Europaudvalget 2020-21
EUU Alm.del Bilag 316
Offentligt
2337454_0001.png
Sundheds- og Ældreministeriet
Enhed: SPOLD
Sagsbeh.: DEPAJU
Koordineret med:
Sagsnr.: 2001466
Dok. nr.: 1290242
Dato: 31-07-2020
NOTAT
Denmark’s position on the ”Europe’s Beating Cancer Plan”
Inequality in cancer incidence and survival
Lower socioeconomic and vulnerable groups have higher morbidity and mortality of
cancer statistically. These groups have lower health literacy, are less aware of cancer alert
symptoms, are less likely to seek medical attention when having symptoms of cancer, and
they participate less in cancer screening programs. The social gradient is present
throughout the entire cancer care pathway in the form of differences in incidence,
diagnosis and treatment, late treatment complications, occupational attachment and
survival.
Reduced inequality within and among countries is one of the United Nations’ Sustainable
Development Goals (SDG 10). Reducing inequality in health is also a key priority for the
Danish government, and Denmark therefore advocates that the “Europe’s Beating Cancer
Plan” should have a broad focus on fighting inequality in health by encompassing
initiatives to even out the social gradient in cancer incidence and survival within each of
the four pillars of the Plan. Citizens have different backgrounds and their preconditions for
using health care are therefore not the same. Denmark advocates that the Cancer Plan
contains initiatives that focus on increasing health literacy and making health care more
accessible for lower socioeconomic population and vulnerable groups.
Knowledge, data and scientific evidence
In recent years, we have gained more knowledge about risk factors for cancer and
effective treatment. There is still a 'knowledge gap', especially in terms of follow-up and
life as a cancer survivor. Denmark supports a partnership and cooperation between EU
member countries on data collection and knowledge exchange in the field of cancer.
It is a Danish priority in the field of cancer to support actions and initiatives to promote
knowledge, data and scientific evidence for example:
Initiatives to develop a cancer knowledge centre whose main task is to promote
cancer treatment, collect evidence and develop guidelines for clinical diagnosis
and treatment practices.
Initiatives for a European clinical quality database covering all cancers that
collects data from all countries and provides epidemiological support to a cancer
knowledge centre.
Development and research into new technologies within medical and digital
welfare solutions as these tools are important in order to meet diverse health
needs within different patient groups. Furthermore, individualised medicines, to
disseminate specialized treatment services, to support medical decision-making,
1
 EUU, Alm.del - 2020-21 - Bilag 316: Regeringens positionspapir vedr. Kommissionens kræftplan (Europe's Beating Cancer Plan)
diagnosis and treatment etc. are also important measures in the future fight
against cancer.
New technologies, such as artificial intelligence (AI) used as decision support tool,
should, however, be assessed in relation to evidence and be validated before
they are widely introduced in order to ensure that the beneficial effects outweigh
the harmful ones, as well as it should be ensured that these new technologies do
in fact create added value and are more cost-effective than existing technologies.
Prevention
Denmark supports the Commission’s emphasis on the importance of promoting disease
prevention initiatives in the fight against cancer, i.e. recommendations on early
interventions such as the importance of a healthier lifestyle and a healthy working
environment.
Tobacco
Children and young people that start smoking are more likely to continue smoking and are
particular vulnerable to the harmful effects of smoking because of long-term exposure.
Denmark therefore finds it important to focus on preventing smoking among children and
young people and to take measures that can prevent young people from starting smoking.
The Danish government published an action plan in December last year on fighting
smoking among children and young people which will introduce a number of initiatives
including standardised packages, increased prices and increased restrictions for marketing
tobacco products.
It is a Danish priority in the field of cancer to support actions and initiatives to promote:
Increased bans on the marketing and sponsorship of tobacco across the EU
(Tobacco Advertising Directive 2003/33/EC).
Revision of the Tobacco Tax Directive (2011/64 / EU). There is a need for an
increase in rates, so that taxes across the EU become more level.
Revision of the Tobacco Products Directive (2014/40 / EU), which focuses, for
example, on the treatment of new tobacco products and nicotine products, as
well as the introduction of standardized packages across the EU.
Healthy and active lifestyle
Prevention of overweight is highly relevant in cancer prevention, as being overweight
increases the risk of 13 different cancers and is the second largest risk factor for cancer
after smoking. At the same time, the focus on how to gain a healthy and active lifestyle
can contribute to prevent overweight.
