The European Code of Cancer Practice (The Code) is a citizen and patient-centred accessible, widely disseminated statement of the core requirements for good clinical cancer practice, in order to improve outcomes for all of Europe’s cancer patients. It has been co-produced by a team of cancer professionals, cancer patients and patient advocates. It has its origins in the European Cancer Patient Bill of Rights, which was launched in the European Parliament on World Cancer Day 2014 and won the prestigious European Health Award in 2018.
While it is intended that The Code will be of value to a wide audience of citizens, patients and healthcare professionals, it is focussed on informing and assisting cancer patients (paediatric, adolescent and adult) at all stages of their cancer journey. The Code sets out a series of 10 key overarching rights, and in particular signposts what patients should expect from their health system, in order for them to achieve the best possible outcomes. It is an empowerment tool and a resource to ensure the best available care is delivered for European citizens and patients.
Each of the 10 overarching rights is linked to three questions that a patient (or for paediatric patients their parent/guardian) may choose to ask their healthcare professionals. Each right is supported by a short section of Explanation (one page, <500 words) which is intended to be accessible to cancer patients and to all other interested parties including citizens, carers, parents/guardians, advocates and healthcare professionals. The rights are based on the best available medical evidence and this is summarised in a supporting paper on the Medical Literature and Evidence upon which the recommendations of The Code are based.
The European Cancer Organisation has set out the Essential Requirements for Quality Cancer Care (ERQCC) for several cancers (breast, prostate, oesophageal/gastric, and colorectal cancers, melanoma and sarcoma) and for key issues which are important to all patients such as primary care. Work to complete ERQCCs for pancreatic, ovarian, lung cancers and glioma is ongoing and it is envisaged that similar approaches will be undertaken for paediatric/adolescent and older patients. The Code is an outwardly-facing citizen and patient-focussed articulation of the ERQCC initiative. In addition to ERQCC, there are also guidelines setting out the key features of good clinical cancer practice in many countries, developed by many cancer organisations and these are supported by national cancer plans. For all patients, access to such standards of good clinical cancer practice defined by clear guidelines is vital. Good clinical practice guidelines are developed to lead to the best possible outcomes for patients, demonstrated through analysis of high quality data. Also, there must be a constant aspiration towards improvement in cancer care, working towards achieving the very best standards in Europe and rapid access to effective innovations in treatment and care.
The Code is a patient-centred initiative but is also of relevance to all European citizens, as early diagnosis when cancer is suspected underpins the timely delivery of the appropriate treatment. Timely and accurate diagnosis and prompt treatment are associated generally with a better chance of survival and improved quality-of-life in the short, medium and long term. Cancer outcomes are dependent on citizens having prompt access to diagnostic expertise and facilities. Primary care and well organised and resourced diagnostic capacity are therefore key determinants of the outcomes for cancer patients and the performance of healthcare systems. Diagnostic delay, such as that experienced during the Covid-19 pandemic, reinforces the need for accurate and timely diagnostic pathways for European citizens and patients.
Cancer prevention and screening are a vital and cost-effective part of any initiative to control many cancers and reduce the number of deaths from cancer across Europe. The European Code of Cancer Practice therefore complements the European Code Against Cancer which identifies the twelve key steps that all European citizens should take to reduce their risk of cancer. For more information about the European Code Against Cancer visit the website of the Association of European Cancer Leagues here.
The Code is made available through the European Cancer Organisation. Each of the 10 overarching rights have been translated into different European languages and made available in hard copy and online here. The Medical Literature and Evidence Supporting Paper is also available online here.
Together with our Quality Cancer Care Network, we will be discussing with our Member Societies and Patient Advisory Committee producing The Code statements specific to individual cancer sites (colorectal, breast, prostate, lung, for example) and particular aspects of cancer practice (e.g. primary care, multidisciplinary care).
We will also be discussing the potential for developing The Code for particular patient populations (e.g. based on their age) that underpin cancer service delivery, again mirroring the work on the Essential Requirements for Quality Cancer Care.
The Code and supporting material are “living documents” which will be constantly revised to ensure that they capture the most up-to-date requirements of European citizens and patients, supported by a comprehensive and balanced insight into the existing and emerging evidence that supports the Codes. In this way, the Code will not only function as a support and advisory document for a wide range of individuals and organisations, but also become the focus of constant critical appraisal and updating of the evidence base that will be essential to underpin continuing improvements in outcomes for Europe’s cancer patients.