—

having regard to its decision of 18 June 2020 on setting up a special committee on beating cancer, and defining its responsibilities, numerical strength and term of office (1),

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having regard to the working document of its Special Committee on Beating Cancer of 27 October 2020 entitled ‘Inputs of the Special Committee on Beating Cancer (BECA) to influence the future Europe’s Beating Cancer Plan’ (2),

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having regard to the Commission communication of 3 February 2021 on Europe’s Beating Cancer Plan (COM(2021)0044),

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having regard to the EU’s Framework Programme for Research and Innovation 2021-2027 (Horizon Europe) (3) and the dedicated Horizon Europe Mission on Cancer (4),

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having regard to the Commission communication of 11 December 2019 on the European Green Deal (COM(2019)0640),

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having regard to the Council conclusions of 15 June 2021 on access to medicines and medical devices for a stronger and resilient EU (5),

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having regard to the guides developed by the Joint Actions on cancer (EPAAC, CANCON, iPAAC) and the Rare Cancer Agenda 2030 established under the Joint Action on Rare Cancers (JARC),

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having regard to the Commission communication of 30 September 2020 on a new ERA for Research and Innovation (COM(2020)0628),

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having regard to Council Recommendation 2003/878/EC of 2 December 2003 on cancer screening (6),

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having regard to the report of the International Agency for Research on Cancer (IARC) of May 2017 on the implementation of the Council Recommendation on cancer screening (7),

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having regard to the European guidelines for quality assurance in breast, cervical and colorectal cancer screening and diagnosis,

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having regard to the Commission communication of 20 May 2020 entitled ‘A Farm to Fork Strategy for a fair, healthy and environmentally friendly food system’ (COM(2020)0381),

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having regard to the Commission communication of 28 June 2021 on the EU strategic framework on health and safety at work 2021-2027 (COM(2021)0323),

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having regard to the Commission communication of 25 November 2020 on the Pharmaceutical Strategy for Europe (COM(2020)0761),

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having regard to the Commission communication of 14 October 2020 entitled ‘Chemicals Strategy for Sustainability — Towards a Toxic-Free Environment’ (COM(2020)0667),

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having regard to the Commission communication of 12 May 2021 entitled ‘Pathway to a Healthy Planet for All — EU Action Plan: “Towards Zero Pollution for Air, Water and Soil” (COM(2021)0400),

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having regard to Directive 2004/37/EC of the European Parliament and of the Council of 29 April 2004 on the protection of workers from the risks related to exposure to carcinogens or mutagens at work (the Carcinogens and Mutagens Directive — CMD) (8), including its three amending directives and the proposal by the Commission for the fourth amending directive (COM(2020)0571),

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having regard to Council Directive 98/24/EC of 7 April 1998 on the protection of the health and safety of workers from the risks related to chemical agents at work (9),

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having regard to the public consultation synopsis report of its Special Committee on Beating Cancer of 19 April 2021 entitled “The impact of the COVID-19 pandemic on cancer prevention, health services, cancer patients and research: lessons from a public health crisis”,

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having regard to the Commission communication of 11 November 2020 entitled “Building a European Health Union — preparedness and resilience” (COM(2020)0724), and to the related Commission proposals for, and the provisional agreements on, regulations of the European Parliament and of the Council of 11 November 2020 on serious cross-border threats to health (COM(2020)0727), on a reinforced role for the European Medicines Agency in crisis preparedness and management for medicinal products and medical devices (COM(2020)0725), and amending Regulation (EC) No 851/2004 establishing a European Centre for disease prevention and control (COM(2020)0726),

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having regard to Regulation (EU) 2021/522 of the European Parliament and of the Council of 24 March 2021 establishing a Programme for the Union’s action in the field of health (“EU4Health Programme”) for the period 2021-2027 (10),

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having regard to the Commission proposal for, and the agreement on, a regulation of the European Parliament and of the Council on health technology assessment and amending Directive 2011/24/EU (COM(2018)0051),

