Across the EU, cancer inequalities are stark along the entire care pathway – prevention, screening and early detection, diagnosis and treatment, and survivorship care. HPV vaccination rates remain far below the 90% target in most countries; colorectal cancer screening ranges from 5% in some Member States to 76% in others; and access to guideline-recommended lung cancer medicines varies from about 50% to nearly 80%. These gaps translate into unequal survival and quality of life. Only eight Member States guarantee cancer survivors the “Right to be Forgotten”, showing that where a person lives in Europe can still determine their cancer outcome.
To address and help overcome these inequalities, on 14th February 2024, Cancer Patients Europe (CPE), together with the Central European Cooperative Oncology Group (CECOG), launched the European Semester on Health Manifesto at the European Parliament during the high-level event “Cancer Momentum: Fighting Inequalities Across Europe”.
The initiative addressed one of Europe’s most pressing challenges: persistent and unacceptable inequalities in cancer care, grounded in the conviction that where you live should not determine if you live.
The event, hosted in collaboration with MEPs from the EPP and S&D, presented the CPE–CECOG joint manifesto on addressing cancer inequalities through the European Semester. Speakers, including MEPs Andreas Schieder (S&D), Cristian Bușoi (EPP), and Tomislav Sokol (EPP); Dr. Caroline Berchet (OECD); patient advocates Alina Comanescu (Community Health Association Romania) and Patrycja Rzadkowska (EuropaColon Poland); as well as Prof. Christoph Zielinski (CECOG) and CPE Chair of the Board Francisco Lozano, highlighted persistent disparities across the cancer pathway and called for coordinated, data-driven, and patient-centred action at the EU level.
The launch marked a milestone in CPE’s advocacy to ensure that the chances of surviving cancer are not dependent on geography. By placing cancer inequalities at the heart of EU economic and governance discussions, the Manifesto aims to move beyond commitments and towards concrete, measurable action.
What is the CPE European Semester on Health Manifesto?
The European Semester is the EU’s primary framework for coordinating economic, fiscal, and social policies across Member States. Since 2020, health has been formally included in the Semester process through health-related thematic annexes in country reports, reflecting growing recognition of the link between health, economic resilience, and social stability. However, these considerations have so far remained limited in scope and are often framed predominantly through a budgetary lens.
CPE argues that health outcomes and cancer outcomes, in particular, must be more systematically and meaningfully embedded within the EU economic governance. Health is not only a social priority; it is a fundamental driver of workforce productivity, competitiveness, and long-term sustainability. The European Semester on Health Manifesto therefore calls for the structured integration of cancer-related indicators into the Semester process, enabling measurable, comparable, and accountable action on cancer inequalities across Europe.
With strong political momentum at the EU level and robust data already available through instruments such as the European Cancer Inequalities Registry, cancer is well placed to serve as a pilot for strengthening the health dimension of the European Semester.
Why Cancer and Why Now?
Cancer remains a top EU priority, underpinned by flagship initiatives such as Europe’s Beating Cancer Plan and the European Cancer Inequalities Registry. Together, these initiatives have generated unprecedented data and policy frameworks that can now be better connected to EU governance mechanisms. While health has begun to feature in the European Semester since 2020, and by 2024 health indicators appeared in the main country’s reports of seven Member States, these references remain limited and largely financial in nature.
Persistent inequalities across the cancer pathway from prevention and screening to diagnosis, treatment, and survivorship remain stark and well-documented. Access to HPV vaccination, organised screening programmes, advanced diagnostics, innovative medicines. The survivorship protections continues to vary dramatically across countries and regions, translating into unequal outcomes and preventable deaths.
Many of the actions needed to address these gaps sit at the national level, making coordination, transparency, and accountability essential. By embedding cancer-specific, standardised, and comparable indicators into the European Semester, EU and national commitments under Europe’s Beating Cancer Plan can be systematically tracked, discussed, and followed up through evidence-based country-specific recommendations. As CPE firmly believes, what gets measured gets done.
The Manifesto’s Core Objectives
The Manifesto sets out two clear and actionable objectives:
- Pilot the inclusion of cancer and cancer – related indicators in the European Semester process, making cancer outcomes visible within EU governance and enabling structured dialogue between the European Commission and Member States.
- Further develop the Inequalities Registry, with the goal of creating a European cancer dashboard that can feed into the European Semester pilot, allowing transparent comparison, monitoring, and follow-up on cancer outcomes across countries.
