Better access to cancer treatment sought

International cancer experts and patient representatives have called for action to ensure all cancer patients have access to …

International cancer experts and patient representatives have called for action to ensure all cancer patients have access to the best treatment available. The call for "a new human rights movement" to improve cancer survival in Europe was made at the 9th International Congress on Anti-Cancer Treatment in Paris yesterday.

The meeting was told there was a correlation between cancer survival and national healthcare expenditure. About one million people in the EU are diagnosed with cancer annually, and more than 750,000 Europeans die. A Dutch expert, Prof Herbert Pinedo, said that while absolute cancer mortality was finally beginning to improve, it was not doing so nearly as quickly as other diseases such as coronary heart disease.

Prof Pinedo, who recently chaired an international task force on government funding of anticancer technologies, said the percentage of all deaths in the EU attributable to the disease had risen from 18 per cent in 1970 to 27 per cent in 1995. It is 23 per cent in Ireland.

"Adequate funding for cancer care services must be a leading priority for every European healthcare system. However, the price of anti-cancer medicines and treatments is too often a target for cost-savings measures, resulting in patients and care-givers being denied access to treatments which are approved by regulatory authorities and backed by robust clinical data," said the head of the Department of Medical Oncology at Vrije University.

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There was variability in standardised cancer mortality rates among European countries, for all cancer and for specific types of cancer, he said. According to WHO figures a colon cancer patient in Switzerland has a 51 per cent chance of surviving for five years while in the UK it is 36 per cent, with survival rates as high as 60 per cent in the US.

According to the best Irish data the survival rate is 42 per cent for colon cancer. In every cancer except skin cancer, he said, the mortality rates in the US were lower than any EU country. "These variations are caused by differences in funding and integration of cancer care, as well as variation in the degree of specialised health are professionals treating patients with cancer," Prof Pinedo said.

He pointed out that the number of oncologists per head of population was lower in the UK than in France or Germany, and spending per head on anti-cancer cytotoxic drugs in 1996 in the UK was half that in Germany and just over a third of that in France. "The age-standardised mortality rate in the UK was higher than in either or these countries."

It was recognised, he said, that funding was only one of many factors influencing cancer outcomes. "However, we believe that the data suggest that current levels of funding across Europe are inadequate, and that with increased investment mortality from cancer in the EU could be reduced."

The panel of international experts speaking at yesterday's meeting, including Dr David Khayat, ICAT chairman, said patients, physicians and governments must forge a working partnership to better prioritise spending.

Prof Pinedo said the Oncology Funding Task Force, a group of clinicians, academic researchers and patients formed to address the funding issue, had many proposals which should be examined.