1996D0646 — EN — 01.01.2001 — 001.001 — 1
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►B DECISION No 646/96/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL
of 29 March 1996
adopting an action plan to combat cancer within the framework for action in the field of public
health (1996to 2000)
(OJ L 95, 16.4.1996, p. 9)
Amended by:
Official Journal
No page date
►M1Decision No 521/2001/EC of the European Parliament and of the
Council of 26 February 2001L 79 1 17.3.2001
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DECISION No 646/96/EC OF THE EUROPEAN PARLIAMENT
AND OF THE COUNCIL
of 29 March 1996
adopting an action plan to combat cancer within the framework for
action in the field of public health (1996to 2000)
THE EUROPEAN PARLIAMENT AND THE COUNCIL OF THE
EUROPEAN UNION,
Having regard to the Treaty establishing the European Community, and
in particular Article 129 thereof,
Having regard to the proposal from the Commission(1),
Having regard to the opinion of the Economic and Social
Committee(2),
Having regard to the opinion of the Committee of the Regions(3),
Acting in accordance withth e procedure laid down in Article 189b of
the Treaty(4) in the light of the joint text approved on 31 January 1996
by the Conciliation Committee,
(1)Whereas, at its meetings in Milan in June 1985 and in Luxem-bourg in December 1985, the European Council underlined theadvantages of launching a European programme against cancer;
(2)Whereas the Council and the Representatives of the Govern-
ments of the Member States meeting within the Council
adopted on 7 July 1986 a Resolution on a programme of actionof the European Communities against cancer(
5) and on 17 May
1990 Decision 90/238/Euratom, ECSC, EEC adopting a 1990 to1994 action plan in the context of the ‘Europe against Cancer’programme(
6);
(3)Whereas in its resolution of 19 November 1993 on public healthpolicy after Maastricht(
7) the European Parliament asked that
activities against cancer be intensified;
(4)Whereas in its Resolution of 13 December 1993(8) the Council
invited the Commission to submit in due course a draft thirdaction plan, taking into account the Council Resolution of 27
May 1993 on future action in the field of public health as well
as the objectives and improvements set out in the Annex to thatResolution(
9);
(5)Whereas the Council, in its Resolution of 2 June 1994(10), in
response to the Commission communication of 24 November1993 on the framework for action in the field of public health,
included cancer among the priority areas for action for which
the Commission was invited to bring forward proposals foraction;
(6)Whereas, by reason of its scale and effects, Community action insupport of cancer prevention enables the desired objectives to be
attained more effectively;1996D0646 — EN — 01.01.2001 — 001.001 — 2
(1) OJ No C 139, 21. 5. 1994, p. 12, and OJ No C 143, 9. 6. 1995, p. 16.
(2) OJ No C 393, 31. 12. 1994, p. 8.
(3) OJ No C 210, 14. 8. 1995, p. 55.
(4) Opinion of the European Parliament of 1 March 1995 (OJ No C 68, 20. 3.
1995, p. 17), Council common position of 2 June 1995 (OJ No C 216, 21. 8.
1995, p. 1) and Decision of the European Parliament of 25 October 1995
(OJ No C 308, 20. 11. 1995). Decision of the European Parliament of 15
February 1996 (OJ No C 65, 4. 3. 1996) and Council Decision of 16
February 1996.
(5) OJ No C 184, 23. 7. 1986, p. 19.
(6) OJ No L 137, 30. 5. 1990, p. 31.
(7) OJ No C 329, 6. 12. 1993, p. 375.
(8) OJ No C 15, 18. 1. 1994, p. 1.
(9) OJ No C 174, 25. 6. 1993, p. 1.
(10) OJ No C 165, 17. 6. 1994, p. 1.