Together, these actions aim to strengthen accountability, support evidence-based policymaking, and foster closer collaboration between EU institutions, national governments, patients, clinicians, and other stakeholders.
Building Momentum Beyond the Parliament
The goals set out by the Manifesto did not stop at its launch at the European Parliament in February 2024.
With further engagement at the European Health Forum Gastein (EHFG), where stakeholders reiterated the need to use cancer as a pilot area within the European Semester framework. The session brought together a diverse panel of high-level speakers, including Christoph Zielinski (CECOG), Silvia Ganzerla (EuroHealthNet), and MEP Vytenis Andriukaitis (S&D, Lithuania), stressing the political urgency of keeping cancer high on the EU agenda.
Contributions also came from Marilys Corbex (WHO Regional Office for Europe on prevention challenges), Alina Comanescu (Community Health Association Romania), Alexander Roediger (MSD), our Senior Policy Officer Josephine Mosset and the Young Forum Gastein on implementation success factors, and CEO of CPE Antonella Cardone, highlighted key prevention challenges, the importance of patient involvement, the role of robust cancer indicators, and the conditions needed to successfully implement a European Semester on Health with cancer as a pilot.
Additionally, on 6th February 2025, CPE hosted the high-level event “Building Momentum: Integrating Health into the European Semester” at the European Parliament. Hosted by MEP Vlad Voiculescu (RENEW), the discussion featured speakers from across EU institutions and the wider health community, including MEPs Tomislav Sokol (EPP, Croatia) and Vytenis Andriukaitis (S&D, Lithuania), alongside representatives from the European Commission, the Committee of the Regions, and the OECD. Among them are, Dirk Van den Steen (DG SANTE), Anton Mangov (DG Employment), Dorota Tomalak (Committee of the Regions), and Dr. Caroline Berchet (OECD). Voices from patients, civil society, and health networks were also represented, including our CEO Antonella Cardone (CPE), Goranka Perc (Nismosame), Michele Calabrò (EUREGHA), Silvia Ganzerla (EuroHealthNet), and other regional and policy stakeholders.
These discussions reinforced the importance of aligning national cancer policies with broader EU objectives and ensuring that health equity becomes a central pillar of European decision-making.
Support for the initiative includes named endorsements from Members of the European Parliament such as MEPs Tomislav Sokol and Michalis Hadjipantela (EPP), Andreas Schieder, Matjaž Nemec, Nikos Papandreou and Vytenis Andriukaitis (S&D), Tilly Metz and Ana Miranda (Greens/EFA), and Vlad Vasile-Voiculescu (Renew Europe), as well as former MEP Cristian Bușoi (EPP). The manifesto is also backed by key cancer stakeholders, including the European Union of Private Hospitals (EUPH), the European Institute of Women’s Health (EIWH), the Federation of European Academies of Medicines (FEAM), the European Liver Patients’ Association (ELPA), the Association of European Cancer Leagues (ECL), the European Association of Urology (EAU), EuropaColon Polska, and the European Society for Pediatric Oncology (SIOPE), highlighting strong alignment between policymakers, patient advocates, and the oncology community in addressing cancer inequalities across the EU.
What Comes Next: The Transition from Vision to Implementation
The European Semester on Health Manifesto represents a decisive step in moving from political commitment to measurable action on cancer inequalities in Europe. By embedding cancer outcomes into the EU’s economic governance framework, the initiative recognises that health equity is not only a moral imperative but a prerequisite for Europe’s social cohesion, resilience, and competitiveness. With strong political support, robust data already available, and patients firmly at the table, cancer can and should serve as the pilot for strengthening the health dimension of the European Semester. For CPE, the message is clear: where you live should not determine whether you survive cancer, and what gets measured, discussed, and acted upon at the EU level can help make that principle a reality.
Building on the political momentum generated by the European Parliament event in February 2025, CPE has developed a concrete proof of concept by identifying in partnership with the Swedish Institute for Health Economics (IHE), cancer-related indicators that could be integrated into the European Semester. This framework demonstrates how existing, comparable EU-level cancer indicators can be systematically embedded within the Semester process to monitor performance, identify gaps, and support targeted policy action.
In 2026, CPE will seek further political, institutional, and stakeholder endorsement of this proof of concept, while continuing to refine the framework and broaden its relevance across EU Member States.
By sustaining momentum and anchoring cancer equity within EU economic governance, this initiative aims to ensure that today’s commitments translate into lasting improvements in cancer outcomes tomorrow.
