Across the EU, cancer is a leading cause of death, and the European Commission has set goals for reducing cancer related deaths by 15% in 2020.
Thrombosis is an often overlooked cause of death in cancer patients that can be readily prevented and treated. Action is needed to reduce the morbidity and mortality of patients with cancer-associated thrombosis (CAT). There is a vital need to increase awareness of:
- the impact of CAT on cancer patients’ morbidity and mortality, their quality of life and on health service costs
- the means of preventing and treating thrombosis more efficiently in cancer patients
- the need for early diagnosis of cancer-associated venous thromboembolism (VTE), which is the main form of CAT
An Expert Steering Group was formed, which had its first meeting in Brussels on 11-12 December 2015, with the objective of setting the high level goal of reducing the negative impact of CAT on cancer patients and recommended actions required to achieve this goal. The group examined the current evidence of the impact of CAT, and the barriers to optimal treatment, early diagnosis and treatment. The Expert Steering Group is jointly chaired by Professor Manuel Monreal of the Universidad Autónoma, Barcelona and Eve Knight of the UK charity AntiCoagulation Europe.
The group found that:
- Cancer patients are unaware of the increased risk of VTE and they experience limited support and information during VTE diagnosis
- VTE is resource intensive and costly in cancer patients due to higher VTE recurrence and complications of therapy
- International consensus and evidence-based guidelines recommending LMWHs for long-term treatment of VTE in cancer appear to be poorly followed
- There is limited awareness and/or recognition of CAT amongst HCPs that often leads to lack of diagnosis or misdiagnosis increasing the risk that the DVT will progress to a PE and potentially cause a fatal outcome
The Expert Steering Group discussed and developed an action plan and endorsed the following goal:
To achieve this goal, the group agreed that the lack of awareness, among all stakeholders, of the increasing risk and impact of thrombosis in cancer patients is the key barrier that needs to be overcome. The action plan aims to raise the level of awareness of health care professionals, policy-makers, health authorities, patients and patient associations. This should be achieved at the national, European and international level by focusing on the following key areas:
- developing and increasing the medical scientific evidence base
- collecting and evaluating physicians’ experience
- collecting more evidence of the current burden of cost for health services of CAT
- provision of expert advice and education to the medical profession
- dissemination of the medical scientific and economic facts to health care professionals, policy-makers, health authorities and patient associations
- monitoring of patients’ experiences and their quality of life
A White Paper was developed. This White Paper sets out the findings of the meeting of the Expert Steering Group in detail and presents the call for action aimed at different target groups.
The White Paper was presented at European Parliament on World Thrombosis Day 2016.
Work is now in progress with MEP’s against Cancer and European cancer groups to achieve the goal and recommended actions.