Time for a European initiative for research to prevent cancer: A manifesto for Cancer Prevention Europe (CPE)

Strategies to decrease inequalities in cancer therapeutics, care and prevention: Proceedings on a conference organized by the Pontifical Academy of Sciences and the European Academy of Cancer Sciences, Vatican City, February 23-24, 2023

Analyses of inequalities related to prevention and cancer therapeutics/care show disparities between countries with different economic standing, and within countries with high Gross Domestic Product. The development of basic technological and biological research provides clinical and prevention opportunities that make their implementation into healthcare systems more complex, mainly due to the growth of Personalized/Precision Cancer Medicine (PCM). Initiatives like the USA-Cancer Moonshot and the EU-Mission on Cancer and Europe's Beating Cancer Plan are initiated to boost cancer prevention and therapeutics/care innovation and to mitigate present inequalities. The conference organized by the Pontifical Academy of Sciences in collaboration with the European Academy of Cancer Sciences discussed the inequality problem, dependent on the economic status of a country, the increasing demands for infrastructure supportive of innovative research and its implementation in healthcare and prevention programs. Establishing translational research defined as a coherent cancer research continuum is still a challenge. Research has to cover the entire continuum from basic to outcomes research for clinical and prevention modalities. Comprehensive Cancer Centres (CCCs) are of critical importance for integrating research innovations to preclinical and clinical research, as for ensuring state-of-the-art patient care within healthcare systems. International collaborative networks between CCCs are necessary to reach the critical mass of infrastructures and patients for PCM research, and for introducing prevention modalities and new treatments effectively. Outcomes and health economics research are required to assess the cost-effectiveness of new interventions, currently a missing element in the research portfolio. Data sharing and critical mass are essential for innovative research to develop PCM. Despite advances in cancer research, cancer incidence and prevalence is growing. Making cancer research infrastructures accessible for all patients, considering the increasing inequalities, requires science policy actions incentivizing research aimed at prevention and cancer therapeutics/care with an increased focus on patients' needs and cost-effective healthcare.

Mapping of clinical research on artificial intelligence in the treatment of cancer and the challenges and opportunities underpinning its integration in the European Union health sector

BACKGROUND

Although current efforts are made to diminish the incidence and burden of disease, cancer is still widely identified late at stage. This study aims to conduct a systematic review mapping the existent and emerging clinical research on artificial intelligence (AI) in the treatment of cancer and to underpin its integration challenges and opportunities in the European Union (EU) health sector.

METHODS

A systematic literature review (SLR) evaluating global clinical trials (CTs; published between 2010 and 2020 or forthcoming) was concluded. Additionally, a horizon scanning (HS) exercise focusing on emerging trends (published between 2017 and 2020) was conducted.

RESULTS

Forty-four CTs were identified and analyzed. Selected CTs were divided into three research areas: (i) potential of AI combined with imaging techniques, (ii) AI's applicability in robotic surgery interventions and (iii) AI's potential in clinical decision making. Twenty-one studies presented an interventional nature, nine papers were observational and 14 articles did not explicitly mention the type of study performed. The papers presented an increased heterogeneity in sample size, type of tumour, type of study and reporting of results. In addition, a shift in research is observed and only a small fraction of studies were completed in the EU. These findings could be further linked to the current socio-economic, political, scientific, technological and environmental state of the EU in regard to AI innovation.

CONCLUSION

To overcome the challenges threatening the EU's integration of such technology in the healthcare field, new strategies taking into account the EU's socio-economic and political environment are deemed necessary.

Revisiting Candidacy: What Might It Offer Cancer Prevention?