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(7)Whereas policies and programmes formulated and implemented
at Community level should be compatible with the targets and
objectives of Community action on cancer prevention; whereas,in particular, implementation of actions under the Community'sbiomedical and health research programme should be closelycoordinated withth e implementation of Community actions oncancer prevention;
(8)Whereas cooperation with the competent international organiza-tions and with non-member countries should be strengthened;
(9)Whereas cancer is a major disease associated with lifestyles;whereas the risk factors inherent in them need to be reduced,especially tobacco consumption, which will also have an effect
on combating other diseases, in particular cardiovascular
diseases;
(10)Whereas, by ensuring wider dissemination of knowledge of the
causes of cancer and of its prevention, by ensuring improved
comparability and dissemination of information on thesesubjects, and by developing complementary actions especiallyin health education, this plan will contribute to the achievementof the Community objectives set out in Article 129 of theTreaty;
(11)Whereas measures must be adopted to combat promotion in themedia of habits which may lead to cancer, such as poor dietaryhabits and smoking;
(12)Whereas it is important that the Commission ensures implemen-tation of this plan in close cooperation with the Member States;
whereas, to that end, provision should be made for a procedure
to ensure that Member States are fully involved in implementingthe plan;
(13)Whereas a modus vivendi between the European Parliament, the
Council and the Commission concerning the implementingmeasures for acts adopted in accordance withth e procedure laiddown in Article 189b of the Treaty was concluded on 20December 1994;
(14)Whereas moreover, in order to have available to it all the neces-sary scientific information, the Commission cooperates with ahigh-level committee of scientific experts appointed by theMember States;
(15)Whereas, from an operational point of view, the investmentmade under the preceding action plans in terms of both the
European pilot networks and the mobilization of all those
involved in combating cancer should be safeguarded and devel-oped;
(16)Whereas this plan must take account of past and currentmeasures implemented in the Member States either by thecompetent authorities or by other parties involved in healthpolicy;
(17)Whereas, however, possible duplication of effort should beavoided by the promotion of exchanges of experience and bythe joint development of basic information modules for thegeneral public, for health education and for training members ofthe health-care professions, which may be targeted on specific
groups, including children;
(18)Whereas a Community strategy to contribute to combatingcancer includes all aspects of primary, secondary and tertiary
prevention, including exchange of experience on quality controlin early detection of the disease and prevention of its develop-ment, and taking into account psycho-social aspects, withparticular emphasis on the quality of life;
(19)Whereas, in order to increase the value and impact of this plan, acontinuous assessment of the measures undertaken should becarried out, with particular regard to their effectiveness and theachievement of objectives at both national and Community level1996D0646 — EN — 01.01.2001 — 001.001 — 3
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and, where appropriate, the necessary adjustments should be
made;
(20)Whereas the objectives of this plan and the actions undertaken to
implement it form part of the health protection requirements
referred to in the third subparagraph of Article 129 (1) of theTreaty and as suchform a constituent part of th e Community'sother policies, such as those on the environment, the protectionof workers, consumer protection, nutrition, agriculture and the
internal market;
(21)Whereas this Decision lays down, for the entire duration of the
action plan, a financial framework constituting the principalpoint of reference, within the meaning of point 1 of the Declara-tion by the European Parliament, the Council and Commissionof 6 March 1995, for the budgetary authority during the annual
budgetary procedure;
(22)Whereas this plan should run for five years in order to allow
sufficient time for actions to be implemented to achieve theobjectives set,
HAVE DECIDED AS FOLLOWS:
Article 1
Establishment of the plan
1. A Community plan of action against cancer entitled ‘Europe
against Cancer’, hereinafter referred to as ‘this plan’, shall be adopted
for the period 1 January 1996 to ►M131 December 2002 ◄within
the framework for action in the field of public health.
2. The objective of this plan shall be to contribute towards ensuring
a high level of health protection and shall comprise actions aimed at:
— preventing premature deaths due to cancer,
— reducing mortality and morbidity due to cancer,
— promoting the quality of life by improving the general health situa-
tion,
— promoting the general well-being of the population, particularly by
minimizing the economic and social consequences of cancer.
3. The actions to be implemented under this plan and their specific
objectives are set out in the Annex under the following headings:
A. Data collection and research
B. Information and health educationC. Early detection and screening
D. Training and quality control and guarantees.
4. The actions to be undertaken shall include in particular:
— the establishment of common objectives,
— the standardization and collection of comparable and compatible
data on health, including the development and strengthening of the
European network of cancer registers,
— programmes for exchange of experience and of health professionals
and for the dissemination of the most effective practices,
— the creation of information networks,
— European-scale studies and dissemination of the results, including
support for epidemiological studies focused on prevention,
— implementation of pilot programmes and pilot projects,
— compilation of reports, especially to monitor the measures taken,— early detection and screening,
— exchanges of experience on quality control of the early detection of
the disease and the prevention of its development, including pallia-tive methods, and contributions for selecting priorities in cancerresearchand transfer of results of basic researchinto clinical trials.1996D0646 — EN — 01.01.2001 — 001.001 — 4
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Article 2
Implementation
1. The Commission shall ensure the implementation, in close coop-
eration with the Member States, of the actions set out in the Annex,►
M1in accordance withth e procedures laid down in Article 5a(2)
and (3)◄.