It is a Danish priority in the field of cancer to support actions and initiatives to promote:
The development of information to health care providers and families with
children of age 3-6 years on healthy eating and meal habits.
Interventions for families in need of additional support during the child's first
year of life.
Alcohol
There is a general need for more information on the link between a high alcohol
consumption and the increased risk of getting cancer. Such information could be useful for
both adults and young people in order to encourage a healthier alcohol culture.
Side 2
2
 EUU, Alm.del - 2020-21 - Bilag 316: Regeringens positionspapir vedr. Kommissionens kræftplan (Europe's Beating Cancer Plan)
It is a Danish priority in the field of cancer to support actions and initiatives to promote:
Increased knowledge in the general population on the link between high alcohol
consumption and the increased risk of cancer.
Healthy working environment
One of the health problems, which faces workplaces across Europe, is work-related
cancer, while exposure to for example hazardous substances and materials carry a risk of
getting cancer.
It is a Danish priority in the field of cancer to support actions and initiatives to promote:
- Health and safety at workplaces.
Early detection and diagnosis
Early detection and rapid detection are important in relation to the prognosis of many
types of cancer.
It is a Danish priority in the field of cancer to support actions and initiatives to promote for
example:
The introduction of new screening programs should be based on evidence, while
at the same time taking into account the balance between beneficial and adverse
effects of introducing new screening programs as well as assessing how such
programs will fit with the organisational set-up of national health sectors.
It is important to conduct research and collect knowledge in existing screening
programs. Firstly, research and knowledge can be used to increase participation
in screening programs. But if necessary, such knowledge can also be used to
optimize and adapt existing screening programs by for example differentiating
existing screening services to meet the needs of specific target groups. It is
important to do ongoing work on introducing screening technologies that are less
intrusive to the target group (such as home-assembled samples and capsule
endoscopy), which potentially also prevents inequality in, who accepts screening
offers.
Consider that quality in screening programs is best achieved through data-driven
quality work knowledge exchange rather than quality control and accreditation
processes.
Treatment and care
In 2008, Denmark introduced cancer packages, with the aim, that no patient should
experience unnecessary waiting time in relation to their examination and treatment of
cancer, and at the same time ensuring a high patient experience and professional quality,
and improved cancer survival.
It is a Danish priority in the field of cancer to support actions and initiatives targeted at
treatment and care such as:
Introduction of gradient times and monitoring
Introduction of the gradient coordinator function
Increased focus on rehabilitation and palliation
Introduction of follow-up programs
Focus on the impact of co-morbidity on the patient cycle
Moreover, it is a Danish priority in the field of cancer to support actions and initiatives
targeted at treatment and follow-up such as:
Development of evidence-based national clinical practice guidelines aimed at
improving and unifying the quality of cancer treatment.
Side 3
3
 EUU, Alm.del - 2020-21 - Bilag 316: Regeringens positionspapir vedr. Kommissionens kræftplan (Europe's Beating Cancer Plan)
Cooperation in the treatment of rare cancer diseases and experimental cancer
treatments.
Quality of life for patients with cancer, survivors and careers
A holistic view on the patient with cancer and survivors life is important to improve their
quality of life. Initiatives to reintegrate cancer patients and survivors into working life are
important.
Denmark finds that a way to improve quality of life of patients is through implementing
standardized healthcare procedures. In Denmark, we have positive experience with
implementing cancer care pathways, which facilitate cross-sectoral collaborations
between multiple sectors and stakeholders in the society, e.g. healthcare planners, health
professionals and private organizations.
Denmark supports a holistic perspective on the patient’s situation of life in planning the
cancer care pathway. It is important to have a focus on all determinant of a healthy life for
patients with cancer and survivors including, individual factors (physical and mental
health), social relations and communities, living and working conditions and general socio-
economic, cultural and environmental conditions.
Some of the tools in the Danish cancer care pathways, to support the patients and their
quality of life is:
the implementation of a person responsible doctor and a contact nurse
through patient decision supportive methods.
Another important point is to ensure the coherence in the follow up/after care. When the
patient’s treatment is almost finished, a follow-up plan, which identifies the further needs
of the patient regarding the rehabilitation and medical follow-up, must be handed out to
the patient. This plan should be available for the patients and aims to increase the
patient’s follow-up and the coherence of the patient care pathway.
Side 4
4