A joint report from the OECD and the European Commission highlights how cancer care demand is rising across the European Union, increasing pressure on health systems to improve outcomes while delivering better value for money. Cancer incidence has increased substantially since 2000, and the burden is increasingly visible among younger populations, particularly women aged 15 to 49. At the same time, mortality has fallen across most cancer sites, meaning more people are living with and beyond cancer and require follow-up and support. These trends are driving higher demand for services and rising spending, with further growth expected as populations age. With fiscal constraints, workforce shortages and unequal access still shaping cancer pathways, timely diagnosis, evidence-based treatment and stronger people-centred care remain central priorities.
Rising Incidence and Shifting Cancer Profiles
Cancer incidence has risen markedly across EU countries over the last two decades. In 2024, more than five people were diagnosed with cancer every minute across the EU, corresponding to an estimated 2.7 million new cancer cases. Since 2000, the number of new cases increased by around 30% for both women and men.
Age-standardised trends vary by sex. Between 2000 and 2022, cancer incidence increased by 10% among women and by 2% among men across EU countries. Despite slower growth, incidence remained higher among men in every EU+2 country, with men estimated to be 38% more likely to be diagnosed with cancer than women on average in the EU.
Early-onset cancers show a distinct pattern. Among people aged 15 to 49, incidence increased more among women than men. Between 2000 and 2022, age-standardised early-onset cancer incidence among younger women rose by 16%, from 143.8 to 166.6 per 100,000 women across 24 EU countries with available data. In contrast, incidence among younger men remained stable on average at 97.0 per 100,000. The increase among younger women was linked to thyroid, breast, skin melanoma and colorectal cancer, with thyroid and breast accounting for a large share. Among younger men, increases were observed for skin melanoma, testicular cancer and colorectal cancer, with variation between countries.
Delays, Emergency Presentation and Unequal Access
Timely access to cancer diagnosis and treatment remains closely linked to outcomes. Delays can occur throughout the pathway, from first presentation and referral to diagnostic testing and treatment initiation, affecting the effectiveness of care and increasing the burden on specialist services.
Screening supports earlier detection and is associated with improved survival, yet participation remains uneven across countries and social groups. Lower uptake can contribute to later diagnosis and reduce the scope for early intervention. Emergency presentation is also a persistent issue. Between 15% and 40% of colorectal cancers are diagnosed via the emergency department, and outcomes are significantly worse for patients entering care through this route. Patients undergoing emergency colorectal cancer surgery can be up to seven times more likely to die within 30 days than those whose surgeries were planned. A substantial share of lung cancers are also diagnosed through emergency departments.
Health system capacity constraints can intensify access problems. Workforce shortages, limited diagnostic capacity and poorly co-ordinated referral systems can slow cancer pathways and create variation in time to diagnosis and treatment. These pressures may be more pronounced for vulnerable populations and rural communities. Financial barriers further affect continuity of care, with 16% of cancer patients postponing or forgoing some care, most often medication and doctors’ appointments.
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Access to oncology clinical trials is also uneven. In the European Economic Area, oncology clinical trial starts have fallen by 22% since 2021, and trial opportunities remain concentrated in a small number of larger countries.
Improving Value Through Consistency and People-Centred Care
Cancer care performance varies widely across EU countries, creating opportunities to improve outcomes while reducing inefficiencies. Unnecessary variation in medical practice and care quality can contribute to both underuse and overuse, limiting the overall value of care delivery.
Overdiagnosis is considered a problem for some cancers, particularly thyroid and prostate cancer. In these cases, diagnosis and treatment may not improve life expectancy but can still affect quality of life and consume resources. Improving consistency of care depends partly on stronger use of standards and mechanisms that support adherence to evidence-based practice. While many countries have established cancer care standards, only 12 EU+2 countries report mechanisms to monitor compliance with clinical guidelines.
Efficiency gains are also linked to redesigning care pathways. Risk-stratified screening can allocate diagnostic resources more effectively, including approaches based on genetic mutations, smoking status and HPV vaccination status. Shifting appropriate services from inpatient to outpatient settings can also improve performance. Nordic countries reported a quarter to half of mastectomy procedures carried out as day surgeries in 2023/24 in Denmark, Finland, Norway and Sweden.
Cancer medicines account for a growing share of spending, and several approaches aim to support better value, including health technology assessment, increased uptake of biosimilars, reducing medication waste and optimising dosing. Evidence also suggests that a substantial proportion of cancer medicines approved over the last 25 years by the European Medicines Agency show negative or unclear added therapeutic value compared with existing treatments, reinforcing the need for careful evaluation of benefit.
People-centred care is increasingly important for improving patient experience and outcomes, particularly in primary healthcare. People living with cancer report worse physical health, well-being and social functioning than other primary care patients, and fewer than one in three report highly people-centred care. Barriers include poor data integration, limited care co-ordination and weak co-production of care with patients. Cancer also has economic consequences, with a diagnosis reducing the likelihood of employment by 14% on average across EU countries. Policy approaches include workplace reintegration measures, extended sick leave provisions and “Right to be Forgotten” legislation, adopted in only a third of EU countries.
Cancer incidence is rising across the EU, with early-onset cancers increasing particularly among younger women, while declining mortality is expanding the population requiring follow-up and long-term support. Persistent challenges include uneven screening uptake, delays in diagnosis, emergency presentation and disparities in access. Improving value depends on reducing unwarranted variation, strengthening evidence-based delivery and supporting more people-centred pathways that respond to the clinical and social consequences of cancer.
Source: OECD
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