2. The Commission shall cooperate with the institutions and organi-
zations which are active in combating cancer.
Article 3
Budget
1. The financial framework for implementation of this plan for the
period from 1 January 1996 to 31 December 2000 shall be EUR 64
million, for the period from 1 January 2001 to 31 December
2001 EUR 13,3 million and for the period from 1 January 2002 to 31December 2002 EUR 13,3 million.
2. The annual appropriations shall be authorized by the budgetary
authority within the limits of the financial perspective.
Article 4
Consistency and complementarity
The Commission shall ensure that there is consistency and complemen-
tarity between actions to be implemented under this plan and the otherrelevant Community programmes and initiatives, including the biome-
dical and health research programme under the Community's
framework programme for researchand th e programmes introducingan integrated information network (information technology in areas ofgeneral interest).
Article 5
Implementing measures
The necessary measures for implementing this Decision, relating to the
matters referred to below, shall be adopted in accordance with themanagement procedure referred to in Article 5a(3):
(a) an annual work programme indicating the priorities for action;
(b) the simplification and improvement of this plan's basic administra-
tive procedures, which shall be duly published;
(c) the arrangements, criteria and procedures for selecting and finan-
cing projects under this action plan, including those involvingcooperation withinternational organisations competent in th e fieldof public health and participation of the countries referred to inArticle 6(2);
(d) the evaluation procedure;
(e) the arrangements for the dissemination and transfer of results;
(f) the arrangements for cooperating with the institutions and organisa-
tions referred to in Article 2(2).
The necessary measures for the implementation of this Decision as
regards other matters shall be adopted in accordance with the advisoryprocedure referred to in Article 5a(2).
Article 5a
Committee
1. The Commission shall be assisted by a Committee.1996D0646 — EN — 01.01.2001 — 001.001 — 5
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2. Where reference is made to this paragraph, Articles 3 and 7 of
Decision 1999/468/EC shall apply, having regard to the provisions ofArticle 8 thereof.
3. Where reference is made to this paragraph, Articles 4 and 7 of
Decision 1999/468/EC shall apply, having regard to the provisions ofArticle 8 thereof.
The period laid down in Article 4(3) of Decision 1999/468/EC shall be
set at two months.
4. The Committee shall adopt its rules of procedure.
Article 6
International cooperation
1. In the course of implementing this plan, cooperation with non-
member countries and withinternational organizations competent in
the field of public health, in particular the World Health Organization
and the International Agency for Research on Cancer, will be encour-aged and implemented ►
M1in accordance withth e procedures laid
down in Article 5a(2) and (3) ◄.
2. This plan shall be open to participation by the following coun-
tries:
(a) the EFTA/EEA countries in accordance with the conditions
provided for in the EEA Agreement;
(b) the associated countries of central and eastern Europe in accor-
dance with the conditions laid down in the Europe Agreements,the Additional Protocols to these Agreements and the decisions of
the relevant Association Councils;
(c) Cyprus which shall be funded by additional appropriations, in
accordance withprocedures to be agreed withth is country;
(d) Malta and Turkey which shall be funded by additional appropria-
tions in accordance with the provisions set of the Treaty.
Article 7
Monitoring and evaluation
1. The Commission, taking into account the reports drawn up by the
Member States and with the participation, where necessary, of indepen-dent experts, shall ensure that an evaluation is made of the actionsundertaken.
2. The Commission shall submit to the European Parliament and the
Council an interim report in July 1998 and a final report upon comple-tion of this plan. The reports shall highlight, in particular, thecomplementarity between this action and others provided for in Article4. The Commission shall incorporate into these reports the results ofthe evaluations. It shall also send the reports to the Economic and
Social Committee and the Committee of the Regions.1996D0646 — EN — 01.01.2001 — 001.001 — 6
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ANNEX
SPECIFIC OBJECTIVES AND ACTIONS
A. DATA COLLECTION AND RESEARCH
Objective
To extend and improve knowledge of the causes, prevention and treatment
of cancer and to facilitate the collection of reliable and comparable data on
the incidence of cancer, including data on paediatric oncology, in particular
to identify trends and to devise European-scale epidemiological studies.
