and Cancer Research - Finding New Solutions [4].

Dr. Tanja Cufer, Professor of Oncology at the University of Ljubljana Faculty of Medicine and senior consultant at the Institute of Oncology in Ljubljana, Slovenia, participated as an EORTC Board member and presenter in Workshop IV which focused on finding new solutions to cancer research. In her presentation, “Challenges and Barriers to Academic Cancer Research” [5], Professor Cufer highlighted the scale of the current problem of cancer worldwide and in Europe but also how cancer research has resulted in significant improvements in 5-year survival rates for many malignancies over the past thirty years. She pointed out how high quality, international, independent clinical cancer research is essential to the discovery of new effective preventive, diagnostic and treatment strategies; to the transfer of new laboratory findings into state-of-the-art clinical practices and to the elimination of less effective and redundant treatments, the end result leading to “best practice” medicine and optimal cancer control.

The advantages of large-scale multinational clinical trials, such as those conducted by the EORTC, include the ability to demonstrate even small improvements in patient survival that significantly impact public health;  the ability to study sufficient numbers of patients with rarer cancers and to discourage smaller,  national studies which rarely demonstrate clinical practice-changing outcomes. Professor Cufer outlined the current threats to academic cancer research today, namely, increased bureaucratic and administrative workload, costly and non-uniform implementation of EU clinical trial directive procedures, regulatory hurdles for bio-specimen handling as well as financial constraints due to the lack of independent research funding. These threats have resulted in a decreasing interest in academic cancer research. Changes to the clinical trial directive that might alleviate some of these threats include further clarification, guidance and harmonisation in the framework of the current and revised legislation and support for non-commercial research, including the waiving of fees, harmonisation of insurance requirements and coverage, data handling support and infrastructure financial support. These proposed changes would ensure that EU patients receive the best medical care.

Professor Cufer concluded by offering solutions that will help save academic cancer research. These measures consist of adapting EU clinical trial legislation to support and regulate clinical research as whole and not only drug development, increasing the availability of clinical trial information in the public domain, introducing legislation for the handling and storage of bio-specimens, improved funding for non-commercial cancer trials and encouraging public-private research partnerships.

            These proposed measures were also echoed and further developed by all  participants of the 4th Workshop on new solutions for cancer research. The panel noted that more clinical/translational research needs to take place across Member State boundaries, achievable through increased collaboration via the formation of pan-European research centre networks and improved financial stimulation of these networks. Most EU member states and the EU commission need to increase investment in cancer research. More EU money should be dedicated to unified pan-European research activities that add European value. The new public health-related research focus of the 7th Framework Programme is a good start; however, Member States should encourage public health-related cancer research spanning prevention and screening to treatment and palliation with this new funding. New modes of collaborative partnerships are needed between academia, industry and patient organisations to ensure the survival of academic non-commercial research which will in part be aided by increased transparency and public awareness of ongoing clinical research.

 

            The Slovenian Minister of Health provided inspiration, in her closing speech, when summarizing all that was shared, discovered and agreed upon during the two day conference. “We can only be successful if our work is complementary. We have to strive for more synergy among Member States, European institutions and civil society, as well as international organisations at the global level. I strongly believe that the Slovenian initiative on cancer presents a new opportunity to strengthen our endeavours to reduce the cancer burden. Great interest and your commitment here at the conference confirm my belief that we are going to use this opportunity to our advantage.”