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Thematic Session: Implications of the new EU approach to PCa detection

Prostate cancer patients can look forward to a continent-wide effort to improve early detection and reduce suffering and mortality, and the first results for patients are expected within five years. This was the optimistic message from Europa Uomo chairman Mr. Ernst-Günther Carl (DE) following a thematic session at EAU23 that brought together a diverse set of experts who discussed the impact of the EU Commission’s recommendations, as announced last December.

In a sense continuing on from that morning’s Plenary Session in the same Auditorium, Thematic Session ‘The road to evidence-based European policy on early detection of prostate cancer’ was chaired by Mr. Carl and incoming EAU Secretary General Prof. Arnulf Stenzl (DE).

Prof. Stenzl emphasised that not only was it important to discuss the critical urology-related news and developments Brussels, the twin chairmanship of the session reinforced patient involvement in these initiatives as well. The session also showed an overlap in the two newest EAU Offices: Policy and Patients.

Prof. Stenzl: “That’s the importance of our Policy Office: the EAU should not just be about education, research, and science. We need to be involved in matters like European legislation, and be able to indicate where public funding is best spent to help patients. ‘Advocacy’ doesn’t really mean we’re involved in ‘politics’ for its own sake, it is rather a concern mainly for our patients. Ultimately, urologists are the tools, with the benefits for the patients.”

Prof. Stenzl also announced that beyond the screening recommendations, the EAU would also be involved in the EC Health Technology Assessment (to come into force in 2025) and orphan medicines (2028).

The speakers at the session highlighted different aspects that will now start to become factors following the decision to start early detection pilots and ultimately, patient representatives and the Policy Office hope, continent-wide early detection programmes.

Among other eminent speakers, Dr. Partha Basu (FR) explained his team’s research into the barriers that might exist once the decision to encourage screening is made, like availability and affordability, or the capacity of the local health system. Different countries have different barriers and each requires close cooperation with national stakeholders.

Prof. Ola Bratt (SE) explained the Swedish approach to prostate cancer early detection, a model that might serve as an example for other countries as it matures. Prof. Bratt noted that prostate cancer affects hundreds of thousands, or millions of men, not just individual patients, making it a public health issue. The approach takes care to not make patients out of healthy men.

Prof. Monique Roobol presented current initiatives in the field of prostate cancer Big (“or rather, ‘smart’”) Data that the EAU was involved in, including PIONEER together with Bayer, and OPTIMA, together with Pfizer. She also introduced the EAU’s efforts to manage clinical trial data in its Data Haven. More on this initiative will be announced in tomorrow’s Thematic Session ‘EAU Data Initiatives’ (12:30-14:00 in Coral 4).

Results for PCa patients

When presenting the concluding remarks (and in a brief interview afterwards) Mr. Carl reflected on how patients will ultimately reap the rewards of all of these initiatives, and, importantly, within what sort of timeframe changes will be felt.

“We know how EU institutions work, it will take 3-5 years. But until recently we had no decision at all! We only had 27 non-comparable patterns. The Swedish have an excellent approach to early detection but that is certainly not currently the case in other parts of Europe. We want a harmonised approach in Europe, anything you can get right from the start, you don’t have to fix later.”

“If we keep making trial after trial and study after study, we will be doing that for the next 70 years. There’s now a paradigm change, let’s make a pilot. If it goes well, we will be proven right. If not, we will at worst look foolish. I think in three to four years we know where we stand.”

Following the foundation of dedicated Policy and Patient offices, collaboration between the EAU and Europa UOMO has improved, Mr. Carl noted.

“We have had good ties for quite a while, with an EAU member also serving as an ex-officio member of our board. Since there is a dedicated office led by Prof. Eamonn Rogers (IE) we definitely notice even more effort into patient involvement than a few years ago. Today the Patient Office is just a phone call away!”