Actions
1. Support for exchanges of information and experience relating to the
collection and dissemination of reliable and comparable data for cancer
registers (prevalence, incidence, mortality, survival rates and age groups).
Development and strengthening of a European network in cooperation
withth e International Agency for Researchon Cancer (IARC).
2. Support for the carrying out of epidemiological studies at European level
and for the dissemination of their conclusions with regard to the identifi-
cation of carcinogens (physical, chemical and biological), with special
attention to environmental factors and related conditions at work, the
risks arising from exposure to them (types of exposure and population
subgroups affected), methods of prevention and the introduction of
programmes for objectively assessing survival rates on the basis of
specific criteria (age, sex, position of the tumour, stage of development,
histological type, etc.) and for assessing sources of disparities in those
rates. On the basis of these conclusions, support for the drawing up and
dissemination of recommendations. Cohort studies on cancer, diet and
health (EPIC network), support for epidemiological studies based on
researchinto nutrition as a potential preventive factor (identification of
protective agents, modification of specific dietary factors) and, where
appropriate, preventive chemical agents.
3. Contribution to the selection of priorities for cancer research to be carried
out under the Community's framework programmes for research, and
specifically the biomedical and health research programme, which
includes basic and clinical cancer research, and promotion of research
methods aimed at early, accurate and reliable diagnosis by means of
laboratory diagnosis techniques, in particular based on immunology and
genetics. Support for the establishment of an inventory of European basic
and clinical cancer research measures; help with the transfer to clinical
trials of the results of basic research; setting up and/or development of
information exchange networks for clinical trials in progress, and help
with the launching of multiple-centre and multinational clinical testing
in order to speed up the assessment of new methods of care.
B. INFORMATION AND HEALTH EDUCATION
Objectives
— To help to improve knowledge of cancer risks and cancer prevention
among European citizens and encourage them to adopt healthy lifestyles;
— to promote and assess policies and measures related to cancer causes and
risks.
Actions
4. Establishment of an annual ‘Europe against Cancer’ week.5. Improving the dissemination and effectiveness of cancer prevention
messages, in particular the recommendations of the European Code
against Cancer, by supporting targeted measures (for teachers, general
practitioners, etc.) and pilot projects, studies and analyses of health
promotion techniques and assessments of action in this field.
6. Supporting and extending pilot action networks for providing informa-
tion and exchanges with regard to cancer prevention, taking into
account the recommendations of the European Code against Cancer, in
order to contribute to the highlighting and dissemination of best practice.1996D0646 — EN — 01.01.2001 — 001.001 — 7
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7. Promoting information and awareness-raising campaigns for specific
population groups on health promotion and cancer prevention, particu-
larly in public places and at work.
8. Encouraging projects witha European dimension relating to th e preven-
tion of tobacco consumption; assessment of the implementation of
recommendations on tobacco consumption in public places, particularly
on public transport and in education establishments. Promotion of strate-
gies aimed at protecting the most vulnerable groups, in particular
pregnant women and children, from the risk of passive smoking. Assess-
ment of the effect of measures taken in the Member States to reduce
tobacco consumption, for example the banning or control of direct or
indirect advertising, taxation measures and the exclusion of tobacco
from the price index, and dissemination of knowledge acquired from
the assessment process. Support and assessment of pilot measures for
preventing tobacco consumption as part of the exchange networks
between Member States, for example networks of no-smoking towns,
no-smoking hospitals and youth clubs in cooperation with healthcare
workers and teachers.
9. Selection at European level and dissemination of the best methods of
overcoming addiction to smoking, and evaluation of their impact as
part of pilot measures to implement these methods in liaison with
opinion formers and healthcare workers in the Member States.
Launching, among the pilot projects in the media, of a project to combat
passive smoking. Continuing classification of dangerous substances and
preparations withth e aim of improving packaging and labelling.
10. Contributing to the formulation and implementation of integrated health
education programmes in different life contexts, withcancer prevention
given a particularly important role. Definition and implementation of
supplementary cancer prevention projects for specific groups in different
contexts (town planners, environmental specialists, architects, radiolo-
gists).
