New report calls for action on EU cancer care inequalities

Unequal access to cancer care and national differences in the training that cancer experts receive is harming thousands of Europeans every year, according to a new study.

The report, on the status of medical oncology in Europe, by the European society for medical oncologists (ESMO) highlights a range of inequalities in cancer care and treatment across the EU.

One of the key issues affecting the provision of specialised care for patients is formal EU recognition of oncology as a medical speciality.

According to Dr. Paolo Casali a member of ESMO’s executive committee, recognition of medical oncology is an essential step in providing optimal treatment to cancer patient sufferers.

“We have a big problem in that medical oncology is currently not recognised at European level as a speciality,” Casali told journalists at a press briefing on Wednesday ahead of a European parliament conference set to discuss the new survey’s findings.

Oncology is a relatively new speciality, only really taking off as a medical profession in the 1970s as new treatments and new drugs were being developed.

European recognition of the profession would, according to ESMO, help to ensure that patients are treated by well qualified physicians skilled in delivering drugs for cancer treatment.

Formal EU recognition would also make it easier for oncologists to move to wherever there is a shortage of trained specialists.

Dr. Adamos Adamou MEP, who is a trained oncologist, told journalists that, “Everyone, including the European commission, parliament and council recognises that cancer is a serious health problem for the EU. The speciality must be formally recognised at EU level”.

However, Adamou said that some member states were still dragging their feet on agreeing to recognise oncology as a professional qualification.

“The European commission is positive about this, but member states need to reach agreement, especially on harmonised training periods”.

The ESMO survey revealed stark differences in the education that cancer experts receive across the EU.  Although basic medical undergraduate studies were relatively consistent at six years in most EU countries, specialist and postgraduate teaching periods varied widely.

Continuing medical education, such as keeping up with advances in diagnosis and treatment, seen as a key component of an oncologists role varied dramatically across the EU, with only 22.5 per cent of medical students required to continue their education after they graduate in order to work in a public health institution.

Professor Roberto Labianca chair of the ESMO MOSES taskforce and author of the report said, “If we don’t have well trained medical students in this discipline we could have problems for patients in the future when these students become doctors”.

“Medical treatment of cancer is becoming more and more complicated and more and more specialised. Other specialities play an important role, but there is a real need for a medical oncologist speciality,” Labianca added.

Another area of concern raised in the report was the issue of palliative care.  The survey found that although a crucial aspect of patient care, only 53.3 per cent of countries had palliative care as part of their curriculum for medical students.

“The report shows how much cancer treatment depends on where you live,” said Labianca.  When you are fighting for your life, you want to know that you are getting the best available care”.

And Labianca, Casali and Adamou all agreed that the only way to tackle cancer effectively, was through the establishment of multi-disciplinary teams made up of experts in surgery, radiotherapy and oncology.

“To treat a cancer patient is not the work of one person, it takes a multi-disciplinary team and we need to reach a common level in qualitative care across Europe,” said Adamou.

“But, if we want patients to be treated by multi-disciplinary teams, then it’s important that we recognise oncology as a medical speciality”.

“Medical oncology is an essential part of the multi-disciplinary team treating cancer patients. With new treatments and new drugs being developed, the speciality becomes essential.”

Casali meanwhile warned that if cancer care was not treated by multi-disciplinary teams the quality of treatment and care could be very poor.

“There are varying survival rates for cancer across Europe.  There are inequalities in cancer survival,” he said.

“One in three Europeans will develop some form of cancer in their lifetime.  This fact shows just how important the need to eliminate these inequalities is,” added Adamou.

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