Europe’s Beating Cancer Plan (EU Cancer Plan) and the EU’s Mission on cancer could offer a number of opportunities for early detection and awareness raising of prostate cancer (PCa). This became clear during the presentations of Dr. Paolo Guglielmetti (IT), principal administrator of the EU Cancer Plan taskforce of the European Commission, and Prof. Christine Chomienne (FR), vice-chair of the Mission’s board, at the European Prostate Cancer Awareness Day (EPAD20).
EPAD20, being held virtually in the middle of ‘Movember’ on 17 November 2020, was hosted by the MEPs Tiemo Wölken (DE) and Tomislav Sokol (HR), both members of the European Parliament’s Special Committee on Beating Cancer. This year a collaboration between the European Association of Urology (EAU), Europa Uomo, the European Cancer Patient Coalition (ECPC), Movember, the European Alliance for Personalised Medicine (EAPM), COCIR, and the Challenge Cancer Intergroup, EPAD20 aimed to call on the EU to address the important issues of early detection and awareness raising of PCa in the EU Cancer Plan, a draft of which is planned for release in January 2021. Nearly 400 unique viewers attended a programme featuring high-level influencers from various fields: oncology specialists, patient advocates, representatives from charities and foundations, and policymakers.
Prof. Hein Van Poppel (BE) opened the meeting by describing the current landscape of early detection of PCa. “After PSA had been introduced, prostate cancer was detected early and thus mortality declined. Yet, PSA testing was discouraged, because prostate cancer diagnosis automatically led to active treatment. We were not able to discriminate between significant and insignificant cancer. But times have changed.” He cited the ability to avoid overdiagnosis and overtreatment, two arguments used against PSA testing. In his later presentation, Prof. Van Poppel proposed a science-based algorithm as a potential way forward for risk-stratified early detection of PCa: an algorithm which will prevent over- and underdiagnosis and overtreatment.
Awareness among men is an essential part to achieve early detection. Ms. Sarah Coghlan (GB) from Movember gave a presentation about the successful awareness-raising campaigns of the foundation. The characteristic grow-a-moustache-in-November movement has borne fruits. “With 48% of our Movember community over the age of 45 taking action to speak to their doctor about the risks of prostate cancer versus less than 20 percent of the general male population, we have learned that our Mo Bros are more aware of these risks,” Ms. Coghlan said, referring to the ‘Movember Is Good For You’ survey. “Helping men understand the risks they face is probably the first step in getting them to take action.”
Recommendations for bold actions
In the second panel “How can this be supported at EU level?” Dr. Guglielmetti gave a talk about the opportunities for PCa under the framework of the EU Cancer Plan. He underlined that early detection is one of the most important targets of the plan and that “new elements to strengthen the recommendations on cancer screening” across the EU are being monitored. “The potential benefit of prostate cancer early detection is on the radar of the plan,” Dr. Guglielmetti stated. “Especially the recent documents you have produced are going in the right direction.”
Dr. Guglielmetti’s presentation was followed by Prof. Chomienne’s about what the EU’s Mission on cancer “can bring to research and innovation to fight against cancer and, of course for all of you here today, to fight against prostate cancer.” She referred to the Mission's thirteen recommendations for bold actions (see figure 1). “All these recommendations are in line with what you wish for prostate cancer." She went on to highlight a few recommendations, among which the fourth one on cancer screening and early detection: “We have listened to all you have been wishing and working on so far.” About the sixth recommendation: “We want to stress how important it is to develop an EU-wide research programme on early diagnostic and minimally invasive treatment and technologies in line with what you also wish.”
Figure 1: The EU Mission on cancer’s thirteen “Recommendations for bold actions.” (click on the figure to enlarge)
The attention PCa deserves
MEP Wölken delivered the closing remarks, summarising the meeting. “I think it is fair to say from what we have heard today that the scientific evidence points to a review of the early detection guidelines for prostate cancer across the EU in order to save lives and raise the quality of life of prostate cancer patients. We hope this will be an area the European Commission will be able to include in its cancer plan. I myself, being a substitute member in the beating cancer committee, will closely follow the debate on the EU Cancer Plan to ensure that prostate cancer gets the attention it deserves.”
Other presenters at EPAD20 were Prof. Monique Roobol (NL), who reported the latest results of the European Randomized study of Screening for Prostate Cancer (ERSPC), Prof. Jelle Barentsz (NL), who demonstrated how MRI is the game changer for early detection and for monitoring active surveillance, Mr. André Deschamps (BE), whose presentation on the results of the Patient-Reported Outcomes EUPROMS study is highlighted in the EMUC report on page 13 of this issue, and Dr. Gregor Thörmer (DE), who gave the industry perspective on establishing high-quality MRI pathways.