Evaluation, in the context of pilot Community networks, of health
education initiatives, withpriority being given to making individuals
more aware of their responsibility for their own health, to discouraging
smoking and excessive alcohol consumption, to promoting a healthy
diet, especially increased consumption of fruit and vegetables, to appro-
priate media campaigns promoting a healthy diet and to making people
aware of the risks associated with excessive exposure of the skin to
ultraviolet radiation, targeted at young people.
11. Support for exchanges of experience under the integrated health educa-
tion programmes withth e aim of improving initial and continuing
training for teachers and project supervisors in the field of cancer
prevention, taking account of the experience gained in the framework
of programmes such as Erasmus and the supporting actions of the
Commission in the education field.
12. Support for the production and dissemination of Community teaching
materials relating to cancer prevention, particularly those tested in the
pilot networks, and for the evaluation of the impact of such materials.
13. Implementation of studies and dissemination of their conclusions,
making it possible to improve the level of knowledge of the perceptions
of young people withregard to cancer, tobacco, diet and th e risks asso-
ciated withexcessive exposure of th e skin to ultraviolet radiation.
Carrying out analyses with the aim of increasing the effectiveness of
preventive programmes among children and young people.
C. EARLY DETECTION AND SCREENING
Objective
To help improve and increase the possibilities of early detection, in parti-
cular through the development and dissemination of effective screening
programmes and appropriate practices.
Actions
14. Support for the introduction and evaluation of European pilot project
networks in the field of mass screening for breast and cervical cancer,
on the basis of recommendations established at European level with
regard to ensuring the quality of screening, and support for the organiza-
tion of meetings to examine the feasibility of extending pilot projects to
national and regional levels.1996D0646 — EN — 01.01.2001 — 001.001 — 8
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15. Support for the preparation and dissemination at European level of a
common terminology and classification in order to improve the quality
of anatomical and cytopathological interpretation, particularly of suspect
growths in the breast and uterus, in particular for anatomists and cyto-
pathologists in the Community.
16. Support for European feasibility studies on mass screening for other
cancers (of the ovary, prostate, skin, colon/rectum and mouth), taking
particular account of the medical, psychological, social and economic
aspects.
D. TRAINING AND QUALITY CONTROL
Objective
To help improve cancer-related training for healthcare workers, including
training in paediatric oncology, and quality control methods.
Actions
17. Further implementation of the Commission Recommendation of 8
November 1989 concerning the training of health personnel in the
matter of cancer; assistance withth e introduction of periodic assessment
of the impact of the European pilot networks on initial and continuing
training in the matter of cancer for the medical, nursing and dentistry
professions, in particular for health personnel working in paediatric
oncology.
18. Support for the mobility of the health professions (particularly trainers),
in order to improve theoretical and practical knowledge of cancer (in
particular primary prevention, early diagnosis, mass screening, particu-
larly for cervical and breast cancer, and quality assurance), between
those specialized centres in Member States offering training of a high
quality, where such mobility is not ensured under existing Community
programmes suchas Comett II or Force.
19. Support for exchanges of experience and the drawing up and dissemina-
tion of conference recommendations for a consensus on good practice in
the field of combating cancer and of recommendations by groups of
experts, in order to speed up the dissemination and implementation of
the results of controlled studies.
20. Preparation of teaching materials of European interest, aimed at
improving training for healthcare workers in the matter of cancer, parti-
cularly through the use of interactive computer programmes; assessment
of the impact of those materials in the pilot networks. In particular,
support for the development, implementation and evaluation of preven-
tion modules intended for the health professions, and of models to assist
in diagnosis and in making decisions on measures to prevent the devel-
opment of the disease and risks of relapse.
21. Promotion of initiatives and support for European studies and dissemina-
tion of their conclusions, particularly in the context of European-levelmeetings and exchanges of experience, in order to gain a better under-
standing of the quality control methods for measures aimed at correct
early detection of the disease and prevention of its development, risks
of relapse and associated syndromes and improving the effectiveness of
those methods, taking into account the psychological and social aspects,
in particular the quality of life of patients, including palliative methods.
22. Support for pilot projects in the area of quality assurance, including
dissemination and evaluation of the results, with particular reference to
practices connected with checks on radiotherapy installations and the
training of health personnel.1996D0646 — EN — 01.01.2001 — 001.001 — 9