As Cancer Survival Improves, Europe Faces a Hard Question: Is Its Care System Fit for Purpose?

Europe is facing a growing cancer burden, with rising cases, especially among younger women, even as survival improves, putting intense pressure on health systems and budgets. The OECD and European Commission warn that faster access, less variation in care, smarter use of resources and more people-centred support are essential to deliver real value for patients and society.

Cancer is reshaping Europe’s health landscape at a speed few anticipated. A major new report by the OECD and the European Commission, drawing on research from bodies including the International Agency for Research on Cancer, the European Cancer Information System, the Joint Research Centre and national cancer registries, shows that cancer cases across the EU have risen by around 30% since 2000. In 2024 alone, an estimated 2.7 million people were diagnosed, more than five every minute. While men still account for more cases overall, the fastest growth is now seen among women, especially those under 50. Breast, thyroid, skin melanoma and colorectal cancers are driving this rise, meaning more people are being diagnosed earlier in life and living longer with the disease.

Survival Is Improving, but Inequality Persists

There is good news. Cancer mortality has fallen steadily across Europe over the past two decades, dropping by nearly 20% for women and more than 25% for men. Advances in screening, surgery, radiotherapy and medicines have helped transform outcomes, particularly for lung and colorectal cancers. Yet these gains are not shared equally. People with lower levels of education continue to face much higher cancer mortality in almost every EU country. The report warns that many cancer registries still lack socio-economic data, making it harder to identify who is being left behind and why. As survival improves, inequality has become one of the defining challenges of cancer care.

Delays and Gaps Cost Lives

Where a person lives still shapes how quickly they are diagnosed and treated. Screening programmes for breast, cervical and colorectal cancer save lives, but participation varies sharply between countries and social groups. Many cancers are still diagnosed late, often through emergency admissions, which are linked to worse outcomes. Delays also occur after diagnosis. In some countries, most patients start treatment within a month; in others, long waits remain common. Workforce shortages, limited diagnostic capacity and poorly coordinated referral systems all contribute. These gaps do not just affect health outcomes, they also drive up costs by pushing patients into more intensive and expensive treatment later on.

Too Much Variation, Too Little Value

The report highlights wide differences in how cancer is treated across Europe, even for similar patients. In prostate cancer, for example, some countries diagnose and treat far more older men than others, raising concerns about overdiagnosis and unnecessary treatment. Such variation cannot be explained by patient needs alone. While most countries have cancer care standards, fewer than half consistently monitor whether doctors follow clinical guidelines. Cancer medicines present a similar problem. Many new drugs come with high price tags but offer limited additional benefit. The report argues that better use of biosimilars, stronger health technology assessment and smarter prescribing could free up resources without harming patient care.

Living With Cancer Means More Than Surviving It

Perhaps the strongest message in the report is that cancer does not end with treatment. People living with cancer report worse physical health, mental well-being and social functioning than other patients. Fewer than one in three say their care feels truly people-centred. Many lack clear care plans and must repeat information because health records do not follow them across services. Cancer also affects livelihoods. On average, a diagnosis reduces the likelihood of employment, with the biggest impacts in parts of Southern and Central Europe. The report calls for cancer systems that support not just survival, but quality of life, through better care coordination, patient involvement, palliative care and policies that protect people from long-term discrimination and financial harm.

Europe’s cancer burden is growing, survival is improving, and costs are rising. The OECD and European Commission make a clear case: the future of cancer care must focus on value, not volume. Faster access, consistent quality, smarter use of innovation and genuine attention to patients’ lives are no longer optional. They are essential if Europe is to meet the cancer challenge without deepening inequality or overwhelming its health systems.