Modernising early detection in cancer care: can EU policy keep pace with the scientific reality?

The NHS recently announced plans to expand the use of liquid biopsies to guide treatment for lung and breast cancer patients. This marks a broader shift towards less invasive, more personalised cancer care (especially in early detection) and signals how molecular diagnostics are moving closer to mainstream clinical practice in the UK. The government’s call for evidence for the UK’s next cancer plan explicitly identifies modern screening and innovative diagnostics as key priorities. 

By contrast, the EU’s approach has been more cautious. While the Europe’s Beating Cancer Plan (EBCP) placed early detection at its core, the integration of advanced diagnostics like liquid biopsies and AI-based tools remains limited and uneven across Member States.  

The 2022 Council Recommendation on cancer screening dropped all references to new technologies, despite their inclusion in the Commission’s original proposal and backing from the EU’s own Chief Scientific Advisers. The omission raises a critical question: how can the EU support Member States in modernising early detection infrastructure and scaling next-generation diagnostics, without making access dependent on geography, budget cycles or shifting political will? As EU momentum around cancer policy slows, and competences remain limited, pushing forward will require a more strategic, focused approach. 

The key issue? Financial Barriers 

The biggest barrier remains funding. Policymakers consistently cite cost-effectiveness as a concern. Prevention and early detection demand significant upfront investment, with savings, such as avoiding advanced-stage care, only materialising years later. This logic was embedded in the 2022 Council Recommendation, which made Health Technology Assessment (HTA)-based cost-effectiveness a central criterion. 

In Spain, for instance, the government commissioned a review on the value of lung cancer screening. Despite strong clinical trial evidence (NLST, NELSON), concerns about cost, uptake and regional variation dampened enthusiasm for a national rollout. Even with updated guidance allowing for risk-based, stratified screening, many Member States have stayed in pilot mode, wary of long-term investments in infrastructure, follow-up, and adherence mechanisms. 

Innovating early detection: a new challenge for Europe 

These concerns now extend to liquid biopsies. Despite their potential to transform the entire cancer pathway, from early detection to treatment monitoring, they don’t fit neatly into traditional HTA frameworks. Their greatest value lies in long-term outcomes: diagnosing cancers earlier, reducing unnecessary procedures, and easing the patient experience through non-invasive methods. But most health systems are not designed to account for indirect, delayed benefits. 

Unlocking their full potential requires a mindset shift: from reactive spending to anticipatory investment. That means new HTA models capturing broader system-wide value, and multi-annual financing tools that allow governments to invest today for future gains.  

A compelling real-world example comes from the 2025 IHE Comparator Report, which highlights how molecular diagnostics, specifically genomic profiling via liquid biopsy, is helping to tailor targeted treatments for patients with advanced non small-cell lung cancer (NSCLC). By identifying actionable mutations more rapidly and less invasively, these tests not only improve patient outcomes, but also guide more efficient use of expensive targeted therapies and reduce adverse effects from inappropriate treatments. When liquid biopsy is integrated early in the treatment pathway, it delivers both clinical and economic benefits that traditional models frequently overlook, benefiting today’s patients and strengthening tomorrow’s health systems. 

What can the EU do next? Strategic Action with Limited Political Capital 

With cancer expected to lose prominence in the EU’s health agenda going forward, partly as cardiovascular diseases take the spotlight, the priority should not be to expand the EBCP but to embed and future-proof what it has achieved. The EBCP must be treated as a living framework, able to evolve with science. The European Parliament’s Committee for Public Health (SANT) has a key role to play. Its ongoing review of EBCP implementation should push for regular, structured evaluation of screening and early detection across Member States. In a world of fast-moving diagnostics, reviewing screening guidance every 20 years is no longer good enough. 

Meanwhile, the European Commission should focus on sustaining and implementing what already exists. Its Initiatives on Breast, Colorectal and Cervical Cancer have developed evidence-based guidelines that now begin to incorporate AI and risk-based screening. The next step is ensuring these are updated regularly and that their national uptake is tracked and supported. 

This is also where investment in advanced diagnostics can pay off. For example, the IHE Comparator Report 2025 points to the use of Oncotype DX in early-stage breast cancer to guide chemotherapy decisions. Countries that integrated this test saw a significant reduction in unnecessary chemotherapy - improving patient quality of life, lowering risks of treatment-related complications, and generating cost savings for health systems. This illustrates how targeted investment in diagnostic innovation can align patient benefit, health system efficiency, and long-term sustainability. 

Conclusion: The Tools Are Here, Now It’s Time to Act 

The tools are there. What’s needed now is political will and practical enablement. This involves helping Member States invest in infrastructure, reforming pathways, and building systems ready for tomorrow’s innovation. The challenge is not reinventing cancer policy; it’s having the determination to deliver on its promise.