The notion of candidacy emerged three decades ago through Davison and colleagues’ exploration of people’s understanding of the causes of coronary heart disease. Candidacy was a mechanism to estimate one’s own or others risk of disease informed by their lay epidemiology. It could predict who would develop illness or explain why someone succumbed to it. Candidacy’s predictive ability, however, was fallible, and it was from this perspective that the public’s reticence to adhere to prevention messages could be explained, as ultimately anybody could be ‘at-risk’. This work continues to resonate in health research, with over 700 citations of Davison’s Candidacy paper. Less explored however, is the candidacy framework in its entirety in other illness spheres, where prevention efforts could potentially impact health outcomes. This paper revisits the candidacy framework to reconsider it use within prevention. In doing so, candidacy within coronary heart disease, suicide prevention, diabetes, and cancer will be examined, and key components of candidacy and how people negotiate their candidacy within differing disease contexts will be uncovered. The applicability of candidacy to address modifiable breast cancer risk factors or cancer prevention more broadly will be considered, as will the implications for public health policy.

Occupational exposure to polycyclic aromatic hydrocarbons and risk of prostate cancer

BACKGROUND

Several industries entailing exposure to polycyclic aromatic hydrocarbons (PAHs) are known or suspected carcinogens. A handful of studies have assessed the role of PAHs exposure in prostate cancer risk, but none has examined tumor aggressiveness or the influence of screening practices and detection issues. We aimed to examine the association between lifetime occupational exposure to PAHs and prostate cancer risk.

METHODS

Detailed work histories were collected from 1,929 prostate cancer cases (436 aggressive) and 1,994 controls from Montreal, Canada (2005-2012). Industrial hygienists applied the hybrid expert approach to assign intensity, frequency and certainty of exposure to benzo[a]pyrene, PAHs from wood, coal, petroleum, other sources, and any source, in each job held. Odds ratios (ORs) for prostate cancer risk associated with lifetime PAHs exposure, adjusted for age, ancestry, education, lifestyle and occupational factors, and 95% confidence intervals (CI), were estimated using unconditional logistic regression.

RESULTS

After restriction to probable and definite exposures, and application of a 5-year lag, no clear association emerged for any of the PAHs, although small excesses in risk were apparent with 5-year increments in exposure to PAHs from wood (OR = 1.06, 95%CI 0.95 to 1.18). While analyses by cancer aggressiveness suggested no major differences, some elevated risk of high-grade cancer was observed for exposure to PAHs from wood (OR = 1.37, 95%CI 0.65 to 2.89), frequently occurring among firefighters.

CONCLUSION

Findings provide weak support for an association between occupational exposure to PAHs from wood and prostate cancer risk.

Impact of tobacco control policies implementation on future lung cancer incidence in Europe: An international, population-based modeling study

BACKGROUND

Despite recent trends in declining smoking rates, tobacco smoking remains the most preventable cause of cancer in Europe. We aimed to estimate numbers and proportions of future lung cancer cases that could be potentially prevented over a 20-year period if countries in Europe were to achieve a comprehensive implementation of tobacco control policies.

METHODS

Historical data from population-based cancer incidence (or mortality) was used to predict sex-specific lung cancer incidence for 30 European countries up to 2037. Hypothetical country-specific smoking prevalence that would be expected if countries would have achieved the highest-level implementation of tobacco control policies (defined by the maximum total score of the Tobacco Control Scale, TCS) was estimated by combining national prevalence data on current smoking and data on the status of implementation of key tobacco control policies. Resulting numbers and proportions of potentially preventable lung cancer cases were estimated taking into account latency periods between changes in smoking prevalence and excess cancer risks.

FINDINGS

In Europe, an estimated 1·65 million lung cancer cases (21·2%, 19·8% in men and 23·2% in women) could be prevented over a 20-year period with the highest-level implementation of tobacco control policies. Large variation was seen in European regions and countries reflecting the current level of tobacco control, with the largest potential for prevention in Western Europe (24·5%), Southern Europe (23·1%) and Eastern Europe (22·5%), and the lowest but still substantial potential for further prevention in Northern Europe (12·5%). In women, among whom lung cancer incidence is expected to increase, we estimated somewhat larger proportions of preventable lung cancer cases ranging from 9·9 to 33·9% as compared to men (8·6-28·5%). In the final year of study period (2037), these proportions even exceed 50% in women for some countries.

