Expert group calls for urgent action as variance of prostate cancer care laid bare

The first analysis of its kind carried out the by the Let’s Talk Prostate Cancer Expert Group – an initiative organised and funded by Astellas Pharma Europe – shows that despite being the most frequently diagnosed cancer in men, and with increasing incidence, prostate cancer does not receive the political attention that it deserves and patients experience wide variations in standards of care, whilst issues such as stigma, social isolation and poor help-seeking continue to raise concerns.

This is why the new Let’s Talk Prostate Cancer Digital Atlas has been launched – a unique and wide-ranging resource hub that provides the latest data, analysis and information on prostate cancer, aiming to aid informed decision-making and policy development to improve prostate cancer care and outcomes.

Analysis reveals that across the EU, just four countries – Austria, Estonia, Germany and the UK (England) – have in place tracked targets to improve prostate cancer outcomes despite prostate cancer accounting for around 25% of all new male cancers and 10% of male cancer deaths every year.

The analysis also shows considerable variation in access to specialist care across Europe. For example, there is a particularly low number of urologists in Ireland and the UK.

Currently, there is one urologist per 64,000 inhabitants in the UK compared to one per 14,000 in Germany. Also, guidelines from the European Association of Urology (EAU) suggest that treating prostate cancer patients in a way that prioritises quality of life requires a multi-disciplinary team, but only out of 27 countries explicitly recommend this in their national guidelines.

The data show that countries which invest more in cancer care tend to achieve better patient outcomes. However, there is a significant variation in cancer medicines spend across Europe suggesting that not all men receive optimal treatment. Belgium, Germany and Austria all have a high per capita spend on cancer treatments. For example, Austria spent €108 per capita in 2018 in comparison to the UK and Portugal, who spent less than half the amount per capita.

In addition, despite the high disease burden on those affected and their families, new analysis shows that prostate cancer is also not as highly prioritised as other types of cancer and that the gold standard of breast cancer care should be applied more widely to all types of cancer. The findings reveal that in five European countries – the United Kingdom, Germany, Italy, France, and Spain – the number of political debates, discussions and groups related to breast cancer is significantly higher than the number for prostate cancer.

For example, in France, prostate cancer is mentioned four times in the national cancer strategy, compared to 25 mentions, and a separate chapter, for breast cancer, despite more new cases of prostate cancer than breast cancer in 2018.

Throughout 2020, Covid-19 has exacerbated issues relating to early detection, treatment and care of patients with cancer, including men with prostate cancer, at a time when health inequalities, stigma and health system challenges are already contributing to sub-optimal outcomes.

It is also widely acknowledged that there is evidence of disproportionate mortality and morbidity amongst black, Asian and minority ethnic people when looking at the impact of Covid-19. This is mirrored by the fact that these communities also have a 30% higher mortality rate when confronted with prostate cancer, demonstrating that there is an urgent need to better understand and support these specific communities.

This new Europe-wide resource hub shows that direct political action is needed across the EU if outcomes for those living with the disease are to be improved. The Let’s Talk Prostate Cancer group is calling on policymakers and health system leaders to ensure that those affected by prostate cancer receive the right treatment at the right time, no matter where in Europe they live. This should include a commitment by national governments to ensure specific and measurable prostate cancer targets are implemented in country cancer plans and that all EU Member States follow the European Association of Urology (EAU) clinical guidelines on prostate cancer.

Tiemo Wölken, MEP said: “Our new analysis reveals considerable variance in prostate cancer care across European countries. Awareness remains relatively low, early detection is a challenge and people living with prostate cancer do not always have access to the treatment and care necessary to secure the best possible outcomes – longer and more comfortable lives despite the disease.

“This variance of cancer care cannot continue. These issues, compounded by the COVID-19 crisis, require urgent action, but they also present a unique opportunity for change and improvement in care.

“We have launched the Let’s Talk Prostate Cancer Digital Atlas today as we are urging policymakers at national and European level to review the level of focus on prostate cancer within cancer strategies. Firstly, the Let’s Talk Prostate Cancer group is calling on all EU Member States to ensure that, as a minimum, the European Association of Urology (EAU) clinical guidelines on prostate cancer are followed.

“This will help reduce the variance in patient care and outcomes. Secondly, all EU Member States should have in place an ambition specific to prostate cancer within their national cancer plans, which is measurable and achievable. We expect the EU Beating Cancer Plan to be launched in January and we strongly encourage these measures to be introduced as part of the implementation of this important plan.”

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