The European Code Against Cancer (ECAC) – Recommendations for Sustainability and Monitoring

Key Contextual Factors

• The European Code against Cancer (ECAC) is a valuable instrument from the European Commission for cancer prevention education, and it has been used as a guide and framework to influence the formulation of European National Cancer Plans. The Code is based on the evidence that around 40% of cancer cases can be prevented and further mortality can be reduced, through practices and actions targeted to the individual and the population. It informs how to avoid or reduce exposures to causes of cancer, to adopt healthy behaviours, and to participate in vaccination and screening programmes under national guidelines. The International Agency for Research on Cancer (IARC/WHO) has been the coordinator of the last update.
• Through the iPAAC’s WP5 consultation and assessment, overwhelming support was expressed by all the stakeholders and EU authorities of the need for the ECAC and its continuous updating, optimization, and wider dissemination. Eight recommendations focused on the scope of a future 5th edition of the ECAC and on the strategies for the implementation and dissemination across Europe, and four recommendations on the research needs, were developed and endorsed.

Key Components/Steps

• Centralized governance and resources to periodically update and maintain the high-quality evidence-based process, to be established.
• Dissemination, monitoring and systematic evaluation Action Plan across EU to be developed.
• Research and resources to support the evidence base and the implementation of prevention measures in the policy agenda, to be established.

Main Impacts / Added Value

• Evidence-based recommendations on cancer prevention to improve health literacy in Europe.
• Alignment with the goals of the Europe’s Beating Cancer Plan.
• Report highlights the need for including cost-effective evidence-based cancer prevention measures at individual and population levels, in synergy with NCDs preventive messages.
• Call for integrating the ECAC into the professional health structures, and engaging with communities, citizens’ advocates and policy-makers early in the process of development of future ECAC.

Lessons Learned

• Successful co-creational consultation process held with all relevant stakeholders across Europe.
• Multidisciplinary consensus, from experts in cancer prevention and public health, to dissemination and communication experts and EU representatives, of the need of the ECAC’s update and maintenance.
• Urgent needs:
  (1) a permanent government structure assessing the need of periodical updating;
  (2) an EU Dissemination Action Plan, including technological innovations and modern ways of communication adapted to socio-political and structural contexts;
  (3) inclusion of implementation research in the policy agenda, and
  (4) a monitoring and evaluation framework to systematically measure the impact of the ECAC across Europe.

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