Proyecto de la Unión Europea – Grupo Europa contra el Cáncer. Alfredo Carrato Mena. I Jornadas Técnicas de la Estrategia en Cáncer del SNS (Madrid, Ministerio de Sanidad y Consumo, 2007)

1. I Jornada Técnica de la ESTRATEGIA EN
CÁNCER DEL SISTEMA NACIONAL DE SALUD
Madrid, MSC, 25 y 26 de Junio de 2007.
PROYECTO DE LA UNIÓN EUROPEA:
GRUPO EUROPEO CONTRA EL
CÁNCER
Alfredo Carrato
Catedrático y Jefe de Servicio Oncología Médica
Hospital Universitario de Elche, Univ. Miguel Hernández

2. CANCER CHARACTERISTICS

3. Cancer Incidence Rates*, All Sites Combined,
All Races, 1975-2000
Rate Per 100,000
700
600 Men
500 Both Sexes
400 Women
300
200
100
0
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
*Age-adjusted to the 2000 US standard population.
Source: Surveillance, Epidemiology, and End Results Program, 1973-1999, Division of Cancer Control and Population Sciences,
National Cancer Institute, 2003.

4. SITUACIÓN DEL CÁNCER EN ESPAÑA 2003
• 162.000 nuevos casos y 95.000 defunciones.
• El cáncer es la primera causa de fallecimiento por delante de las
enfermedades cardiovasculares.
• Uno de cada 3 hombres y una de cada 5 mujeres se diagnosticarán
de cáncer en algún momento de su vida.
• El cáncer colorrectal es el más frecuente con 25.600 casos nuevos
anuales
• Los más frecuentes:
– en hombres son el de pulmón (16.600 nuevos casos/año), el
colorrectal (14.204) y próstata (13.212).
– En mujeres el de mama (15.979), colorrectal (11.461) y útero
(7.164).
• Supervivencia a 5 años (57%): 64% en mujeres y 50% en hombres

5. Gene-Environment Interaction and
Likelihood of Developing Cancer
A cancer gene could be expressed without any environmental influence or
only when activated by environmental factors. Lichtenstein P. N Engl J Med 2000; 343:78-85

6. FRENTES EN LA LUCHA CONTRA EL CÁNCER
• Aumento de conocimientos sobre la biología del cáncer
(Incremento de la investigación básica, traslacional y
clínica)
• Prevención primaria (Hábitos saludables, fármacos, cirugía,
etc.)
• Prevención Secundaria (Diagnóstico precoz)
• Mejorando el diagnóstico (Innovación tecnológica)
• Mejorando el tratamiento (Fomento de la investigación
traslacional y clínica. Nuevos fármacos y estrategias.
Tratamientos individualizados, administrados por
profesionales bien entrenados)

7. Tobacco Use in the US, 1900-2000
5000 100
4500 90
Per Capita Cigarette Consumption
Age-Adjusted Lung Cancer Death
4000 80
3500 70
Per capita cigarette consumption
3000 60
Rates*
2500 50
Male lung cancer death rate
2000 40
1500 30
1000 20
500 10
Female lung cancer death rate
0 0
1900
1905
1910
1915
1920
1925
1930
1935
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Year
*Age-adjusted to 2000 US standard population. Source: Death rates: US Mortality Public Use Tapes, 1960-2000, US Mortality Volumes, 1930-
1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002. Cigarette consumption: US Department of
Agriculture, 1900-2000.

8. Trends in Obesity* Prevalence (%), By Gender,
Adults Aged 20 to 74, US, 1960-2000
45
40
34
35
31
30 28
Prevalence (%)
26
23
25
21
20 17
16 17
15
13 15
12 13
15
11
10
5
0
Both sexes Men Women
NHES I (1960-62) NHANES I (1971-74) NHANES II (1976-80)
NHANES III (1988-94) NHANES 1999-2000
*Obesity is defined as a body mass index of 30 kg/m2 or greater. Source: National Health Examination Survey 1960-1962, National Health and
Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2000, National Center for Health Statistics, Centers for Disease Control
and Prevention, 2002.