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having regard to Regulation (EU) No 536/2014 of the European Parliament and of the Council of 16 April 2014 on clinical trials on medicinal products for human use, and repealing Directive 2001/20/EC (11) (the Clinical Trials Regulation) and to the Clinical Trials Information System set up in accordance with that regulation,

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having regard to Regulation (EU) 2021/694 of the European Parliament and of the Council of 29 April 2021 establishing the Digital Europe Programme (12),

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having regard to Report No 21/2019 of the European Environment Agency (EEA) entitled “Healthy environment, healthy lives: how the environment influences health and well-being in Europe” (13),

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having regard to the opinion of the European Economic and Social Committee of 9 June 2021 on Europe’s Beating Cancer Plan (14),

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having regard to the conclusions and recommendations of the study prepared for its Panel for the Future of Science and Technology (STOA) in July 2021 on “The health impact of 5G” (15),

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having regard to the UN Sustainable Development Goals (SDGs), in particular SDG 3 on good health and well-being,

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having regard to the fourth edition of the European Code Against Cancer (16),

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having regard to the European Code of Cancer Practice (17),

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having regard to the Commission communication of 24 March 2021 entitled “EU strategy on the rights of the child” (COM(2021)0142),

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having regard to the Commission staff working document of 19 July 2018 on combatting HIV/AIDS, viral hepatitis and tuberculosis in the European Union and neighbouring countries — State of play, policy instruments and good practices (SWD(2018)0387),

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having regard to the report of the World Health Organization (WHO) of 2020, entitled “Alcohol and cancer in the WHO European Region: An appeal for better prevention” (18),

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having regard to the activity and conclusions of the all-party interest group MEPs Against Cancer (MAC),

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having regard to its resolution of 15 January 2020 on the European Green Deal (19),

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having regard to its resolution of 2 March 2017 on EU options for improving access to medicines (20),

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having regard to its resolution of 10 July 2020 on the Chemicals Strategy for Sustainability (21),

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having regard to its resolution of 12 February 2019 on the implementation of the Cross-Border Healthcare Directive (22),

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having regard to its resolution of 16 January 2019 on the Union’s authorisation procedure for pesticides (23),

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having regard to its resolution of 10 July 2020 on the EU’s public health strategy post-COVID-19 (24),

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having regard to its resolution of 17 September 2020 on the shortage of medicines — how to address an emerging problem (25),

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having regard to its resolution of 15 December 2016 on the regulation on paediatric medicines (26) and the Commission’s inception impact assessment concerning the revision of the EU legislation on medicines for children and rare diseases,

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having regard to Rule 54 of its Rules of Procedure,

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having regard to the report of its Special Committee on Beating Cancer (A9-0001/2022),

A.

whereas Europe’s Beating Cancer Plan (“the Plan”) should effectively respond to the call for progress by the families and health professionals of the 1,3 million people who die from cancer each year in Europe, including 6 000 children and young people, the crucial needs of patients who are currently in need of timely diagnosis and effective, innovative, accessible and affordable treatments and care for cancer and cancer-related complications and comorbidities, the rightful expectations of more than 12 million cancer survivors and their families facing the difficult return back to a “normal life”, the clear will of future generations to be protected against health threats and risk factors, and the concern of governments facing a growing economic and social burden from cancer and its related treatments; whereas Union actions in the fight against cancer should aim to increase the five-year survival rate of cancer patients;

B.

whereas Europe represents less than 10 % of the world’s population, but accounts for a quarter of all cancer cases, and whereas cancer is the second leading cause of death in Europe after cardiovascular diseases and the first cause of death by disease in children older than one year; whereas the specific needs of children and adolescents with cancer require continued attention and support globally, and paediatric oncology should be differentiated from adult cancer management; whereas although there has been a slight decrease in mortality rates thanks to screening campaigns, improved diagnostics and therapeutic innovation, the number of cases diagnosed is nevertheless increasing, notably due to longer life expectancies, which result in ageing populations; whereas almost three quarters of all cancer diagnoses in the EU occur in people aged 60 or above;

