Europäischer Rechnungshof - European Court of Auditors
EU’s ambitious plan to combat cancer suffers from uncertainty
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EU’s ambitious plan to combat cancer suffers from uncertainty
- Many initiatives are laudable, but overlap and lack sustainability
- Cancer inequalities persist within and between EU countries
- The future of the programme beyond 2027 is unclear
The EU’s flagship programme against cancer – Europe’s Beating Cancer Plan (EBCP) – is fraught with uncertainty, according to a report by the European Court of Auditors (ECA) published today. Cancer remains one of Europe’s greatest public health challenges, claiming more than 1 million lives every year and affecting millions more. The EBCP supports coordinated efforts between EU counties in their fight against cancer. But the auditors note that uneven participation by member states, overlapping initiatives, and uncertain future financing may affect the plan’s long-term impact .
Every minute in the EU, five people are diagnosed with cancer, and more than two lose their lives to it, making it the second leading cause of death in the 27 member states. The disease also takes an enormous economic toll – estimated at over €100 billion annually in the EU. In response, the EU launched its Europe’s Beating Cancer Plan in 2021. With an initial budget of €4 billion for 2021–2027, it seeks to address every stage of the disease pathway – from prevention and early detection to treatment and quality of life for cancer patients and survivors.
“Cancer is unquestionably one of the worst scourges of our time, as one in two people in the EU will be diagnosed with the disease at some point in their lives”, said Klaus Heiner Lehne, the ECA Member responsible for the audit. “Europe’s Beating Cancer Plan is the EU’s key strategy in the fight against cancer, but without more coherent implementation, clear milestones, and secure future financing, it will not achieve its full potential.”
The auditors found that the EBCP has triggered numerous EU-wide actions – many of them with high potential value. One of the plan’s merits, they note, is that four EU countries have developed new national cancer plans, and 10 have updated existing ones. However, the auditors warn that overlap and duplication are undermining the plan’s effectiveness. Several EU-funded projects – such as mobile apps for prevention and awareness – pursue similar aims and target groups, meaning that spending and efforts are duplicated and funds are used inefficiently as a result. Other projects – although well conceived – have struggled to produce sustainable outcomes because they have not been taken up by EU countries. However, without national uptake, long-term financing plans and structures for continuity, there is a risk that many EBCP initiatives will not translate into lasting improvements with tangible effects.
Major disparities remain between EU countries, particularly in cancer prevention and screening. Rates of vaccination against the human papillomavirus (HPV) in girls under 15, which average 64 % in the EU, range from 7 % in Bulgaria to 91 % in Portugal – a stark contrast given the EU target of 90 % by 2030. In Bulgaria, Estonia and Latvia, vaccination rates have actually declined over the last decade. Participation in breast-cancer screening also varies widely. Although it exceeds 75 % in Denmark, Finland, Sweden and Slovenia, it remains below 40 % in Romania, Cyprus, Slovakia, Hungary, Bulgaria, Latvia and Poland. Even more alarmingly, more than half of EU countries – including Germany, France and Italy – report decreasing participation, despite already being below the EU average.
In their report, the auditors also point to weaknesses in the plan’s design: the EBCP lacks quantifiable targets, a definitive end date, and coherent indicators. This makes it difficult to measure progress, or assess the plan’s long-term impact. The auditors also raise concerns about the future of the plan. The overall EU4Health budget was cut by over 35 % in 2024 – a reduction of about €1 billion – raising uncertainty about the EBCP’s implementation up to 2027. Beyond 2027, EU vision and financing remain unclear, and will ultimately depend on the next long-term EU budget for 2028–2034.
Background information
Article 168 of the Treaty on the Functioning of the European Union states that responsibility for defining health policies and organising and delivering health services and medical care – including the allocation of resources – lies with the member states. The EU’s role is therefore to support and complement member state action.
The objective of the EBCP, which the European Commission adopted in February 2021 as part of the European Health Union, is to reduce the cancer burden through a comprehensive strategy structured around four pillars: prevention, early detection, diagnosis and treatment, and quality of life for cancer patients and survivors. The EBCP also promotes research and innovation, digitalisation, data-sharing, and synergies with other EU and national policies.
Special report 07/2026, “Europe’s Beating Cancer Plan – A wide-ranging plan facing an uncertain future”, is available on the ECA website, together with a one-page overview of the key facts and findings.
Contact:
ECA press office: press@eca.europa.eu