NoC 101/22 Official Journal of the European Communities 28. 4. 86 
the other structural funds so that the coordination between 
the various funds' interventions can be assessed. 
4.4. The Committee feels that if the new Regulation is to 
be successful following the Community's latest enlarge­
ment, ERDF funds will have to be at least doubled and 
productive investment encouraged, resources will have to 
be channelled into and concentrated on the Community's 
real problem areas and ERDF interventions will have to be 
rationally coordinated with those of the other structural 
funds and other financing instruments. In this context it 
proposes the modification of certain Community policies 
of regional significance and the introduction of new 
measures to complement them. 
4.5. The Committee would invite the Commission to 
recommend measures and methods for concentrating 
ERDF aid in those sectors where the most jobs would be 
created at the lowest cost, in line with the objectives of 
regional policy. This could prove to be a more effective way 
of contributing to policy and initiatives in favour of small 
firms as, thanks to their inherent versatility and adapt­
ability — essential assets in combatting the recession and 
mobilizing local economic resources — they are capable of 
making a direct impact on regional development by 
creating jobs. 
4.6. The Committee agrees with the Commission that 
infrastructure projects contribute, directly or indirectly, to the creation of jobs. It would invite the Commission to 
carry out detailed research in order to back up this claim 
with precise official data wherever possible. 
4.7. The Committee would encourage the Commission 
not only to provide information and administrative and 
technical assistance for national and local authorities when 
requested, but also to devise other ways of ensuring the 
successful and effective application of the Regulation. 
4.8. The Committee would urge the Council and the 
Commission to take appropriate measures to enhance the 
role of the ERDF and to redouble their efforts to 
incorporate adequately the regional dimension into other 
Community policies. 
4.9. In regions with development problems, appropriate 
new technologies should be introduced and applied, taking 
account of the comparative advantages and physical 
resources of these regions, so as to help them to overcome 
their structural weaknesses as rapidly as possible. 
4.10. Finally, the Committee believes that, by mobiliz­
ing all the natural and human resources of the regions, 
regional development policy and regional financing 
instruments could prove to be a key factor in defeating the 
recession. Measures designed to bring about economic 
recovery should therefore go hand in hand with regional 
development measures, as part of efforts to achieve 
economic convergence and European integration. 
Done at Brussels, 26 February 1986. 
The Chairman 
of the Economic and Social Committee 
Gerd MUHR 
Opinion on the proposal for a Council resolution on a programme of action of the European 
Communities on cancer prevention 
(86/C101/08) 
On 4 December 1985 the Council decided to consult the Economic and Social Committee, under 
Article 198 of the Treaty establishing the European Economic Community, on the abovementioned 
proposal. 
The Section for Protection of the Environment, Public Health and Consumer Affairs, which was 
responsible for preparing the Committee's work on the subject, adopted its opinion on 4 February 
1986, in the light of the report by Mr Brassier. 
At its 234th Plenary Session (meeting of 27 February 1986), the Economic and Social Committee 
adopted the following opinion by 63 votes for, none against and with 14 abstentions: 
28. 4. 86 Official Journal of the European Communities No C 101/23 
The Committee has examined the proposal for a Council 
resolution on a programme of action of the European 
Communities on cancer prevention, and like the Commis­
sion, welcomes the initiatives taken on the subject at the 
European Council meetings in Milan (June 1985) and 
Luxembourg (December 1985). These initiatives meet the 
concern expressed on more than one occasion by the ESC 
and are in line with the recommendations and possibilities 
of action put forward at international level in the 
programme adopted by the World Health Organization's 
(WHO) Regional Committee for Europe under the heading 
'Health 2000', 24 to 29 September 1984. 
The Committee regrets, however, that its proposals on 
occupational cancer (*) have not been taken sufficiently 
into account. 
The Committee basically shares the views put forward in 
the proposal for a Council resolution, subject to the general 
and specific comments set out below. 
Preliminary remarks on the size of the problem 
In the Community, one million people develop cancer every 
year and 500,000 people die from it. 
Of deaths before the age of 70, 20 % are cancer-related. 
Between now and the year 2000 more than one million 
people are likely to die from lung cancer alone. One of the 
factors contributing to lung cancer is tobacco. 
Concentrating on the five most lethal forms of cancer, it 
would be possible to reduce mortality by 10 to 15 % if 
Europe were to make a concerted effort in fundamental 
research and in the prevention and treatment of cancer. 
A 15 % reduction in mortality is the cancer target of the 
WHO's 'Health 2000' programme. This target could be 
achieved first and foremost by reducing tobacco consump­
tion. According to recent evaluations, a substantial 
reduction in tobacco consumption would lead to a 
considerable fall in cases of cancer. 
