Background
There is an increasing number of cancer survivors, including children, adolescents, young adults, individuals of working age, and the elderly, within the Belgian and European population. Yet, survivorship care and rehabilitation are often treated as an afterthought in care organisation. This not only directly affects the quality of life of survivors and carers, but also puts the sustainability of the healthcare and social security systems at risk.
Methods
We analysed the ongoing Europe Beating Cancer Plan (EBCP) to identify the actions supporting survivorship (care) developments, then compared their weight in the EBCP to the other domains of cancer control. Following this analysis, and comparison with related ongoing projects, and current infrastructure in Belgium, several unmet needs were identified.
Conclusion
To better address these unmet needs, we recommend that Belgium incorporates survivorship care and long-term follow-up in clinical guidelines and care pathways, and considers including indicators related to cancer survivorship in the planning and design of quality insurance schemes, including certification of comprehensive cancer centres. Furthermore, we suggest further investment and support for research and knowledge exchange in the field of survivorship.
Introduction
The prevalence of cancer survivors is growing every year (around 3% per year), and is now estimated at over 12 million survivors in Europe, with about 300.000 childhood cancer survivors [1]. The five year survival rates for all cancers combined is 71% for the 2014–18 period in Belgium [2].
Cancer survivors experience a wide range of problems related to physical and mental functioning, including symptoms such as fatigue and pain, sexual problems, issues related to body image, distress, fear of recurrence, in addition to cognitive, social and physical functioning [3].
Improvements in prevention, diagnostics and treatment are key elements for cancer control, leading to increases in survival. However, relative to the medical and technical developments, there is less focus placed on adequately addressing the plethora of challenges associated with cancer survivorship.
In spite of relative recent attention attributed to survivorship, the work that remains is colossal [4, 5]. It is urgent to address these challenges to ensure high quality long-term care and quality of life for cancer survivors.
Methodology
The issue overview, gaps, and recommendations were identified in a participative manner with Belgian Europe’s Beating Cancer Plan (EBCP) Mirror Group on Survivorship. The group consists of more than 50 members, with representatives from patient organizations, NGOs, hospitals, professional organizations, registries and universities.
Building off evidence-based recommendations on survivorship from the Joint Action CanCon [6], the Belgian EBCP Mirror Group on Survivorship [7] developed concrete recommendations to improve survivorship care in Belgium. They did so by reviewing the 42 actions of the EBCP and assessing these actions for opportunities to address cancer survivorship issues. They then compared the actions in EBCP and the evidence based recommendations from CanCon with current open calls and/or ongoing projects at the EU-level in which cancer survivorship is addressed. Synergies with the Belgian context were then identified and the extent to which the EBCP projects could benefit to the Belgian Handbook for Supportive Care were assessed (Table 1). The main objective of this work was to identify the challenges hindering the rehabilitation and the quality of life of cancer survivors.
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