INTERPRETATION

Improved and expanded implementation of evidence-based tobacco control policies at the most comprehensive level could reduce future lung cancer incidence considerably across Europe.

FUNDING

The study was funded by the German Cancer Aid ("Deutsche Krebshilfe"), grant number 70112097.

Solving problems is smart, preventing them is wise: Lessons learned from the 2nd International DKFZ Conference on Cancer Prevention

The 2nd International DKFZ Conference on Cancer Prevention (CCP2020) organized by the German Cancer Research Center (DKFZ) was held as a virtual event on 17-18 September 2020. The event gathered experts on cancer prevention from around the world with the aim of generating a stimulating interchange of opinions between clinicians and basic researchers working in the field. The talks and posters of the conference fueled exciting discussions and debates about the state of the art of cancer prevention and provided a comprehensive outlook on the many aspects of the field. The program was divided into three main sessions, illustrating the most recent methodological approaches and interventions in primary, secondary and tertiary prevention, enriched by introductory lectures depicting the most relevant aspects of each session. The key concepts covered in this meeting were risk factors, early detection, improving life after cancer, cancer prevention in Europe and personalized prevention. The importance of the latter was expressly highlighted, many presentations emphasizing that in the era of personalized medicine, prevention also needs to be based on the unique genetic, epigenetic, social and behavioral characteristics of the individual to achieve maximal efficacy. In this article, we summarize the key messages emerging from each section, with particular attention on the most important challenges yet to be met in the field of cancer prevention.

Tobacco-related cancers in Europe: The scale of the epidemic in 2018

BACKGROUND

Tobacco smoking is the major preventable cause of cancer. Despite the longstanding decline in smoking prevalence, lung cancer remains one of the most frequently diagnosed cancers in both sexes. We aimed to estimate the current cancer burden attributable to smoking in Europe.

METHODS

Smoking-related cancer incidence by country, cancer type, sex and age in Europe was estimated from GLOBOCAN 2018. We applied a modified version of the indirect method to estimate the population attributable fraction (PAF) for lung cancer and applied Levin's formula to estimate the PAF for other smoking-related cancer sites.

RESULTS

In Europe in 2018, 572,000 and 186,000 cancer cases were attributable to tobacco smoking in males and females respectively, accounting for 28% (males) and 10% (females) of all cancer cases. By region, the largest and the lowest PAF due to smoking in males occurred in Eastern Europe (35% of all cancer cases) and Northern Europe (21%), respectively. Among women, this pattern was reversed (16% in Northern Europe and 6% in Eastern Europe). Lung cancer accounted for more than half of the total cancer burden attributable to smoking (382,000). Other major contributors to the total PAF were lip, oral cavity and pharynx, bladder and laryngeal cancers in men (27% out of total PAF) and colorectal, pancreatic, oral cavity and pharyngeal cancers (21%) in women.

CONCLUSIONS

Tobacco smoking was responsible for one in five cancer cases in Europe in 2018. The introduction and robust implementation of tobacco control programmes are critical to reduce this cancer burden in the future.

Doxorubicin hydrochloride loaded nanotextured films as a novel drug delivery platform for ovarian cancer treatment

An approach for cancer treatment is modulation of tumor microenvironment. Based on the role of extracellular matrix in cell modulation, fabrication of textured materials mimicking extracellular matrix could provide novel opportunities such as determining cancer cell behaviour. With this background, in this work, we have fabricated doxorubicin hydrochloride loaded nanotextured films which promote topographical attachment of cancer cells to film surface, and eliminate cells by release of the anti-cancer drug encapsulated within the films. These films are designed to be placed during surgical removal of the tumor with the intent to prevent ovarian cancer recurrence by capturing cancer cell residuals. With this aim, hemispherical protrusion shaped surface textures were acquired using colloidal lithography technique using 280 nm, 210 nm or 99 nm polystyrene particles. Once moulds were formed, nanotextured films were obtained by casting water-in-oil stable polycaprolactone emulsions encapsulating doxorubicin hydrochloride. Films were then characterized, and evaluated as drug delivery systems. According to results, we found that template morphologies were successfully transferred to films by atomic force microscopy studies. Hydrophilic surfaces were formed with contact angle values around 40°. In-vitro drug release studies indicated that nanotextured films best fit into the Higuchi model, and ∼30% of the drug is released from the films within 60 days. Cell culture results indicated increases in the attachment and viability of human ovarian cancer cells to nanotextured surfaces, particularly to the film fabricated using 99 nm particles. Our results demonstrated that delivery of anti-cancer drugs by use of nanotextured materials could be efficient in cancer therapy, and may offer new possibilities for cancer treatment.

