On the implementation of Europe’s Beating Cancer Plan

Every two minutes, a European dies of cancer. In 2022, 2.7 million Europeans received a new diagnosis and 1.3 million lost their lives. Without decisive action, demographic ageing will drive an 18 % increase in new cases and a 26 % increase in deaths by 2040. The economic toll already exceeds EUR 100 billion annually. Member States lose the equivalent of 1.1 million full-time workers each year, and per capita cancer-care expenditure is expected to grow by 59 % between now and 2050.

The Draghi report on European competitiveness framed Europe’s central challenge as a widening gap between the quality of its science and its ability to turn that science into products and services that reach citizens. Draghi warned that failure to close this gap would amount to a ‘slow agony’. Nowhere is this more visible than in cancer. Europe has some of the strongest health systems in the world, universal coverage that most countries can only aspire to, and population-scale screening infrastructure that generates data of unmatched quality. Europe’s pharmaceutical industry still leads globally in trade value. European researchers produced the world’s most important evidence on AI in cancer screening. The question this report poses is whether we will build on these strengths, or whether we will allow the innovations emerging from European research and European public investment to be commercialised and scaled elsewhere, leaving European health systems to purchase at a premium what they helped develop.

What Europe’s Beating Cancer Plan has achieved

This report starts from a position of genuine appreciation. Europe’s Beating Cancer Plan, launched in February 2021, is the most comprehensive EU-level cancer framework ever adopted. It mobilised EUR 4 billion, structured policy around four coherent pillars, and catalysed real achievements: the expansion of screening recommendations to lung, prostate and gastric cancers; the first EU network of Comprehensive Cancer Centres; and 898 cancer-focused research projects under Horizon Europe. More than 90 % of planned actions have been concluded or are ongoing. I wish to acknowledge the commitment of DG SANTE and the Commission services in driving this agenda forward under demanding circumstances, including a 35 % mid-programme budget cut to EU4Health. These foundations are real, and this report seeks to build on them, not to diminish them.

Where honest assessment is needed

Building on these foundations, however, requires honesty about what remains to be done. The 90 % implementation figure measures whether actions were launched, not whether they improved survival or reached patients. The European Court of Auditors’ Special Report of February 2026 confirmed that the Plan lacks coherent outcome indicators.

On prevention: key legislative commitments have been delayed: the revision of the Tobacco Products Directive, mandatory health warning labels on alcohol, promised for 2023, have not materialised. New WHO data released in 2025 underscores the urgency: the WHO European Region records the highest global prevalence of tobacco use, with 173 million adult users (24.1 %), and is projected to have the highest prevalence rate globally by 2030. Among young people aged 13–15, 4 million are already tobacco users and European girls have the highest tobacco prevalence of any WHO region worldwide. The 62 million female smokers in the European Region represent over 40 % of the world’s adult female smokers. E-cigarette use among 15–16-year-olds has reached 22 % on average across 34 European countries, up from 14 % in 2019, with prevalence higher among girls (25 %) than boys (19 %). In 2023, 467 000 cancer deaths in the Region were attributed to tobacco. These figures make the continued delay of the Tobacco Products Directive revision not merely regrettable but indefensible.

Where a European citizen is born still determines, to an unacceptable degree, whether their cancer is caught early, treated effectively, and survived. A 20 % gap in breast cancer survival and a tenfold difference in screening uptake between Member States are not footnotes, they are the measure of the Plan’s unfinished work.

Most of the EU cancer budget is research funding. This investment is valuable: fundamental and basic research is the foundation on which all clinical progress rests, and it should not be judged by immediate patient outcomes. But the EU’s cancer portfolio lacks a dedicated pipeline to translate research results into clinical deployment, and that is a policy design problem, not a research quality problem. The JRC Knowledge Centre on Cancer tracks 4 106 cancer-relevant projects funded between 2014 and 2024, totalling EUR 7 billion in EU contributions. Over 93 % flows through Horizon 2020 and Horizon Europe. Of the 1 881 completed Horizon 2020 cancer projects, 76.9 % remained at the preclinical or basic research stage. Only 20.2 % were designed to involve direct clinical engagement. While individual project deliverables are recorded on CORDIS for Horizon-funded projects, no EU framework assesses whether these outputs have translated into clinical practice or patient outcomes. This is precisely the translation gap Draghi identified across European industry: strong research that does not convert into innovation citizens can benefit from.

