On World Cancer Day we work and hope for healthier days

together all our actions matter

Today, 4th of February is World Cancer Day. We mark it to raise attention across the globe and inspire action for a cancer-free future. It is a day that means much to many - all? - of us. Cancer has touched nearly everyone's lives. Raquel Carvalho knows it too well, because her job is to quantify and monitor cancer burden across Europe.

In this interview (conducted by Sandra Caldeira), Raquel shares her work with us, tells us about the cancer burden in the EU and in Portugal and shares her commitment to continue working to tackle this devastating disease.


Sandra Caldeira (SC): Hello Raquel! I know you are taking part in the awareness raising campaign #IAmAndIWill and talking about your work with the European Cancer Information System (ECIS). Do you want to tell us about it?

Raquel Carvalho (RC): I have the pleasure of working for the development of the European Cancer Information System (ECIS). ECIS is the reference point for reliable and comparable indicators on cancer burden in Europe, and these are essential to the development of effective, evidence-based policies and optimal use of resources for tackling the European cancer burden.

We disseminate cancer burden indicators through the ECIS web application that we developed at the JRC. We work together with the European Network of Cancer Registries (ENCR), with a focus on standardisation and harmonisation of cancer registries data to ensure comparability across regions in the EU and allow the exploration of geographical patterns and temporal trends in cancer burden indicators.

SC: That is so interesting! And important... as the saying goes "if you can't measure it, you can't improve it".

How did you end up doing this?

RC: My educational background is in Biochemistry (University of Coimbra, Portugal and University of Bergen, Norway). I have a great interest in cancer risk factors, which started when I joined the JRC 12 years ago, to work in risk assessment of environmental pollutants, including chemical carcinogens.

When I moved to the Health in Society Unit to work on the Cancer Information system, I started thinking about how we could link the data-rich environmental monitoring databases existing in Europe with cancer data.

SC: And what does ECIS tell us Raquel, about the situation in Europe and in Portugal?

RC: When we consider all cancer sites (except non-melanoma skin cancer), Portugal has lower incidence rate than the EU-27 average. This is particularly significant in women, where the cancer incidence rate is the second lowest of all EU-27 countries. For mortality, women also continue to have one of the lowest rates in the EU, but for men it is not so. Men in PT have higher cancer mortality rates than the EU average.

Cancer incidence and mortality in the EU by country by sex
Estimated cancer incidence and mortality in the EU by country by sex. Source: data from ECIS (https://ecis.jrc.ec.europa.eu/)


RC: If you look at different cancer sites, there are also some differences between Portugal and the EU-27. Cancers of the colorectum, stomach and thyroid are more frequent in PT than in the EU as whole, while breast cancer, lung cancer and melanoma of the skin are less frequent in PT.

Comparison of estimated incidence by cancer site, both sexes
Source: data from ECIS (https://ecis.jrc.ec.europa.eu/)


SC: Do you have a concrete example showing how risk factors do affect cancer burden?

RC: It is estimated that more than 40% of all cancers in the EU could be prevented by avoiding specific risk factors. One of the most studied risk factors is cigarette smoking and it is responsible for the majority of lung cancers in the EU.

Something very interesting in Portugal is the fact that even though the national incidence rate of lung cancer is lower that the EU-27 average, this is not homogeneous in different regions of Portugal. For instance, the Central region has very low incidence rate of lung cancer while the Azores archipelago has more than 3 times that rate.

Incidence of lung cancer in PT regions
Source: data from ECIS (https://ecis.jrc.ec.europa.eu/)


RC: This can be explained, at least partially, by a higher smoking prevalence in the Azores. Having access to this type of information can help focus preventive measures on the populations who will benefit the most.

But smoking is not the only risk factor - the European Code against Cancer lists many others and gives 12 simple recommendations to reduce cancer risk.

Distribution of daily smokers in PT by regions
Source: Eurostat, Proportion of daily smokers for population aged > 15 years (2014)


SC: What will 2021 bring you and your work?

RC: The ECIS team is preparing a new data call to update ECIS with the most recent statistics. Our aim is to improve the timeliness of the computed indicators, the data coverage, the geographical detail and have more and better data on cancer stage and treatment. We want to invest in a more efficient communication of cancer information to the public  by making ECIS even more user-friendly.

I am also committed to facilitate a greater use of cancer data and the interoperability between the ECIS database and different environmental monitoring databases to investigate potential linkages between human exposure to environmental risk factors and cancer incidence.

Environmental risk factors are a small proportion overall, but they are often out of the control of the individual; that is why it is so important to monitor the situation across the EU so that higher- risk situations can be identified and tackled.

SC: Thank you so much for this interview Raquel! To you and the ECIS team, please keep measuring it - all our actions matter and we are so thankful for the great work you are doing!


For more on Raquel and JRC's work on Cancer check our headline today  JRC scientists on #worldcancerday