Diet, Physical Activity, Obesity, and Breastfeeding: How French People Perceive Factors Associated with Cancer Risk

The French Cancer Barometer, a population-based-survey, is carried out every five years and is, to date, one of the few national studies conducted to investigate individual perception linked to cancer risk factors. The aims of the present study were to describe the perceptions of the French population in 2015 and to assess their evolution over a 5-year period (2010–2015). The French Cancer Barometer surveyed a randomly selected sample of participants aged 15–75 years (n = 3345 in 2010) and 15–85 years (n = 3764 in 2015), representative of the French population. Questions were on perception of diet, physical activity, obesity, and breastfeeding as cancer risk factors. In 2015, nutritional/activity factors were perceived as having an important role in cancer development for the majority of those surveyed (diet (90.8%), obesity (76%), and physical activity (70%)) with the exception being breastfeeding (34%). However, there was a moderate perception of the risks of red meat (43%) and salt or salty food (55%) consumption. Perceptions of nutritional risk factors were mostly associated with age and education level. Interestingly, there was a greater perception of nutritional risk factors in 2015 compared to 2010, and the participants’ opinions were also stronger. Efforts should be made on individuals with lower educational level and to promote the beneficial effects of breastfeeding. However, to impact food behavior, measures are needed at the environmental level and not only at the individual one.

Time to care: why the humanities and the social sciences belong in the science of health

Health is more than the absence of disease. It is also more than a biological phenomenon. It is inherently social, psychological, cultural and historical. While this has been recognised by major health actors for decades, open questions remain as to how to build systems that reflect the complexity of health, disease and sickness, and in a context that is increasingly technologised. We argue that an urgent change of approach is necessary. Methods and concepts from the humanities and social science must be embedded in the concepts and methods of the health sciences if we are to promote sustainable interventions capable of engaging with the recognised complexity of health, disease and sickness. Our vision is one of radical interdisciplinarity, integrating aspects of biological, psychological, social and humanities approaches across areas of urgent health need. Radical interdisciplinarity, we argue, entails the practical, methodological and conceptual integration of these approaches to health.

Presentation of lung cancer in primary care

Survival from lung cancer has seen only modest improvements in recent decades. Poor outcomes are linked to late presentation, yet early diagnosis can be challenging as lung cancer symptoms are common and non-specific. In this paper, we examine how lung cancer presents in primary care and review roles for primary care in reducing the burden from this disease. Reducing rates of smoking remains, by far, the key strategy, but primary care practitioners (PCPs) should also be pro-active in raising awareness of symptoms, ensuring lung cancer risk data are collected accurately and encouraging reluctant patients to present. PCPs should engage in service re-design and identify more streamlined diagnostic pathways—and more readily incorporate decision support into their consulting, based on validated lung cancer risk models. Finally, PCPs should ensure they are central to recruitment in future lung cancer screening programmes—they are uniquely placed to ensure the right people are targeted for risk-based screening programmes. We are now in an era where treatments can make a real difference in early-stage lung tumours, and genuine progress is being made in this devastating illness—full engagement of primary care is vital in effecting these improvements in outcomes.