C.

whereas cancer illustrates social injustice and inequity in healthcare, as differences in cancer survival rates across the EU Member States exceed 25 %; whereas EU citizens are facing inequities in terms of prevention, and are unequally protected against risk factors, unequally educated in terms of healthy behaviours and unequally equipped against misinformation; whereas EU citizens are unequal in terms of timely access to affordable and quality treatment and care from Member State to Member State and from region to region in any given country; whereas access to fully multidisciplinary and multiprofessional medical teams varies widely across Europe; whereas after recovery or when in remission, EU citizens are unequal in their ability to return to work, to be financially independent and to return to a harmonious familial, social and emotional life; whereas class and gender are important measures and drivers of inequalities and inequities at all stages of the disease;

D.

whereas specific national or regional cancer policies have been set up in most Member States, whose missions, capacities and budgets are heterogeneous; whereas some regions have become hubs in the fight against cancer, with an expertise that should be shared all over the Union;

E.

whereas the goal of the Plan should not only be to fight against a crucial public health issue and to help patients live longer and better lives, but should also be to initiate a reduction in health inequalities and inequities and lower the social and economic burden of the disease; whereas the Commission should promote a patient-centred and citizens’ rights-based approach by integrating considerations of justice, sustainability, equity, solidarity, innovation and collaboration at the very core of the Plan, including its ‘Helping Children with Cancer Initiative’;

F.

whereas the COVID-19 pandemic has caused, and is still causing, severe disruptions to cancer screening programmes, treatment, research, and survivorship and follow-up services, with the resulting impact on cancer patients, families and healthcare professionals; whereas the pandemic has created an urgent need to build back cancer services in all European countries and to address highly concerning backlogs in prevention actions, as well as in early detection and diagnosis; whereas an estimated 100 million screening tests were not performed in Europe during the pandemic and 1 million cancer cases are undiagnosed; whereas 1 in 5 cancer patients did not receive the surgical or chemotherapy treatment they needed on time (27); whereas healthcare professionals have taken on the burden of a pandemic and have had to cope in a very stressful working environment;

G.

whereas health literacy includes the acquisition of knowledge and skills, awareness of rights and the confidence to take action to improve personal and community health; whereas actions to promote health literacy under the Plan should focus on empowering patients and citizens through state-of-the-art communication tools, and also by seeking the expertise of, and collaborating with, patient organisations and other NGOs which have been working on disseminating and spreading health literacy for years; whereas patient empowerment requires assisting patients in understanding their rights; whereas all efforts to increase health literacy, including digital literacy, should take into account people who are experiencing exclusion and the needs of people with learning disabilities; whereas inequalities in knowledge of, access to and use of IT technologies, as well as regional, national, social and economic differences, should be taken into account; whereas the necessary information should be available in common non-EU languages in order to reach migrants, new arrivals and other vulnerable groups and minority communities; whereas in efforts to improve health literacy, the onus should also be on assisting citizens in identifying misinformation, noting the harmful impacts this can have across all areas of cancer care, including prevention, vaccination and treatment;

H.

whereas about 40 % of cancer cases in the EU are preventable; whereas prevention is more effective than any cure, as well as the most cost-effective long-term cancer control strategy; whereas the Plan should address all key risk factors and social determinants of cancer; whereas the EU level is crucial in cancer prevention as it has significant competences that have an impact on most risk factors for cancer;

I.

whereas according to Report No 21/2019 of the EEA, cancer is the top non-communicable disease attributable to the environment, with more than 250 000 cancer deaths attributed to the environment in 2016 in 32 high-income European countries; whereas the EEA identified ambient air pollution, chemicals, indoor fuel combustion and radiation as environmental risk factors for cancer;

J.

whereas air pollution is a main driver of mortality, with pollutants from a wide range of sources, including energy, transport, agriculture and industry, contributing to 400 000 premature deaths per year, including from lung cancer, heart disease and strokes;

K.

