European Commission Initiative on Breast Cancer

European women’s probability of developing breast cancer over a lifetime is approximately 1 in 8*. A woman’s individual risk of breast cancer may be higher or lower than this average, depending on a number of factors, including age, family history, reproductive history (such as menstrual and childbearing history), race/ethnicity, and others.

The ECIBC is developing recommendations for breast cancer screening and diagnosis. Each recommendation is specifically tailored to the needs of citizens and patients, health professionals, and policy makers. All recommendations are based on the female population at ‘average’ and ‘below average’ risk of developing breast cancer.

To read more about this initiative on the Europa.eu site: http://ecibc.jrc.ec.europa.eu/recommendations/

Public health interventions to manage sunbeds

 

Skin cancer is the most common form of cancer among light-skinned populations. The chief environmental cause of skin cancer is ultraviolet radiation (UVR). UVR exposure comes mainly from the sun, but over the past three decades there has been an increase in the use of artificial sources of UVR in the form of artificial tanning devices, such as sunbeds, stand up booths and facial tanners. This deliberate exposure to UVR is increasing the incidence of the major types of skin cancer.

The World Health Organization has produced a document intended for government health authorities, to assist in the development of public health interventions in relation to the use and management of sunbeds. The document provides a summary of health effects as well as a catalogue of interventions that have been used to reduce risks associated with artificial tanning. It is supplemented by a WHO database on sunbed regulations.

Artificial tanning is a recent phenomenon. Sunbeds and other tanning devices emitting artificial ultraviolet radiation (UVR) were developed in the 1960s but it was not until the 1980s that people began to use tanning beds in large numbers. During the 1990s, the artificial tanning industry grewrapidly in Northern Europe, Australia and the Americas. With increasing exposure by young people,often women, to artificial ultraviolet radiation, the health risks soon became apparent. Artificialtanning is now seen as a public health issue accounting for about half a million new cancer diagnoseseach year in the United States of America, Europe and Australia. Evidence of an association between artificial tanning and risk of skin cancer clearly shows that the risk is highest in those exposed to artificial tanning in early life.

More information on public health interventions to manage artificial tanning devices on the who.int website.

Breast implants

The European Commission and its Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) has published two Scientific Advices related to breast implants and health. They are on 1) new scientific information on the safety of PIP breast implants and 2) the possible association between breast implants and anaplastic large cell lymphoma (ALCL).

The first piece of advice concerns whether there is sufficient new scientific information on the safety of PIP breast implants to warrant an update of the 2014 SCENIHR Opinion and based on the scientific information it has gathered and evaluated, the SCHEER concludes that this is not the case at present.

The second piece of advice is on the state of scientific knowledge on a possible association between breast implants and anaplastic large cell lymphoma (ALCL). The SCHEER concluded that, at present, there is insufficient scientific information available to establish a methodologically robust risk assessment on the potential association of breast implants with the development of ALCL.

To download the full advice on the safety of PIP breast implants from the ec.europa.eu website

To download the full advice on the association between breast implants and ALCL from the ec.europa.eu website

Effective cancer control saves lives, money and time

A new Guide available online gives recommendations on how to boost cancer control in Europe. The Guide is the result of a three-year effort by top experts in 25 countries and 126 partner organisations. They have been working together in an EU co-funded joint action, known as Cancon (officially titled European Guide on Quality Improvement in Comprehensive Cancer Control Guide).

The Guide’s authors stress that besides saving money and time, effective cancer control increases quality of life. Currently some 2.6 million people in Europe are diagnosed with cancer annually. But more and more cancer patients are overcoming the disease. Therefore greater attention needs to be given to access to care, early diagnosis, rehabilitation, and survivorship.

For more information and to download the Guide to effective cancer control from the cancercontrol.eu website

Cancer screening in the EU

In 2012 almost 1.3 million lives were lost to cancer in Europe alone. Nearly half of cancer deaths can be avoided with more preventive action to address and mitigate the risks. While we aim to reduce the incidence of cancer by tackling major life-style determinants, such as smoking, nutrition and physical activity, screening remains a very effective prevention tool. Regular and systematic examinations can detect the disease early, when it is more responsive to
less aggressive treatment. Followed by appropriate care, these examinations can significantly reduce cancer mortality and improve the quality of life of cancer patients.
In 2003, the Council of the EU had issued recommendations setting out principles of best practice in the early detection of cancer. The recommendations called on all EU countries to take common action to implement
national, population-based screening programmes for breast, cervical and colorectal cancer. A first report analysing the state of implementation followed in 2008 and showed that, despite progress being made, Member States still had fallen short of the target set for the minimum number of examinations by more than 50%.
The second report has now been published and allows the comparison of the national programmes by these  indicators and may eventually pave the way to define common benchmarks for cancer screening programmes in the EU.
To download the report on cancer screening in the EU from the ec.europa.eu website

Guide to cancer early diagnosis

Detecting cancer early can effectively reduce the mortality associated with cancer. In resource-poor settings, cancer is often diagnosed at a late-stage of disease resulting in lower survival and potentially greater morbidity and higher costs of treatment. Even in countries with strong health systems and services, many cancer cases are diagnosed at a late-stage. Addressing delays in cancer diagnosis and inaccessible treatment is therefore critical in all settings for cancer control.

