Described as a "clarion call to the European Commission", the European Cancer Research Funding Survey identified 139 non-commercial sources of funding in the whole of Europe (including accession, associate and applicant States and the European Free Trade Area) and found that:
- European Member States spend seven times less per person than the USA – a funding gap far wider than previously thought;
- there is insufficient funding for preventative and clinical research, while funding for basic scientific research is proportionately much higher;
- Europe is weak in its overall support of cancer research, both centrally and at the Member State level;
- more than half of European cancer research is funded by the charitable sector;
- opportunities exist for greater collaboration and co-operation between funders across Europe and between different research areas.
Dr Richard Sullivan, chair of the European Cancer Research Managers Forum that conducted the survey, told a news conference at the Royal College of Surgeons in London: "The EU is massively behind the USA in its support of non-commercial cancer research. This gap is a substantial threat to the ability of the EU to translate cancer research into patient benefit. Also threatened is the ability to recruit and retain clinicians and scientists to work in cancer research, as well as the commercial attractiveness of the EU. It would appear that the problem lies both with a lack of central EU funding and with inequality between Member States, with many failing to support cancer researchers adequately in their own countries.
"In the short term, Europe needs to double the amount it spends on cancer research."
Funded by the European Commission, the Survey shows that the USA spends five times more per person (€17.63 compared to €3.76), and four times more as a percentage of GDP (0.0578% compared to 0.0163%), on cancer research than the 15 countries that were members of the EU before May 2004. When USA spending is compared to the 25 current EU members, this gap widens to seven times more per person (€17.63 versus €2.56) and four times more as a percentage of GDP.
Spending on cancer research varied widely across Europe in 2002/2003. The UK spent the most (€388 million) while Malta spent nothing. The European Commission contributed around €90 million. When the Survey analysed the spending as a proportion of GDP, the UK spent the most (0.0267%), followed by Sweden, Germany, France and the Netherlands.
The independent chair of the news conference, Professor Gordon McVie, senior consultant to the European Institute of Oncology in Milan, said: "This is a clarion call to the European Commission to increase funding for cancer research. The Survey shows that Europe is a second-class continent in terms of cancer research funding. We know that cancer research leads to better cancer care for the patient, and so it is vital that it is properly funded in Europe. I estimate that 10,000 to 20,000 more lives would be saved each year through better patient care if funding for cancer research was increased[1]."
The Survey shows that the EU concentrates a large proportion of its spending on basic scientific research at the expense of preventative and clinical research. Biology receives 41% of all cancer research funding, compared with 20% for treatment and just 4% for prevention. In contrast, the USA spends 25% on biology, 25% on treatment and 9% on prevention.
Professor Françoise Meunier, Director General of the European Organisation for Research and Treatment of Cancer (EORTC) and one of the Survey's authors, told the news conference: "Proportionally there is insufficient non-commercial funding for clinical research in Europe. This is worrying, particularly in respect of translational research, and it needs to be addressed urgently; otherwise Europe will fall further behind in the development of novel anti-cancer agents. Likewise, new and more effective non-drug interventions and prognostic markers depend on academic clinical trials for their development.
"We need strong, independent clinical research in Europe that is funded by governmental and charitable organisations. Independent research of this kind can investigate the rarer and harder-to-treat cancers for which new treatments and cures are desperately needed, but which are less attractive for commercial organisations to invest in.
"The under-funding of clinical cancer research, coupled with a disproportionately burdensome regulatory environment, is seriously damaging European cancer research and its competitiveness. This is bad news for Europe, but more importantly, it is bad news for cancer patients." Mrs Kathleen Vandendael, Executive Director of the Federation of European Cancer Societies (FECS) and one of the Survey's authors, said: "The Survey identifies, for the first time, most of the non-commercial sources of cancer research funding in Europe. FECS represents more than 18,000 European cancer experts, promoting and co-ordinating collaboration between different European cancer societies in order to improve, ultimately, the delivery of the best possible treatment for cancer patients. It is clear that opportunities exist for funders of cancer research to collaborate and co-operate in a wide variety of areas, and that opportunities to develop partnerships between member states and all partners involved in the field of oncology also exist.
"FECS and its members are actively promoting political awareness of these issues at a European level."
Dr Sullivan said: "There are four important conclusions to draw from the results of this survey of cancer research funding in Europe. The first is that the EU is not spending enough on cancer research and the funding gap between the EU and the USA is so wide that this has major implications both for the ability of the EU to reverse the emigration of cancer researchers to the USA and for the overall commercial attractiveness of the EU. With such a close correlation between research activity and high quality service delivery, this is also likely to have an effect, ultimately, on the overall care of cancer patients.
"Secondly, Europe needs to develop a broad portfolio for cancer research, and more funding needs to go to translational, clinical and preventative research, which is currently under-funded.
"Thirdly, charitable (not-for-profit) organisations are major funders of cancer research and should be recognised as equal partners in all matters, from European cancer policy development to accessing EU research funding.
"Finally, there is huge disparity in cancer research funding between Member States. Individual countries should be aware of this and make efforts to increase their own funding, while the European Commission should address the problem, both through its funding policy and through improved co-ordination and collaboration across the whole of Europe.
"We hope the data from this report will be used to improve the support of cancer research across Europe through practical approaches to a wide range of issues."
Notes
1 Estimated from calculating the impact that would be made on cancer cure rates by bringing all European countries up to the standards of those that have the best survival rates.
2 The ECRM was set up in 2001 to promote networking and co-operation between national funding bodies and strategic decision makers.
For the Survey, ECRM members helped to identify non-commercial funding sources in their own countries and then the ECRM secretariat contacted every organisation, asking for their most recent figures for annual direct cancer research spend, and to classify the spend according to the seven main classifications of the Common Scientific Outline (CSO). The resulting data were crosschecked extensively to prevent any duplication, and then sent back to the contributing organisations for final verification.
3 In 2004, there were 2,886,800 new cases of cancer and 1,711,000 deaths from the disease in the whole of Europe (Cancer incidence and mortality, P. Boyle and J. Ferlay, Annals of Oncology, doi:10.1093/annonc/mdi098)
4 A pdf of the full report is available to download from the ECRM website from 11am on March 30, 2005, at www.ecrmforum.org