The importance of exogenous factors (tobacco, alcohol, 
diet, environment, etc.) varies according to the population 
in question and may also depend on socio-geographical and 
even religious factors. The role of exogenous factors is so 
important that by tackling this aspect it is possible to 
reduce the risk of cancer. 
Our statistics on exogenous factors need to be improved if 
we are to arrive at a first-rate epidemiology of cancer. 
Therapeutic progress may depend on this, even though the 
results obtained today are already better than in the past. 
At present a cure or therapeutic success is achieved in about 
45 % of cases. This figure could be improved by better 
knowledge of the causes of cancer and by better public 
information so that people will be more likely to consult a 
doctor at an early stage. 
(!) OJ No C 176,4. 7. 1983, p. 16. OJ No C 188,29. 7. 1985, p. 1. 1. General comments 
1.1. The proposal on cancer prevention is part and 
parcel of a vast plan to combat cancer. The broad outlines 
of this plan are set out in a Commission communication of 
13 December 1985 entitled 'Action against cancer'. The 
plan has several elements, viz.: 
1. The launching of a campaign under the general heading 
of 'Europe's fight against cancer', which is designed to 
ensure: 
(a) optimum coordination of all current initiatives in 
Europe; 
(b) the study of new initiatives in the fields of 
— prevention, 
— research, including therapeutics; 
2. The creation for this purpose of an ad hoc committee 
— composed of top-level scientists and cancer special­
ists, 
— entrusted with the task of drawing up recommend­
ations on how to carry out this European anti-cancer 
campaign, 
so that specific Commission proposals can be submitted 
within a few months; 
3. The examination, as a matter of priority: 
— (now) of the proposals on which the ESC is being 
consulted at the moment, 
— (at the start of 1986) of the proposals for renewing 
the medical research programme for the period 1987 
to 1999, including action for coordinating the fight 
against cancer. 
This programme should clearly define an anti-cancer 
campaign in three areas: 
— screening and diagnosis, 
— chemical methods of treatment and tests, 
— research. 
1.2. The Committee considers that, at the present stage, 
an overall strategy and a concerted action programme are 
absolutely necessary if the campaign against cancer is to be 
effective. 
The content of the proposal submitted to the Committee is 
only part of the more general plan referred to above. This 
general plan gives more coherence to the policy for fighting 
cancer — a disease which is a veritable scourge of society. 
1.3. The Committee urges that representatives of the 
two sides of industry be co-opted on to the ad hoc 
committee, given the existence of occupational cancers. 
1.4. The Committee would like to see research into the 
prime causes of cancer as well as into the factors conducive 
to cancer; this should be backed up by arrangements for 
facilitating the dissemination of information about 
research into the different forms of cancer. 
No C 101/24 Official Journal of the European Communities 28. 4. 86 
The Committee also considers that research should be 
planned and coordinated at Community level. 
1.5. The Committee also attaches the utmost import­
ance (a) to providing the public with correct information; 
(b) to making as many people as possible aware of, and 
involved in, preventive action; and (c) to promoting 
knowledge of the therapeutic treatment for the most 
widespread forms of cancer. Schools and universities 
should also be among the targets for any cancer inform­
ation campaign. 
1.6. Accompanying the proposal submitted to the ESC 
for an opinion is the Commission's financial statement, 
which lays down the guidelines for the allocation of 
resources to cover expenditure on studies, experts, 
meetings, subsidies and pilot projects within the frame­
work of an action programme or programme of activities 
lasting five years. 
The funds needed to cover such expenditure increase every 
year, giving a cumulative total of 6 300 000 ECU at the end 
of the fifth year. 
The Committee considers that the share of the funds to be 
allocated to pilot projects and to information (for the 
health professions as well as the general public) is vague, 
apparently insufficient, and disproportionate to the other 
items of expenditure. 
2. Specific comments 
2.1. Neither the explanatory memorandum, nor the 
recitals, nor the resolution itself have given rise to any 
major comments, except for the feeling that a certain 
number of ideas tend rather to be repeated; some of these 
ideas are moreover spelt out in detail in the Annex. 
2.2. Point l(ii) of the proposal for a resolution 
Instead of saying that one of the objectives is to decrease 
'the potential years of life lost from cancer', it would be 
preferable to use the expression 'loss of years of survival' or 
'loss of potential life'. These suggestions reflect the wish to 
reduce the differences in life expectancy and to prolong the 
period of survival after treatment for cancer. This would 
probably come about through: 
— a larger number of screenings or early diagnoses, if 
possible under the social security scheme, 
— and/or more effective treatment as a result of the 
earliness of the treatment and/or the progress of 
therapeutic techniques. 