This WHO Guide to cancer early diagnosis aims to help policy-makers and programme managers facilitate timely diagnosis and improve access to cancer treatment for all.

To download the WHO Guide to cancer early diagnosis from the who.int website

Global Action Plan to Prevent & Control NCDs

Noncommunicable diseases (NCDs) – mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes – are the biggest cause of death worldwide. More than 36 million die annually from NCDs (63% of global deaths), including 14 million people who die too young before the age of 70. More than 90% of these premature deaths from NCDs occur in low- and middle-income countries, and could have largely been prevented. Most premature deaths are linked to common risk factors, namely tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol.

The World Health Organisation has launched a Global Action Plan for the Prevention and Control of Non-Communicable Diseases, which provides a road map and menu of policy options for countries, intergovernmental organisations, NGOs and the private sector. If these are implemented by 2020, a number of global targets will be reached, including a 25% reduction in premature mortality from NCDs by 2025.

For more information about the Action Plan to prevent NCDs on the who.int website

Sun-beds – no safe limit for UVR exposure

The final Opinion on the biological effects of ultraviolet radiation relevant to health with particular reference to sunbeds for cosmetic purposes has been published by the European Commission and its Scientific Committee on Health, Environmental and Emerging Risks (SCHEER).

Ultraviolet Radiation (UVR), including that emitted by sunbeds, is considered a complete carcinogen, in that it can initiate and promote cancer. Based on the available scientific evidence, the SCHEER concludes that exposure to UVR in the context of sunbed use is:

  • strongly associated with skin melanoma and squamous cell carcinoma, especially when first exposure takes place at a younger age;
  • moderately associated with basal cell carcinoma and ocular melanoma;
  • responsible for a significant proportion of both melanoma and non-melanoma skin cancer cases associated with early onset melanoma.

As there is no threshold level of UV-irradiance and UV–dose for the induction of skin cancer, the SCHEER concludes that there is no safe limit for exposure to UVR from sunbeds.

Furthermore, as the risks outweigh the benefits, there is no need to use sunbeds to induce vitamin D production.

Read the full opinion on the Health Risks of Sunbeds on the ec.europa.eu website

Breast cancer care and psychological support

Psycho-oncological support has become increasingly recognised and used as part of breast cancer care services in recent years. According to a recent review of EU and EFTA member states’ national/regional cancer plans and certification schemes, the need for psycho-oncological services is widely recognised. However the concrete allocation of resources and personnel to provide these services has not been specifically addressed in most of them.

Scientists reviewed 25 national and 4 regional cancer plans/strategies among 32 researched countries. They found that while 28 recognise the need for organised psycho-oncological support only 10 have actually identified the criteria for good psychosocial care, including the resources required or educational needs.

Read more about Breast cancer care and psychological support on the ec.europa.eu website

12 ways to reduce your cancer risk.

The European Code Against Cancer focuses on actions that individuals can take to reduce their risk of developing cancer. It lists 12 actions that will make a significant difference to a person’s health and longevity:

  • Do not smoke. Do not use any form of tobacco.
  • Make your home smoke free. Support smoke-free policies in your workplace.
  • Take action to be a healthy body weight.
  • Be physically active in everyday life. Limit the time you spend sitting
  • Have a healthy diet: eat plenty of whole grains, pulses, vegetables and fruits; limit high-calorie foods (foods high in sugar or fat) and avoid sugary drinks; avoid processed meat; limit red meat and foods high in salt.
  • If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention.
  • Avoid too much sun, especially for children. Use sun protection. Do not use sunbeds.
  • In the workplace, protect yourself against cancer-causing substances by following health and safety instructions.
  • Find out if you are exposed to radiation from naturally high radon levels in your home. Take action to reduce high radon levels.
  • For women: Breastfeeding reduces the mother’s cancer risk so if you can, breastfeed your baby; Hormone replacement therapy (HRT) increases the risk of certain cancers so limit use of HRT.
  • Ensure your children take part in vaccination programmes for Hepatitis B (for newborns) and Human papillomavirus (HPV) (for girls).
  • Take part in organised cancer screening programmes for:
    • Bowel cancer (men and women)
    • Breast cancer (women)
    • Cervical cancer (women).

Print the full Code against Cancer from the cancer-code-europe.iarc.fr website