whereas the Commission communication on strengthened cooperation against vaccine-preventable diseases (COM(2018)0245) recommends developing EU guidance to establish comprehensive electronic immunisation information systems at national level for effective monitoring of immunisation programmes; whereas this should be done in full compliance with data protection rules; whereas human papillomavirus (HPV) is a sexually transmitted infection associated with almost 5 % of all cancers in women and men worldwide, namely cervical and oropharyngeal, but also anal, penile, vaginal and vulval cancers; whereas both reaching HPV vaccination coverage targets for girls and setting up high-quality organised cervical cancer screening is necessary in order to reach the 2030 WHO goals regarding the elimination of cervical cancer as a public health problem; whereas HPV vaccination rates are worryingly low across the Member States; whereas, regretfully, there are major discrepancies in vaccination coverage between Member States, ranging from less than 30 % to more than 70 % (with the required level of population immunity being at 70 %); whereas Helicobacter pylori is the principal infectious cause of cancer worldwide, mainly for non-cardia gastric adenocarcinoma;

L.

whereas certain endocrine cancers (such as thyroid, breast and testicular cancer) are on the rise; whereas endocrine treatments for hormone-dependent cancers can have endocrine side effects; whereas cancer treatments can have long-term effects such as endocrine comorbidities in cancer survivors; whereas obesity is a known risk factor for many cancers, including endocrine cancers; whereas exposure to endocrine-disrupting chemicals (EDCs) is known to have an effect on the development of obesity and cancer; whereas EDCs cost the Member States between EUR 157 and 270 billion annually (up to 2 % of EU GDP) (28) in healthcare expenses and lost earning potential, largely due to neurodevelopmental and metabolic disorders and cancer;

M.

whereas exposure to dangerous substances at work is responsible for about 120 000 work-related cancer cases each year, leading to approximately 80 000 fatalities annually, which represents 8 % of all cancer deaths (12 % of cancer deaths among men, and 7 % of cancer deaths among women); whereas it can be difficult to establish causal relationships, however, due to long latency periods; whereas the WHO’s IARC has identified 50 priority carcinogens and shown that workers are widely exposed to them in Europe; whereas the vast majority of cancers induced by occupational carcinogens at work appear to be preventable if the carcinogens are regulated accordingly but, under Directive 2004/37/EC, binding occupational exposure limit (OEL) values exist to date for only 27 of them; whereas further action is necessary to prevent, detect and better recognise occupational cancers related to night-shift work as well as UV radiation (for outdoor workers);

N.

whereas a changing labour market with demographic developments, new technologies and new types of jobs has potential impacts on occupational health and safety; whereas more workers are moving into platform work, non-traditional work or atypical employment; whereas factors such as radiation, stress, work organisation and working conditions have all been linked to work-related cancer (29); whereas there is currently a lack of reliable and comparable EU-level data on workplace exposure to cancer risk factors (30);

O.

whereas contrary to workplace accidents, where injuries can be more easily assessed and compensation awarded, it can take years or decades before work-related cancers are diagnosed and the cause is properly identified; whereas the Commission Recommendation on occupational diseases (31) recommends that Member States introduce, as soon as possible, into their national laws, regulations or administrative provisions concerning occupational diseases liable for compensation the European schedule set out in Annex I to the aforementioned recommendation; whereas the existing disparities between Member States with regard to the recognition rate of occupational diseases mean that many workers never have their occupational disease recognised;

P.

whereas radon is a radioactive gas that has no colour or odour, and as radon decays in the air, it releases radiation that can damage the DNA of cells inside the body; whereas radon levels vary widely in different regions or even residential areas and can be present in both outdoor and indoor air;

Q.

whereas in 2011 the IARC classified radiofrequency electromagnetic fields as possibly carcinogenic to humans, based on an increased risk of glioma associated with mobile phone use; whereas there are studies, published in 2015 and 2018, showing a significant increase (more than doubling) in glioblastoma tumours over 20 years (1995-2015) in all age groups, and others showing the increased risk of glioblastoma associated with mobile and cordless phone use in people aged 18-80; whereas more studies are needed to establish these associated risks;

