For its back-to-school conference, Unicancer, a federation representing 18 cancer centers (CLCC), presented a paradoxical observation: while its activity saw a significant increase in 2024, the financial health of the centers it represents remains precarious. “Between 2023 and 2024, there is an increase of +7% [in activity]. Nevertheless, in 2024 we have 11 cancer centers out of 18 that are in deficit. And for the first time, the cumulative result of the centers will be in deficit of 14 million euros,” lamented Sophie Beaupère, general delegate of Unicancer. The disparity, among other things, is due to a 2.8% tariff differential between public establishments and CLCCs, to the detriment of the latter. “We ask that there are no new degradations of our prices for the coming year,” added Sophie Beaupère.

2025: A Symbolic Year

Despite the financial challenges, Unicancer remains optimistic for 2025, a year that holds significant symbolic importance. “It’s the 80th anniversary of General de Gaulle’s ordinance which creates cancer centers, but it is also the five years of the ten-year strategy decided by the President of the Republic in the fight against cancer. It is therefore an opportunity to take a step assessment,” defined Jean-Yves Blay, president of Unicancer. In terms of cancer incidence, recent years have shown alarming trends. “We have found a rapid increase in the number of cancers, multiplied by two in thirty years, or around 430,000 new cases per year. We also note an increase in the number of cancers in young people without risk factors, for which many studies are underway to determine the causes. We also worry about an increase in digestive cancers, for example colon cancer in young people, but also gynecological cancers. According to the World Health Organization (WHO), the number of cancers will further increase by +77% until 2050,” established Jean-Yves Blay. “At the same time, WHO estimates that there are currently some 10 million doctors worldwide,” adds Jean-Yves Blay.

Access to Care

To address these challenges, Jean-Yves Blay recalled the principles of the ten-year strategy adopted by the majority of actors involved in the fight against cancer. “The equity of access to care for all is a major issue for us. Molecular and immunological tests are now standards for all recommendations for international practices, and must be accessible to all patients,” notably said Jean-Yves Blay. “Access equity is worth for the whole territory, and in particular the overseas departments. We are currently developing advanced practice nursing training (IPA) in oncology for overseas nurses,” completed Sophie Beaupère.

Prevention

Prevention (primary, secondary, and tertiary) is also one of the fundamentals of the ten-year strategy. As primary prevention, Jean-Yves Blay wishes “Develop HPV vaccination. Australia is in the process of eradicating HPV cancers. There is no reason that we do not do the same,” he said. “For secondary prevention, the news is very rich. I would especially like to highlight the Mypebs international study (My Personal Breast Screening), a fairly remarkable project which makes it possible to guide the screening of breast cancer according to the level of individual risk. Some women after 50 years will need an annual mammography, when others can be satisfied with a mammography every five years, according to their profile,” announced Jean-Yves Blay. The results of this study are expected for 2026.

Home Chemotherapy

Improving the quality of life of patients is also one of the themes of the ten-year strategy. “The decree authorizing chemotherapy at home has been signed, which will allow a significant improvement in the patient’s comfort. We believe that 5% of patients can be taken care of in home hospitalization,” said the president of Unicancer. Another concern of Jean-Yves Blay: bad prognosis cancers, “Who represent 22% of cancers and 30% of cancer mortality. Unfortunately, these data have been stable for years, but we have been engaged in many research programs, including the Rosalind program in collaboration with cure51 [annuaire de survivants au cancer]. This study concerns patients who have survived more than 5 years to the most lightning cancers.” He also called on the public authorities to reduce the validation deadlines for clinical trials, “To restore our competitive capacity at European level.”

Fresh Insights and Analysis

The financial strain on cancer centers is a global issue, not just limited to Europe. In the United States, similar challenges are faced by cancer treatment centers, where the cost of care and the need for advanced treatments are constantly increasing. The American Cancer Society reports that the total cost of cancer care in the U.S. is expected to reach $246 billion by 2030. This financial burden underscores the need for innovative funding models and increased government support to ensure that cancer centers can continue to provide high-quality care.

One potential solution is the implementation of telemedicine and remote monitoring technologies, which can reduce the cost of care by minimizing hospital visits and improving patient outcomes. For instance, the Mayo Clinic has successfully integrated telemedicine into its cancer care programs, allowing patients to receive consultations and follow-up care from the comfort of their homes. This not only improves patient convenience but also reduces the financial burden on both patients and healthcare providers.

Another critical area of focus is the development of personalized medicine. The Mypebs international study, which tailors breast cancer screening based on individual risk profiles, is a prime example of how personalized medicine can revolutionize cancer care. By leveraging genetic testing and advanced analytics, healthcare providers can offer more targeted and effective treatments, ultimately improving patient outcomes and reducing healthcare costs.

Counterarguments and Criticisms

Critics may argue that the focus on financial sustainability and cost reduction could compromise the quality of care. However, it is crucial to recognize that financial stability is essential for the long-term viability of cancer centers. By implementing cost-effective measures and leveraging technology, cancer centers can maintain high standards of care while ensuring their financial sustainability.

Additionally, some may question the effectiveness of home chemotherapy and telemedicine in providing the same level of care as traditional in-hospital treatments. While these methods are not suitable for all patients, they offer a viable alternative for those who can benefit from them. The key is to provide a range of options that cater to the diverse needs of patients, ensuring that everyone receives the best possible care.

Conclusion

The challenges faced by cancer centers are multifaceted, encompassing financial, logistical, and technological dimensions. However, with innovative solutions and a commitment to equitable access to care, the fight against cancer can be significantly strengthened. As Jean-Yves Blay highlights, “It’s the 80th anniversary of General de Gaulle’s ordinance which creates cancer centers, but it is also the five years of the ten-year strategy decided by the President of the Republic in the fight against cancer. It is therefore an opportunity to take a step assessment.” This assessment is not just about looking back but also about looking forward to a future where cancer care is more accessible, effective, and sustainable.