9. Supervivencia a 5 años en cáncer en la UE

10. European Alliance Against Cancer
• Justified by the challenge that cancer represents for Europe on
the human, scientific and political fronts.
• The Alliance had come about as a result of a proposal made
by European Ministers of Health in April 2005.
• Twenty-three representatives from European Member States
were present at the first meeting in Paris, December 13, 2005
• There was a presentation by each country of their national
organisation in the area of cancer, key challenge, innovative
area of working and expectations from the Alliance.
• Policies, programmes and projects implemented by the
European Commission were also presented.

12. Mission Statement
• quot;Cancer is a major health challenge for Europe. It is the second
cause of mortality and more than two million new cases are
recorded each year.
• The European Alliance against Cancer aims:
• To define, promote and offer joint actions through voluntary
cooperation to strengthen national measures and to ensure
equal access to prevention and treatment for all European
citizens, and to improve outcomes including patients’ overall
experience of care.
• To explore ways of supporting research efforts and their
implementation into practice.quot;

13. Discussion on suggested areas of
collaboration
• Clinical guidelines - Teresa Moss, UK
• Tumour Banks* - Marcella Mottolese, Italy (E de Álava)
• High throughput technologies* – François Amalric, France
(X Bustelo)
• Education and Training* – Miklós Kásler and Maria Godeny ,
Hungary (A Carrato)
• Clinical trials database – Thierry Le Chevalier, France
• Primary prevention -Harald Zur Hausen, Germany
• Secondary prevention. Sergio Pecorelli, Italy

14. Regina Elena Cancer Institute, Rome,
Steering Committee Meeting, 27 April 2006
• 11 members of the steering committee were present at the
meeting, representing 10 countries.
• In Europe, there are major differences in the level of health care
between and within countries.
• EAAC was set up as an Alliance focused on political issues in
cancer and therefore one of its objectives is to set the minimum
service which should be available in Europe
• Patients can move in Europe to get treatment with E112
documents which allow patients to be treated in another country
because the ‘best treatment” is not available in their own
country.

15. Educational Working Group Meeting
National Institute of Oncology, Budapest, 17th July, 2006
• Discussion about the educational systems of the present
representatives (3) of the participant countries (9).
Christine Lepage (EAAC member, France)
–
Alfredo Carrato (Spain)
–
Maria Gődény (Hungary)
–
Breborowicz (Poland)
–
• Minimum Recommendations have to be pointed for
– Undergraduate programs (medical faculties, universities)
– Graduate programs (resident’s training)
– CME

16. Tumor Bank Working Group Meeting
Regina Elena Cancer Institute Rome, 7th December, 2006
Distribución de tareas entre los miembros del equipo:
• preparar un documento para los Ministros de Sanidad de
cada nacioón acerca de las condiciones mínimas que deben
tener los bancos de tumores europeos,
• Una guía para la promoción de bancos nuevos, como para la
acreditación de bancos ya existentes, allá donde aún no se
hayan puesto en marcha sistemas de acreditación de
biobancos (cualquier lugar excepto UK).

17. Budget
• France would finance the work of the Alliance and host the
secretariat during the first year of its activities.
• It was agreed that each country should be asked to make a
contribution to an initial budget for the next three years of the
EAAC's activity and that individual working groups could also
look for further funding from other sources such as the EC.
• It was agreed that industry funding for meetings was not
acceptable.
• France, Germany, Italy, Portugal and Spain all thought that they
would be able to secure funding. Representatives from Hungary,
Ireland and Luxembourg were not able to commit without further
consultation and the Teresa Moss, for the UK, was sure that she
would not be able to secure funding.

18. FACTORES CRÍTICOS PARA EL ÉXITO EN EL PROGRESO DE LA ONCOLOGÍA
Impulsar la colaboración entre todos los sectores y
centrarla alrededor del paciente
Incremento inversiones en prev formac asist e investig cáncer
Gobiernos Nacionales
y otros ...
Unión Europea
Industria
Agencias Reguladoras
Farmacéutica
Paciente
Centros de
Sociedades Investigación
Científicas
Instituciones
Instituciones
Académicas
Clínicas

19. ¡Gracias!