Cancer Prevention Europe

The case for cancer prevention in Europe is the same as for all other parts of the world. The number of cancers is increasing, driven by demographic change and evolution in the exposure to risk factors, while the cost of treating patients is likewise spiralling. Estimations suggest that around 40% of cancers in Europe could be prevented if current understanding of risk and protective factors was translated into effective primary prevention, with further reductions in cancer incidence and mortality by screening, other approaches to early detection, and potentially medical prevention. However, the infrastructure for cancer prevention tends to be fragmented between and within different countries in Europe. This lack of a coordinated approach recently led to the foundation of Cancer Prevention Europe (Forman et al., 2018), a collaborative network with the main aims of strengthening cancer prevention in Europe by increasing awareness of the needs, the associated required resources and reducing inequalities in access to cancer prevention across Europe. This article showcases the need for strengthening cancer prevention and introduces the objectives of Cancer Prevention Europe and its foreseen future role in reducing the European cancer burden.

Translational cancer research - a coherent cancer research continuum

The main components of the cancer research continuum are basic/preclinical research, early and late clinical research and, after the adoption of an innovation by the healthcare or health organisations, outcomes research. Translational cancer research, defined as a coherent cancer research continuum, is mandatory to address the increasing burden of cancer effectively. The growing cancer problem can only be significantly modified by concerted action involving prevention to decrease incidence, early detection and treatment to increase the cure rate, and personalised/precision cancer medicine to adapt early detection and treatment to the biology of a tumour with the aim of increasing the cure rate, prolonging survival and improving health-related quality of life. By definition, translational cancer research for therapeutics has a focus on patients' needs and for prevention for individuals at-risk. Consequently, to increase the effectiveness of translational research, the different components of the cancer research continuum need to be better connected to the fundamental aim of a mission-oriented approach to cancer (Celis and Pavalkis, ).

Primary prevention: a need for concerted action

The burden of cancer is increasing worldwide, and Europe is no exception in this regard. Cancer incidence rate for men in 2018, excluding nonmelanoma skin cancers, averaged over the 40 UN-defined European countries has been estimated as 436/100 000. For women, the estimated incidence rate is 332.6/100 000. Although mortality rates are declining in most European countries, the total number of cancer deaths continues to rise due to an increase in the number of older people in the age range when the cancer typically occurs. The increase in incident cases and cancer deaths increases the pressure on healthcare infrastructure and related costs, thus presenting a challenge to health service sustainability in countries. In the general population, there remains a perception of an ever-increasing cancer risk. Hence, treatment alone is not a solution to address the cancer burden. At the same time, recent estimates of preventable fractions of cancer suggest that about half of all cancer cases could be prevented through rigorous implementation of successful prevention measures, among other actions, by following the cancer prevention recommendations of the European Code against Cancer. Smoking alone explains almost half of all preventable cancers, and the scattered way of implementing tobacco control in Europe with still increasing numbers of lung cancers in women demonstrates the gap between prevention potential and effectively implemented prevention. Cancer prevention clearly needs more resources, stronger support from decision-makers and society, and a solid network to better speak with one voice. The newly established 'Cancer Prevention Europe' (Forman et al., ) offers promising opportunities for the latter.

Quality-assured research environments for translational cancer research

In order to secure high-quality cancer care for increasing numbers of cancer patients in the upcoming decades, the complete continuum of cancer research and cancer care needs a thorough overhaul, with more emphasis on prevention and early detection, and a greater focus on the development of innovative treatments that are also scrutinised for effectiveness and quality-of-life aspects. Therefore, under-resourced research areas, such as primary prevention, early diagnosis/secondary prevention (Song et al., ; Wild et al., ) and outcomes research (Cavers et al., ), should be given more emphasis, whereas basic, preclinical and clinical cancer research requires more innovation and effective collaboration to develop more effective treatments at an affordable cost. Innovative collaborative research in this translational trajectory requires the participation of well-resourced and well-organised institutions that are committed to high scientific and ethical standards. Offering focused funding to distinct segments of this research continuum concomitant with incentives to aspire to high-quality standards is the most effective route to achieve these goals. Therefore, a rigorous quality assessment system for institutions operating in this research continuum is a high priority.

