Data & Evidence
The case for equal access to cancer trials isn't just emotional — it's backed by hard data. Here's what the evidence shows.
Cancer Burden in the EU
This section covers the scale of cancer across the EU today — how often it's diagnosed, who it affects, and how the burden is projected to grow if nothing changes.
1 in every 12 seconds
a person is diagnosed with cancer in the EU
30% / 25%
lifetime risk of being diagnosed with cancer before age 74 for men / women, EU-wide, based on 2024 estimates
+16%
rise in cancer diagnoses in women under 50 since 2000 — and still rising
23.9%
share of all EU deaths in 2023. Without further progress in prevention, early detection, and treatment, cancer could become Europe's leading cause of death by 2035.
The Funding Gap
<€150 vs >€400
Hungary, Croatia, Romania, Latvia and Bulgaria spend under €150 per capita on cancer care annually; Germany and Switzerland spend over €400 — nearly a three-fold gap, and higher spending is associated with higher survival.
Stable share of healthcare spend
Cancer care has held a stable share of total healthcare expenditure over the last decades, despite a growing number of cases.
The Accessibility Gap
Including new treatment options and clinical trials
<100 vs 900 days
Germany reimbursed nearly all cancer medicines with EMA approval from 2019–2022 within 100 days. Malta, Estonia, Slovakia and Romania reimbursed fewer than 20% of new medicines, and average time to reimbursement in Latvia and Lithuania was close to 900 days.
Uneven diagnostic access
Molecular diagnostics are vital for precision oncology, but access remains limited, especially in Central and Eastern European countries, where testing infrastructure lags behind Western Europe.
42% → 21%
Europe's share of global oncology clinical trial starts, 2009–2024.
30% vs. 11%
Share of eligible large B-cell lymphoma (LBCL) patients receiving CAR T-cell therapy, France vs. Italy (2023) — access varies sharply across major European countries.
The Survival Gap
~200,000
Cancer deaths that could be avoided each year across Europe if more countries achieved survival rates similar to Sweden's.
1.6x / 37%
Cancer mortality rates vary 1.6-fold across EU countries, and by up to 37% between regions within a single country.
EU vs World
This section compares clinical trial capacity between the EU and the rest of the world, covering Europe's shrinking share of global trials, the oncology-specific gap with the US, the next frontier in cell and gene therapy, and what's driving the divergence.
Oncology trial starts, EU vs. US
+25%
US oncology trial starts, change since 2018
-22%
EEA oncology trial starts, change since 2018
Since 2021, oncology trial starts in the EEA have fallen every year and now sit below 2018 levels. The US moved in the opposite direction, climbing steadily from 2018 through 2021 and holding well above its starting point ever since.
Falling behind on the next frontier
25% → 10%
Europe's share of global cell and gene therapy trials, 2013–2023
10% → 42%
China's share of global cell and gene therapy trials, 2013–2023
In cell and gene therapy, one of the most promising fronts in cancer treatment, Europe's global trial share dropped from 25% to 10% between 2013 and 2023. China's share rose from 10% to 42% over the same period, driven by faster regulatory pathways and heavy strategic investment.
Slower every step, and it depends where you live
34 vs 37 months
US vs EEA average trial timeline
1–25 months
range in patient recruitment timing across EEA countries
Even inside the EU, a patient's odds depend on which country they live in. Poland, Spain, and Denmark consistently recruit fastest; other countries take far longer.
This is the gap our proposed Cancer Clinical Trials Fund is built to close: enabling genuine cross-border access so a patient's postcode doesn't decide whether they can enroll, and backing the harmonisation Europe needs to compete again for the trials that save lives.
The Economics of Inaction
This section lays out the real cost of cancer to European health systems and economies — including annual healthcare costs, lost workforce productivity, and the case for treating clinical trial investment as cost-saving rather than an added expense.
The scale of the cost
+43%
1995–2023
rise in cancer's combined direct and indirect cost across Europe between 1995 and 2023, from €159 billion to €228 billion (2023 prices)
€97B
Annual, current
annual cost to European health systems (PPP)
€50B
Annual, current
annual lost workforce productivity
€1.3 trillion
2018–2040 projection
projected lost labour productivity from cancer-related premature mortality between 2018 and 2040 — an average of €58.7 billion a year, or 0.43% of EU-27 GDP, every year, for two decades
Inequality shows up in the cost data too
The case for research as cost-saving, not just cost
The European Cancer Clinical Trials Fund isn't competing against existing costs — it's a comparatively small, high-leverage investment set against a €97B/year health cost and €50B/year productivity loss that's already being paid, with or without the Fund.
Clinical Trial Access
This section covers the EU's current clinical trials regulatory system (CTR/CTIS), recent efforts to speed up trial approvals, and why none of that yet guarantees a patient can actually reach a trial that exists elsewhere in the EU.
41% → 21%
EU's share of global oncology clinical trials, 2008–2023 — a near-halving of relative research capacity in 15 years
~0.75 Gini index
for clinical trial access across global income tiers — comparable to some of the world's most unequal income distributions, applied instead to trial access
The current regulatory architecture (CTR/CTIS)
Recent acceleration efforts
The direction is right, but still procedural: FAST-EU is a voluntary one-year pilot, the Biotech Act is still a proposal working through the legislative process, and even the Commission's own strategy stops at ambition — not a dedicated funding line for rare cancer trials.
The gap this section sets up: CTIS, FAST-EU, the Biotech Act make it faster and cheaper to authorise a trial a sponsor already chose to run in the EU. None of it addresses where sponsors choose to run trials in the first place, or guarantees a patient in a country with no open trial can enroll in one elsewhere. Procedural streamlining hasn't reversed the EEA's shrinking share of global trials (12% in 2023, down from 22% in 2013) — because the barrier isn't paperwork speed, it's where trial capacity and funding are sited.
Rare Cancers — What Exists, What's Missing
This section covers the scale of the rare cancer burden across the EU, the cross-border infrastructure that already exists (like the European Reference Networks), and why rare cancers make the sharpest case for a dedicated trials fund.
~5.1 million
people across the EU and UK affected by rare cancers (incidence under 6 per 100,000/year), 650,000+ new cases annually
~22–24%
share of all cancer diagnoses that are rare cancers, collectively — not a small policy problem
What exists — and where it breaks down
The EU already built the infrastructure: European Reference Networks (ERNs) link specialist centres in all 27 countries into disease-specific networks — EURACAN for rare adult solid cancers, EuroBloodNet for rare blood cancers — solving the problem that no single country has enough rare cancer patients to sustain expert care alone. Orphan drug rules add real incentives on top: up to 10 years of market exclusivity, faster review, and fee waivers.
What's missing is money to run it. ERNs were never funded to do the cross-border trial-matching work they exist for — and it shows: only 5–6% of rare diseases have a dedicated treatment, and patients still face delays, fewer trials, and worse outcomes than the infrastructure was built to prevent.
Why this is the sharpest case for the Fund: Rare cancers are the textbook example of the Gap Analysis argument — no single Member State has enough patients to power a trial alone, ERNs already provide the cross-border clinical infrastructure to pool them, but there's no dedicated funding mechanism to actually run the trials once patients are pooled. The Fund would complete a chain EURACAN and EuroBloodNet can't finish alone.