2.3. The Annex to the draft resolution deals at some 
length with 10 points: 
Point 1: Nature and extent of the cancer problem (see the 
preliminary remarks above) Point 2: Recent Community actions and activities related 
to cancer prevention 
As far as occupational cancer is concerned, the Committee 
considers that the causes of risks should be eliminated as far 
as possible. With regard to asbestos, the Committee notes 
with satisfaction that the Council has already adopted 
measures to limit the placing on the market of asbestos 
(including blue asbestos or crocidolite (]) and to protect 
workers against the risks related to the exposure to asbestos 
at the workplace (2); it also notes that a new proposal on 
the prevention of environmental pollution by asbestos has 
just been presented by the Commission to the Council (3). 
The Committee would nevertheless emphasize that the 
asbestos standards fixed by the Commission do not always 
provide effective guarantees. The Commission should 
therefore considerably improve the protection of workers 
and the general public against the cancer risks of asbestos 
(and look for alternative products which are not harmful). 
Point 3: Aims and objectives of the present programme 
The objectives are considered to be pertinent and 
important but should perhaps be more specific. 
Point 4: Initiatives to be taken at Community level 
We should be talking of a 'dietary' not a 'nutritional' 
strategy. In this area, it should be possible to offer 
consumers the freedom to choose a healthy diet with 
minimum cancer risks. There is still a problem, however, 
with the whole range of additives (preservatives, colouring 
matter) and with residues contained in animal products 
(antibiotics, hormones). 
Where foodstuffs, conservation methods and manufactur­
ing processes may possibly be carcinogenic, the European 
Community should embark on research into substitute 
products and processes. 
Point 5: Nutrition (or, better diet) 
1. Same remark on terminology. 
2. We are hardly in a position today to make very firm 
recommendations about certain aspects of cancer risks 
because of a lack of scientific proof. It is difficult to base a 
strategy on non-proven facts. We shall therefore have to 
leave it to research to establish scientifically certain causes 
of cancer or factors conducive to cancer. 
Since a link between excessive alcohol intake and cancer 
has been proved, the Community should have the courage 
to consider and propose practical preventive measures that 
offer a hope of reducing alcohol abuse. These measures 
0) Directive 76/769 amended by Directive 83/478. OJ No L 263, 
23.9.1983, p. 25 et seq. 
(2) Directive 83/477. 
(3) COM (85) 632 final. 
28. 4. 86 Official Journal of the European Communities No C 101/25 
may include the following if a case is established by 
research that they would be effective: 
— a substantial increase in the taxes on alcohol, 
— a ban on alcohol advertisements, including the sponsor­
ship of sports events by producers and distributors of 
alcoholic beverages, 
— a campaign in schools to inform pupils about the 
dangers of alcohol abuse in all its forms, 
— a ban on the sale of alcoholic drinks in certain public 
places (e.g. stadiums). 
Point 6: Tobacco 
The carcinogenic properties of tobacco have been scientifi­
cally proved. 
1. It is necessary to underline the harmfulness of tobacco 
in all its forms. 
2. Cigarette smoke contains lung cancer-producing tars. 
The Community would therefore be well advised to remove 
from the market all cigarettes which yield large quantities 
of tar (20 mg per cigarette would seem to be an acceptable 
ceiling during the initial phase of the policy). 
3. Cigarettes with filter tips, the effectiveness of which 
varies, reduce the quantities of nicotine and tar absorbed. If 
they reduce the risk of cancer, they do not necessarily 
reduce the risks of bronchitis and ischemic heart diseases. 
4. Since reduction of tobacco consumption can diminish 
the risk of cancer by 15 %, it is important to take practical 
measures to achieve this reduction by, for example: 
— increasing the taxes on tobacco, 
— banning tobacco advertising, 
— banning indirect tobacco advertising through the 
sponsorship of sports events, 
— enforcing the ban on smoking in certain places (offices 
— meeting rooms — certain compartments in trains) 
and gradually expanding non-smoking areas. 
Point 7: Services for screening and early diagnosis 
The following should be made clear from the outset: 
1. Systematic screening can bring to light cancerous 
lesions in the early stages (e.g. breast cancer discovered by 
self-examination or X-rays) or sometimes even pre­
cancerous lesions (e.g. cancer of the cervix). 
2. In the case of pre-cancerous lesions (e.g. cervix) it is 
possible to give preventive treatment of proven effective­
ness ; hence the case for developing a systematic screening 
programme. 
3. Where malignant lesions are detected at an early 
stage, this is extremely beneficial for the individual but places a heavier burden on society in general, since 
diagnosis and treatment are more complex. 
Systematic screening for breast cancer certainly reduces the 
mortality rate for this type of cancer, but there is a need for 
continuous evaluation of the results of the method used. 
