The global burden of cancer is increasing faster than ever and given the impact of COVID-19 on cancer services, it is now crucial that the full potential of laboratory diagnostics for cancer is realised. Laboratory diagnostics play a vital role in prevention (when 30-50% of cancers could be prevented (1) and in achieving better patient outcomes. In clinical decision making, laboratory diagnostics account for up to 66% of decisions – and yet less than 2% of total healthcare spending is allocated to this technology (60). European Union Member States need strong, coordinated policies that recognise the strength of robust cancer screening strategies and early detection. These policies must take a holistic approach – reflecting the value of diagnostic information across the full cancer care continuum (screening, diagnosis, treatment and monitoring) and for all stakeholders (patients, healthcare professionals, healthcare providers and the healthcare system as a whole).
Recommendations concerning the implementation of the Europe’s Beating Cancer Plan (EBCP):
1. National cancer plans: There is an array of actions that the EU can take to promote more robust national policies for prevention, screening and early diagnosis, with a focus on improved programmes, guidelines, infrastructures and awareness.
2. Cancer inequalities: Reduce cancer inequalities by assessing country performance in screening and early detection through the Cancer Inequality registries by ensuring that the used indicators include the rate of participation in cancer screening, the time to diagnosis, and the rate of early detection as well as the related enabling infrastructures.
Recommendations concerning the general organisation of healthcare systems:
3) Patient access: The EU needs to enable broad and timely patient access to innovative diagnostics to improve cancer patient outcomes. Access to diagnostics allows for the most appropriate and personalised treatment for cancer patients, improving outcomes. This can be achieved by providing accelerated and permanent reimbursement of diagnostic tools and adopting EU-wide guidelines to ensure predictability and consistency across Member States.
4) Value assessment: When assessing the value of laboratory diagnostics, the assessment methodology needs to be adapted to consider the value of testing for screening and early detection, the clinical value at each stage of the cancer care continuum, and the overall value for society from more people living longer and better quality lives, either in remission or living with cancer.
5) Healthcare systems preparedness: Actions must be taken to improve the preparedness and continuity of cancer care during future health crises by deploying funds for screening, modernising relevant infrastructures, and a targeted approach to citizens, ensuring healthcare systems resilience. Furthermore, targeted actions need to be taken at the EU level to address the COVID-19 backlog, and tackle delayed or undiagnosed cancers.
The paper “The Value of Diagnostic Information (VODI) in Cancer care” provides more information on the value of laboratory diagnostics across the whole cancer continuum, the current situation in Europe and how the above recommendations could be implemented in practice.
1 WHO. Cancer. [Online]. Available at: https://www.who.int/health-topics/cancer#tab=tab_1. [Last accessed: May 2022].
60 Rohr UP, Binder C, Dieterle T, Giusti F, Messina CG, et al. The value of in vitro diagnostic testing in medical practice: a status report. PloS one. 2016;11(3):e0149856.