R.

whereas 24 % of all new cancer diagnoses, including all paediatric cancers, across Europe each year are rare forms of cancer and represent a public health challenge in themselves; whereas patients with rare cancers face challenges linked to late or incorrect diagnosis, lack of access to appropriate therapies and expertise, lack of understanding of underlying science, lack of commercial feasibility in developing new therapies, few available tissue banks, difficulties in conducting well-powered clinical studies, and also feelings of isolation;

S.

whereas the Plan should be implemented in close association with the recommendations and actions of the IARC, the UN SDGs for global health, including the objective of achieving universal health coverage, the recommendations and guidelines of the WHO, international health agreements including the WHO Framework Convention on Tobacco Control and the WHO Global Initiative for Childhood Cancer, the EU Joint Actions on Cancer, and recommendations and guidelines by experts and patients’ associations; whereas the Plan should acknowledge as a priority the EU’s solidarity and partnership with low- and middle-income countries, including those in the wider WHO Europe region;

T.

whereas the Act concerning the conditions of accession of Austria, Finland and Sweden grants an exemption to Sweden from the EU-wide prohibition of the sale of certain types of tobacco for oral use;

U.

whereas the Mediterranean diet is known as a healthy, balanced diet that plays a protective role in the primary and secondary prevention of the main chronic degenerative diseases;

V.

whereas while the Plan gives remarkable attention to a range of policy needs in respect of cancer screening, less initiative is offered for early detection of cancers not covered by screening programmes; whereas targeted action is therefore necessary to foster better awareness of cancer warning signs among citizens and healthcare professionals;

W.

whereas the increase in the prices of cancer medicines has exceeded the increase of total cancer spending, and new cancer medicines coming onto the market at a high price were identified as an important driver of the increase in cancer care expenditure; whereas the WHO Technical Report of 2018 on the pricing of cancer medicines and its impacts (32) recognised that prices of cancer medicines were higher than for other indications and their costs were growing at a faster rate, resulting in lack of access to treatment for many patients worldwide and hampering the capacity of governments to provide affordable access for all;

X.

whereas addressing cancer in a comprehensive strategy such as the Beating Cancer Plan presented by the Commission could be used as a model for other non-communicable diseases, and whereas patients with other chronic diseases should therefore also benefit from the achievements and principles of the Plan, and similar plans should be developed for other pathologies with high mortality rates;

Y.

whereas coordination between European countries, a common policy driven at European level and cross-border knowledge-sharing are absolutely essential for progress in the area of cancer; whereas the primary responsibility for health protection and healthcare systems lies with the Member States;

Z.

whereas a comprehensive, multidisciplinary and coordinated approach to addressing behaviour-related, biological, environmental, work-related, socio-economic and commercial health determinants is needed at regional, national and European level in order to support actions targeting all aspects of cancer (prevention, detection, treatment, palliative care, follow-up care for survivors and reintegration) through the effective mobilisation of key tools such as adequate resources and funding, legislation, research and knowledge-sharing; whereas patient-centred approaches to treatment have been shown to improve the quality of life and overall survivorship of patients; whereas new technologies and artificial intelligence have high potential for improvements in the field of cancer research, treatment processes and care;

AA.

whereas research and innovation are our only hope of definitely beating cancer one day; whereas sustained and effective funding is needed to support ambitious projects and good and stable working conditions for researchers working in the cancer field; whereas pharmaceutical companies, including SMEs, are key stakeholders for innovation in the cancer field;

AB.

whereas the ‘Health in All Policies’ and ‘One Health’ approaches should be promoted further, and efforts to fight cancer should be integrated into all EU policies;

AC.

whereas the EU and its Member States should mobilise their forces and provide adequate incentives and sustainable budgets so as to achieve the ambitious objective of conquering the cancer burden and the fatality of cancer in Europe;

AD.

whereas the Plan could therefore represent an important step towards a real European Health Union and a public demonstration to citizens of the success that EU health cooperation can achieve;

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