Cancer screening in Europe
Lawrence von Karsa
International Agency for Research on Cancer, Lyon, France
Implementation of population-based screening programmes for breast, cervical and colorectal cancers according to European quality assurance guidelines has been recommended by the Council of the European Union on in 2003. The first report on the follow-up of the Council Recommendation was prepared by the International Agency for Research on Cancer based on information from official sources in all 27 EU Member States, 22 of which returned a questionnaire distributed in 2007 by the Health and Consumers Directorate General of the European Commission. Additional information was obtained from two projects in the EU Health Programme dealing with monitoring, evaluation and quality assurance of cancer screening (European Cancer Network – ECN, and European Network for Information on Cancer - EUNICE). The report will be regularly updated.
In 2007, approximately 55 million examinations were performed on persons attending screening programmes for breast, cervical or colorectal cancer in 26 Member States. A substantial number of examinations (approximately 23 million) were provided by population-based screening programmes. At current levels, over 500 million examinations will be performed in the EU over the next 10 years. Although the current annual volume of screening is considerable, this volume is less than one-half of the minimum number that would be expected if the screening tests specified in the Council Recommendation were available to all EU citizens of appropriate age (approximately 125 million examinations per year). Furthermore, less than one-half of the current volume of examinations (41%) is performed in population-based programmes. However, a population-based approach is necessary to implement comprehensive quality assurance.
Despite the broad consensus at the Community level and among the Member States on the importance of population-based screening as a tool of cancer control, considerable effort will be required over the coming years to successfully implement current policies and to overcome existing barriers to successful programme implementation.