Education aimed at increasing international collaboration and decreasing inequalities

Educational initiatives in cancer research have to align with the needs of patients, individuals at risk, healthcare systems and public health organisations. The above interests demand strong translational interactions between basic research, clinical/prevention research and entrepreneurship. The resulting synergy between these three entities is expected to stimulate identification of unresolved issues in cancer biology, as well as unmet needs in diagnostics, treatment and prevention. It will also encourage the development of international research collaborations and, in turn, improve access to innovative research infrastructures. Education and dissemination of knowledge and technologies must be a cornerstone of any future European mission-oriented approach to cancer, as it will ensure that new cancer treatments reach all patients within the European Union, and also help reduce gross inequalities in cancer incidence and mortality. A large number of educational institutions ranging from local universities to pan-European organisations have developed excellent educational activities. However, a cancer mission will highlight additional roles for higher education that will complement and provide novel approaches. Educational and training activities should target the general public (dissemination) for primary cancer prevention, as well as the next generation of cancer researchers in basic and clinical research all over Europe. The experiences of patients are also needed to improve health-related quality-of-life and outcomes research. A mission approach to cancer would enhance the exchange of researchers within Europe and worldwide, and prioritise collaborations between Western/Central and Eastern Europe countries. The Comprehensive Cancer Centres (CCCs) will be crucial to train scientific staff in established centres as well as in candidate centres aspiring to join networks of CCCs. In addition, CCCs will have an important role to play by offering educational programmes for the next generation of clinical/research leaders.

Towards a mission-oriented approach to cancer in Europe: an unmet need in cancer research policy

Today, cancer is a significant challenge for society, healthcare systems and the growing number of affected patients and their families. This article argues that new paradigms and conditions for responsible science and innovation policy across the European Union (EU) require (i) the collective action of Research & Development institutions, (ii) a system approach to health systems, higher education and patient organizations, and (iii) new initiatives to encourage international cooperation across an enlarged Europe; no single country can successfully fight the disease(s) on its own. Recently, a cancer mission was proposed (Celis and Pavalski, ), the origins of which are rooted in the continuous efforts of the research community, cancer patient organizations, member states and the European Commission during nearly two decades to address the fragmentation and lack of coordination of European cancer research; these efforts led to the creation of Cancer Core Europe and Cancer Prevention Europe, consortia aimed at linking therapeutic and prevention geometries. Ultimately, the platform/infrastructure will be composed of networks of Comprehensive Cancer Centres and cancer research centres across Europe to reach the critical mass of expertise, patients and collaborative portfolio of projects that are necessary to promote science-driven and social innovations in the era of personalized (precision) cancer medicine. Employing a mission-oriented approach to achieve the goal of ensuring a long life expectancy for three out of four cancer patients by 2030 is likely to have a particularly positive impact on the way European citizens' value science and knowledge. It will change the lives of many families across Europe and beyond and should be oriented to ensure that Europe is at the forefront when it comes to quality of life. It is our collective responsibility to ensure that not a single person or region in Europe is left behind.

A report from a conference jointly organised by the European Academy of Cancer Sciences and the Pontifical Academy of Sciences, The Vatican, November 16-17, 2018

Cancer is a massive challenge with a significant impact on society, healthcare systems, the economy and an increasing number of patients and their families. To help meet this societal challenge, the European Commission has recently proposed a mission‐oriented approach to cancer in Horizon Europe, and about 60 participants met at the Vatican to discuss a mission‐oriented approach to cancer in Europe, as documented in this report. Painting: Rowe, Ernest Arthur. Courtyard of the Casina Pio IV (ca. 1911–1913).

