Calls for investment to reduce pancreatic cancer deaths in Europe

Calls for investment to reduce pancreatic cancer deaths in Europe
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Researchers are calling on European policymakers to invest adequate resources to tackle pancreatic cancer in Europe.

There have been limited advancements in the treatment of pancreatic cancer, which is one of the most deadly cancers, in recent years. Researchers now say investment is needed if death rates from the disease are to be reduced across Europe, predicting that 42,300 men in the EU and 5,000 in the UK will die from pancreatic cancer by the end of this year.

Lead researcher, Professor La Vecchia at the University of Milan said: “Among the major cancers, pancreatic cancer is the fourth most common and remains the only one showing no overall fall in death rates over the past three decades in Europe in both sexes. It is important that governments and policymakers provide adequate resources for the prevention, early diagnosis, and management of pancreatic cancer in order to improve these trends in the near future.

“If the cancer is detected early, it is easier to treat successfully, but most cases are advanced by the time of diagnosis. Avoiding smoking and excessive alcohol consumption, controlling weight and, hence, diabetes are the main ways we know to help to prevent the disease, but they only account for a proportion of cases. New, targeted drugs are leading to some improvement in treatment, but it’s difficult to quantify their potential impact at present.”

Tackling pancreatic cancer

After adjusting for differences in age distribution in the population, the age standardised rate (ASR) of deaths in men will be eight per 100,000 and 6.5 per 100,000 in the EU and UK respectively this year. This represents a 0.8% decline in death rates since 2015. Among women, six per 100,000 are predicted to die from pancreatic cancer in the EU, representing a 0.6% increase since 2015. In the UK, five women per 100,000 are predicted to die, representing a 4% decline in the death rate.

Co-author, Professor Paolo Boffetta (MD), the Annals of Oncology associate editor for epidemiology, professor and associate director for population sciences at Stony Brook University, New York (USA), and professor at the University of Bologna (Italy), said: “Cancer remains the second major cause of death in Europe after cardiovascular disease. Although we predict that death rates in many cancers will decrease this year, the absolute number of deaths from the disease will continue to rise due to ageing populations. This underlines the increasing public health importance of the issue. Delayed cancer diagnosis and treatment due to the COVID-19 pandemic may increase the cancer burden over the next several years.

“The results we report this year are particularly important because they stress the fact that trends in mortality from pancreatic cancer and female lung cancer do not show the positive pattern of other major cancers, underlying the need for further efforts for research and control of these neoplasms. Measures to continue to improve cancer death rates should include stopping smoking, particularly in women, controlling overweight and alcohol consumption, optimising screening and early diagnosis for breast, bowel and – in central and eastern Europe – cervical cancer too. Up-to-date data management needs to be adopted throughout Europe, particularly in central and eastern Europe, and vaccinations should be widely available for women to eliminate cervical cancer, which is caused by the human papillomavirus, and against hepatitis B, which is linked to liver cancer. Effective treatment of hepatitis C will also contribute to controlling liver cancer.”

Impact of COVID-19

Accompanying the findings, Professor José Martín-Moreno, from the University of Valencia, Spain, and Ms Suszy Lessof, from the European Observatory on Health Systems and Policies, Brussels, Belgium, write that this analysis gives cause for hope; however, they highlight potential problems from COVID-19 as cancer is a “severe risk factor for COVID-19 infected patients, carrying as it does a higher probability of ICU admission, mechanical ventilation and mortality”.

They write that: “The positives [from Prof La Vecchia’s paper] – the concrete evidence that there is scope for effective action which, over time, leads to positive outcomes – should not mask the shadow of the COVID-19 pandemic.

“Its impact on cancer patients (and the fear of that impact) is looming. Beyond the direct harm of this new coronavirus to immunocompromised and particularly vulnerable people, there is the blow to comprehensive clinical care and the interruption of research. Perhaps most worrying for the long term is the paralysis of prevention programmes, screening, and early diagnosis.

“Since March 2020, all of the activity linked to progress over recent decades has come to a screeching halt. It is, of course, too early to characterise the impacts, but it seems inevitable they will have marked, if not dramatic, consequences.

“The possible impact of the COVID-19 pandemic on actual consolidated mortality for 2020, for 2021 and beyond, demands vigilance.”

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