Cancer Control in Central and Eastern Europe: Current Situation and Recommendations for Improvement

Abstract

: The incidence of many cancers is higher in Western European (WE) countries, but mortality is frequently higher in Central and Eastern European (CEE) countries. A panel of oncology leaders from CEE countries participating in the South Eastern European Research Oncology Group (SEEROG) was formed in 2015, aiming to analyze the current status and trends of oncology care in CEE and to propose recommendations leading to improved care and outcomes. The SEEROG panel, meeting during the 11th Central European Oncology Congress, proposed the following: (a) national cancer control plans (NCCPs) required in all CEE countries, defining priorities in cancer care, including finance allocation considering limited health care budgets; (b) national cancer registries, describing in detail epidemiological trends; (c) efforts to strengthen comprehensive cancer centers; (d) that multidisciplinary care should be mandated by the NCCPs; (e) that smaller hospitals should be connected to multidisciplinary tumor boards via the Internet, providing access to specialized expertise; (f) nationwide primary prevention programs targeting smoking, obesity, and alcohol consumption and centrally evaluated secondary prevention programs for cervical, colorectal, and breast cancers; (g) prioritize education for all involved in cancer care, including oncology nurses, general practitioners, and palliative care providers; (h) establish outpatient care in day hospitals to reduce costs associated with the current inpatient model of care in CEE countries and to improve patients' quality of life; (i) long-term pharmacoeconomic evaluations of new therapies in CEE countries; (j) increase national oncology budgets in view of the higher mortality rates in CEE compared with WE countries; and (k) CEE countries urgently need help from the European Union to increase and monitor overall investment in cancer care.

Implications for practice: Significant differences in cancer incidence and mortality have been observed between European countries. While the incidence of many cancer types is higher in Western European (WE) countries, the mortality is generally higher in Central and Eastern Europe (CEE). The primary purpose of this review was to describe the current status and trends of oncology care in the CEE region, to raise awareness among physicians, regulators, and payers, and to propose the most needed changes in order to make the oncology care in CEE closer to the WE standards.

Keywords: Cancer; Health care budget; Incidence; Mortality; Oncology; South-East Europe.

Figure 1.

Correlation of health expenditures per capita and mortality-to-incidence ratio: all cancers/male (n = 25); a red square represents a Central and Eastern European country; a yellow rhombus represents a neighboring Western European (WE) country; a blue circle represents other WE countries; and a green triangle represents Nordic countries [2, 14].

Figure 2.

Correlation of health expenditures per capita and mortality-to-incidence ratio: all cancers/female (n = 25); a red square represents a Central and Eastern European country; a yellow rhombus represents a neighboring Western European (WE) country; a blue circle represents other WE countries; and a green triangle represents Nordic countries [2, 14]. Abbreviation: FYR, Former Yugoslav Republic.