The European Cancer Patient Coalition and its central role in connecting stakeholders to advance patient-centric solutions in the mission on cancer

There is an urgent need for solutions to the economic and social inequalities in cancer care that still exist in many European countries. Patient preferences, ‘big data’, mobile digital technology and molecular and genomic profiling are among the innovative research topics that connect cancer patients to comprehensive cancer centres, and link translational research to cancer diagnosis, treatment and care. The question is whether Europe can deliver the complex infrastructure needed for universal coverage and equitable access to cancer care. The European Cancer Patient Coalition (ECPC), the leading ‘umbrella’ cancer patient organisation in Europe, has a central role in bringing the unmet needs of patients with cancer to the forefront of cancer policy, care and research. The ECPC is a respected and reliable partner in the oncology community and has effectively collaborated with institutional stakeholders and organisations, as well as with the European Commission, on cancer research projects and in the development of tools to advance health care and cancer policies at the European and national level. The ECPC believes that innovation cannot emerge and grow without patient involvement and is fully committed to increasing patient education and contribution in cancer research through its active participation in various European cancer research programmes and educational resources. The ECPC is expected to play a major role in the mission on cancer, given its previous achievements in policy and research to help overcome the inequalities in cancer prevention, treatment, rehabilitation and survivorship care. The mission on cancer will be facilitated by active collaboration between patient organisations and scientists, clinicians, politicians and industry, with the aim of identifying important research questions regarding quality of life and social issues for cancer patients of all ages.

Cancer Core Europe: A translational research infrastructure for a European mission on cancer

Cancer Core Europe is a European legal alliance consisting of seven leading cancer centres – most of them Comprehensive Cancer Centres (CCCs) – with a single portal system to engage in various research projects with partners. Cancer Core Europe was established to create a sustainable, high‐level, shared research infrastructure platform hosting research collaborations and task forces (data sharing, clinical trials, genomics, immunotherapy, imaging, education and training, and legal and ethical issues), with a controlled expansion agenda. Translational cancer research covers the cancer research continuum from basic to preclinical to early clinical, late clinical, and outcomes research. Basic–preclinical research serves as the ‘engine’ for early clinical research by bridging the early translational research gap and is the primary and current focus of the consortium as exemplified by the launching of the Basket of Baskets trial, Europe's largest precision cancer medicine trial. Inspired by the creation of Cancer Core Europe, the prevention community established Cancer Prevention Europe, a consortium of ten cancer prevention centres aimed at supporting the complete prevention research continuum. Presently, Cancer Core Europe and Cancer Prevention Europe are integrating therapeutics and prevention strategies to address in partnership the widening cancer problem. By providing innovative approaches for cancer research, links to healthcare systems, development of quality‐assured multidisciplinary cancer care, and assessment of long‐term outcomes, the virtual infrastructure will serve as a hub to connect and interact with other centres across Europe and beyond. Together, Cancer Core Europe and Cancer Prevention Europe are prepared to function as a central engine to tackle, in collaboration with various partners, a potential ‘mission on cancer’ addressing the cancer burden.

European Academy of Cancer Sciences - position paper

The European Academy of Cancer Sciences (EACS) is an independent advisory body of well-recognised medical specialists and researchers striving to create a compelling interactive continuum of cancer research, from innovative basic research to implementation of state-of-the-art evidence-based cancer care and prevention. Achieving the above will entail bridging high-quality basic and preclinical cancer research to research on prevention, early detection and therapeutics as well as improving coordination of translational research efforts across Europe. The latter is expected to be expedited through quality assuring translational cancer research in Comprehensive Cancer Centres - entities that link research with the healthcare system - and networks of cancer research centres. Achieving a critical mass of expertise, resources and patients is crucial. Improving late translational research, which involves clinical studies to assess effectiveness, and added value for the health care is also a high priority. Both high-quality Big Data collections and the intelligent use of these data will promote innovation in cancer research and support outcomes research to assess clinical utility, quality of cancer care and long-term follow-up of treated patients. The EACS supports the mission-oriented approach recently proposed by the European Commission in Horizon Europe to deal with major challenges and would like to persuade the EU and its member states to formally launch a mission in cancer to boost and streamline the cancer research continuum in Europe. Building a coherent translational cancer research continuum with a focus on patients and individuals at risk will require, however, foresight as well as the extensive and continuous provision of evidence-based advice to inform policy.