Question écrite de
M. Antonius MANDERS
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Commission européenne
Subject: Ageism in cancer-related healthcare
Under Commissioner Dubravka Suica, the Commission (2019-2024) has addressed the topic of demography and ageing. Initiatives have included the Green Paper on Ageing (January 2021) and the Demography Toolbox for Action (October 2023), which focused on empowering older people and supporting their welfare. However, there is no comprehensive EU Age Equality Strategy to integrate ageism considerations across all Commission policies.
Ageism, defined by the WHO as age-based stereotypes, prejudice, and discrimination, significantly affects access to healthcare. This is evident in cancer care, with the OECD’s ‘Beating Cancer Inequalities in the EU’ report (January 2024) highlighting varied age targets for cancer screenings across EU states. For example, cervical cancer screening age ranges from 23-70 in Sweden to 30-40 in Bulgaria.
Furthermore, older people’s representation in clinical trials is particularly low, impacting their access to innovative treatments. Despite no legal age limit for trial participation in EU legislation, older adults are frequently excluded, as they are deemed to be more fragile and less likely to benefit.
Against this backdrop:
1. Is the Commission creating an EU Age Equality Strategy and will the Directorates-General for Justice and Consumers (DG JUST) and for Health and Food Safety (DG SANTE) collaborate to address healthcare inequalities for older persons?
2. Are these services working to combat ageism in cancer care as part of the ‘Europe’s Beating Cancer Plan’?
3. And is there a focus on improving the participation of older persons in clinical trials?
Submitted:16.4.2024
Answer given by Ms Kyriakides on behalf of the European Commission (10 July 2024)
The Union of Equality strategies (1) adopted by the Commission in 2020 and 2021 stress, among other things, the need to combat stereotypes, fight age-based discrimination, and foster equal chances to thrive. These strategies take an intersectional approach and pay due attention to differences, including of age (2).
Europe’s Beating Cancer Plan pays particular attention to combatting health inequalities, including ageism. The European Cancer Inequalities Registry (3), one of its Flagship initiatives, monitors inequalities, including by age (4).
A factsheet (5) alerts to the demographic effect on cancer burden and to age as a cancer risk factor. Furthermore, the Council Recommendation on cancer screening (6) indicates age targets for breast, cervical and colorectal cancer screening, including for older age groups.
The Clinical Trials Regulation (7) provides that clinical trial reports describe the population demographics, including age distribution.
1 ∙ ⸱ https://commission.europa.eu/strategy-and-policy/policies/justice-and-fundamental-rights/gender-equality/gender-equality-
strategy_en; https://commission.europa.eu/strategy-and-policy/policies/justice-and-fundamental-rights/combatting- discrimination/lesbian-gay-bi-trans-and-intersex-equality/lgbtiq-equality-strategy-2020-2025_en; https://commission.europa.eu/system/files/2021-
01/eu_roma_strategic_framework_for_equality_inclusion_and_participation_for_2020_-_2030_0.pdf; https://commission.europa.eu/strategy-and-policy/policies/justice-and-fundamental-rights/combatting- discrimination/racism-and-xenophobia/eu-anti-racism-action-plan-2020-2025_en; https://eur-lex.europa.eu/EN/legal- content/summary/strategy-for-the-rights-of-persons-with-disabilities.html
2 ∙ ⸱ https://commission.europa.eu/strategy-and-policy/policies/justice-and-fundamental-rights/union-equality_en
3 ∙ ⸱ https://cancer-inequalities.jrc.ec.europa.eu/
4 ∙ ⸱ https://cancer-inequalities.jrc.ec.europa.eu/data-tool-by-age
5 ∙ ⸱ https://cancer-inequalities.jrc.ec.europa.eu/sites/default/files/ECIR-inequalities-factsheet-2040-cancer-estimates-May-
2023.pdf
6 ∙ ⸱ https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32022H1213(01)
7 ∙ ⸱ http://data.europa.eu/eli/reg/2014/536/2022-12-05
| | )Furthermore, the European Medicines Agency’s assessment report for marketing authorisation has a ‘special population’ section, analysing age distribution of the target group, and discussing differences emerging from clinical data for excluding vulnerable groups.