Europe’s chance to save lives and increase quality of life for prostate cancer patients
For a number of years now, the European Association of Urology has been working with patient cancer organisations to raise the profile of prostate cancer in EU policies and activities. With the EU Cancer Plan, the European Commission has a unique opportunity to take forward the fight against prostate cancer and to build consensus, so that together, we can beat this disease.
Why is prostate cancer an important condition for the EU to address? Well, first and foremost, prostate cancer is a serious European public health issue that has a significant impact on patients and their families, and on health systems across Europe. Prostate cancer is the most common male cancer, and killed 107,000 men in Europe in 2018; it is thus not an indolent disease. It is responsible for 10% of all male cancer deaths and is the second cause of male cancer death before colorectal cancer. Today, prostate cancer kills more men than breast cancer kills women.
Despite this significant public health burden, relatively little is performed at EU level on prostate cancer, particularly in comparison to breast, cervical and colorectal cancers, which have all benefited from technical guidelines from the European Commission on early detection (on the basis of a mandate from the European Council Recommendations in 2003 on cancer screening).
Earlier in 2020, in order to respond to the consultation on the EU Cancer Plan, we joined forces with Movember, Europa Uomo, the European Cancer Patient Coalition and the European Alliance of Personalised Medicine to update our 2017 White Paper on Prostate Cancer. This updated White Paper gives recommendations on how the EU Cancer Plan can tackle prostate cancer.
One clear recommendation from the White Paper is to add prostate cancer to the list of cancers that benefit from European Commission supported guidelines on early detection. The evidence is clear: early detection of prostate cancer in well- informed men saves lives, improves quality of life and reduces costs for health care systems. We would like the EU Cancer Plan to tackle EU wide guidance on this, as it has done with other cancers in the past.
The early detection of prostate cancer has been controversial because the use of PSA testing (that is the test that measures the amount of prostate specific antigen (PSA) in the blood to estimate the risk of prostate cancer in men) has led to a drop in mortality rates, but has come at the cost of over-diagnosis and overtreatment.
The most updated scientific evidence supports the use of PSA in early detection of prostate cancer with a risk-adapted approach in informed men, thus avoiding over-diagnosis and overtreatment. PSA can now be used more cleverly with Magnetic Resonance Imaging (MRI) and further risk stratification (using risk calculators which are freely available on the web) in men at higher risk. This combined approach will allow a substantial reduction of over-diagnosis and the number of men who need to undergo biopsy. Also, with the application of MRI- guided active surveillance for all low- and some intermediate- risk prostate cancers, the monitoring of patients can happen less invasively. This approach is reflected in the multidisciplinary ‘EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer’ https://uroweb.org/guideline/prostate-cancer/.
The EU Cancer Plan offers the European Commission a unique opportunity to tackle this issue and support EU member states to deliver consistent and clear guidelines on early detection of prostate cancer. By doing this, it can save lives and increase quality of life outcomes for patients across Europe.
We invite anyone interested in this subject to join us on 17 November at 17h30 for a virtual event on prostate cancer in the EU Cancer Plan, focusing on early detection. For more registration and more information on the event and the prostate cancer campaign, please see epad.uroweb.org.