Point 8: Epidemiological data on cancer mortality and 
morbidity 
1. Ways need to be found of facilitating access to 
information on the medical causes of cancer morbidity and 
mortality — at least for certain qualified persons whose 
sole purpose is the study of epidemiological data. 
In contrast, access should be barred to all members of the 
health professions — even if technically qualified — who 
are not specifically authorized to carry out such studies. 
The Committee proposes that the Commission look into 
the possibility of introducing, in the countries where this is 
necessary, the obligation to notify cases of cancer, as with 
infectious diseases, for example. 
Where a central cancer register is kept, this should be 
accessible only for the purposes of: 
— epidemiological studies, 
— determining the fundamental cause of cancer. 
2. Since certain social groups are exposed to various 
cancer risks, the obstacles to the study of occupational 
cancer must be removed as soon as possible. Above all, it is 
necessary to intensify the study of products/processes 
which are probably, but not yet proven to be, carcinogenic 
so that their use can be regulated if need be. 
3. & 4. With exceptions (children in the Federal 
Republic of Germany and the whole population of the 
United Kingdom and Denmark) the systems for recording 
cases of cancer are very rudimentary or inadequate. One of 
the major difficulties is confidentiality, which doctors insist 
upon on the basis of current ethical codes. The patient is 
often kept in ignorance of the real diagnosis. Yet progress 
in the fight against cancer is in part dependent on good 
epidemiological data throughout a region or a country. 
Often patients with cancer would be receptive to or wish 
for more information on the diagnosis and treatment of 
their case. At all events, few would be likely to object to the 
registering of data relating to their case. It is important that 
the patient should not be treated as an 'object'. 
No C 101/26 Official Journal of the European Communities 28. 4. 86 
There should therefore be provisions enabling the barriers 
created by the invoking of medical confidentiality or by 
professional codes to be removed — with due respect for 
the rights of the individual — in the interests of scientific 
progress and hence an improvement in the quality of life. 
On the other hand, as has been pointed out by some parties, 
steps must be taken to ensure that certain Community 
health rules do not introduce new or additional barriers to 
epidemiological studies. 
Point 9: Health education 
9.1. Health education is regarded as very important but 
we are only just beginning to discover which methods are 
effective. 
Television and the other media may play a decisive role but 
on certain conditions: 
— use is made of recognized specialists, 
— people who give misleading information or are not 
competent on the subject should be barred from 
appearing, — provision could be made for a systematic right of reply 
in the case of inaccurate information. 
The value of public lectures on cancer has been vouched for 
by some parties. 
The resources allocated to education must not be limited by 
an overly narrow cost/benefit approach. 
Point 10: International collaboration 
10.2. It would be useful to implement the measures 
provided for in the WHO 'Health 2000' document with the 
aim of securing a 15 % reduction in mortality. 
Attention should also be focused on two further matters: 
— on the cooperation front, the assistance the Community 
could give to non-member countries with less-de­
veloped health facilities, in the fight against cancer or 
certain forms of cancer that are more prevalent in these 
countries, 
— support for the plan for a meeting in Milan of 
representatives of European national cancer centres, to 
follow up the initiative taken by France, Italy and 
Germany. 
Done at Brussels, 27 February 1986. 
The Chairman 
of the Economic and Social Committee 
Gerd MUHR 
APPENDIX 
to the opinion of the Economic and Social Committee 
Rejected amendements: 
The following amendments tabled in accordance with the rules of procedure were rejected by the Committee 
during the debate: 
Paragraph 2.3., point 4 
Delete in last line the words '(antibiotics, hormones)'. 
Reasons 
1. What evidence is available that antibiotics in animal products are carcinogenic? 
2. Endogenous hormone levels are frequently higher in vegetable products than in animal products. Is it 
suggested that there is a specific difference in carcinogenicity between the same endogenous hormones in 
vegetable and animal products ? 
28. 4. 86 Official Journal of the European Communities No C 101/27 
Result of the vote: 
For: 34. Against: 36. Abstentions: 3. 
Paragraph 4, point 6 
Amend the text after the words '... risk of cancer' to read: 
'..., it is important to take practical steps through further detailed research to establish the effectiveness of 
measures such as: 
— higher taxes on tobacco, 
— banning tobacco advertising, 
— banning smoking in certain places (offices, meeting rooms, reserved compartments in trains), in influencing 
the reduction of tobacco consumption.' 
Reasons 
While research findings to date have established a correlation between consumption of tobacco and cancer, 
there is no clear evidence that the measures proposed in this paragraph will achieve the desired results. Without 
research these measures could, if adopted, prove counterproductive. It would be more practical therefore, to 
urge appropriate research at Community level to establish the facts to support the proposals. This approach is 
consistent with the Section's call for more research in other areas. 
Result of the vote: 
For: 15. Against: 54. Abstentions: 8.