Even innovations that do cross the valley from laboratory to clinic face a widening regulatory bottleneck. In the United States, AI medical devices receive FDA clearance in a median of 142 days; in Europe, CE marking under the Medical Devices Regulation takes an estimated 13 to 18 months. Before the MDR took effect in 2021, Europe was actually ahead of the US in approving AI medical devices. Today, the FDA has authorised over 1 200 AI devices; Europe has no centralised register and no comparable count. There is little point in investing billions in cancer research if the regulatory pathway ensures that the resulting innovations reach American patients years before European ones.

From research to patients: closing the implementation gap

These findings lead to a clear proposition: the next phase of Europe’s Beating Cancer Plan needs to complement research grants with instruments designed to drive implementation. A common objection to stronger EU cancer action is that Article 168 TFEU limits the Union to a supporting and coordinating role. However, the legal impediments to Union action in health are less restrictive than is commonly understood. The EU has already used internal market legislation, research programmes, Council recommendations, and the 2022 cross-border health threat regulation to build the cancer policy architecture we have today. The instruments exist, the question is whether we use them with the ambition the situation demands.

Concretely, I propose four shifts. First, results-based variable tranches, modelled on the Recovery and Resilience Facility, that tie a share of cancer funding to verified screening and vaccination targets. Second, challenge prizes linked to EU procurement commitments, ensuring that a winning low-cost diagnostic enters a framework agreement accessible to all Member States rather than remaining in a laboratory. Third, AI regulatory sandboxes under the AI Act, which requires every Member State to establish at least one sandbox by August 2026, designated for cancer screening and linked to EUCAIM data access; given the regulatory gap documented above, these sandboxes are essential to ensure that validated AI screening tools can be deployed under supervised conditions while the full conformity process runs its course. Fourth, conditionality in cohesion policy: requiring an updated National Cancer Control Plan as a prerequisite for health-related ERDF investments, with a tiered design that rewards improvement from each country’s own baseline rather than imposing uniform thresholds.

That better approaches are feasible is no longer a theoretical argument. AI-supported mammography has demonstrated a 29 % increase in cancer detection and a 44 % reduction in radiologist workload in the Swedish MASAI trial. In Germany, AI-assisted reading across 463 000 women raised detection by 17.6 % with no increase in false alarms. Germany went further: its national lung cancer screening programme, established in July 2024, requires all participating radiologists to use AI. This is already happening inside the EU’s own regulatory framework. OECD modelling shows that achieving best-practice risk factor levels across Europe would save EUR 20 billion annually and prevent nearly 300 000 premature deaths. The evidence is there and what is needed is the political decision to act on it.

Europe’s health systems and its pharmaceutical industry represent a formidable competitive asset. Draghi’s report stressed that EU private investment in pharmaceuticals is a quarter of US levels and that public R&D spending is less than half. But Europe has something the United States does not: universal health coverage, structured population screening programmes, and the European Health Data Space. These are the ingredients for training and validating AI at a scale and diversity no other region can match. If the EU invests in turning its cancer research into deployed clinical tools, it can offer its citizens earlier diagnosis and longer survival while building a globally competitive health technology industry. If it does not, it will watch European innovations migrate to the United States and China, and European health systems will end up purchasing, at full price, products that European taxpayers helped develop.

The role of this Parliament

If we ask the Commission to deliver better outcomes, we must equip ourselves to verify that they are achieved. Other committees have established exactly this kind of structured oversight: ECON conducts quarterly Monetary Dialogues with the ECB President and regular Recovery and Resilience Dialogues with the Commission; AGRI and EMPL hold regular Structured Dialogues with their respective Commissioners. I propose two concrete mechanisms for SANT:

A Structured Dialogue on the implementation of Europe’s Beating Cancer Plan, requiring the Commission to report annually to the SANT Committee against a set of key performance indicators covering all pillars of the Plan, disaggregated by Member State.

An independent Cancer Implementation Scoreboard, produced by the European Parliamentary Research Service, drawing on data from the Cancer Inequalities Registry, OECD Country Cancer Profiles, and the European Cancer Information System. Without systematic, independent monitoring, the next phase of the Beating Cancer Plan risks repeating the same pattern: ambitious announcements followed by incomplete delivery.

Cancer will touch every European family. This Parliament has the democratic legitimacy to ensure that Europe’s ambition is matched by delivery. I commend this resolution to colleagues as an honest assessment of where we stand, and as a foundation for a stronger, smarter cancer policy that can save lives, reduce inequalities, and keep Europe at the forefront of health innovation.

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