Health networking is in principle a formidable instrument to address many challenges
posed by cancer, one of the two most common and most lethal non-communicable chronic
diseases. The European Union (EU)'s Beating Cancer Plan foresaw the addition of new
health networks to the four already existing European Reference Networks on rare cancers:
the Network of Comprehensive Cancer Centres and several networks of expertise (NoEs),
which will be shortly deployed on items as complex and poor-prognosis cancers, palliative
care, survivorship, personalised primary and secondary prevention, omic technologies,
hi-tech medical resources, and cancers in adolescents and young adults. The community
of experts of the EU Joint Action, due to build such NoEs, has drafted this 'green
paper', incorporating 13 open questions, in an effort to foster discussion on some
open questions about health networking on cancer in the EU. These affect highly diverse
issues such as the following: how gaps in research into the instrument of health networking
may be filled; which items lend themselves more to health networking in the EU; what
degree of cooperation and harmonisation should be required of EU member states to
best exploit health networking and give rise to European networks of national/regional
networks; how the idea of subsidiarity may be best interpreted to support health networking
in the context of EU treaties, which basically do not include health; how health networks
should be funded and with what degree of cooperation between the EU and national levels;
whether EU health networks should be shaped as legal entities or could give rise to
secondary legal entities, also with a view to fundraising; how health networks should
be best shaped to advance cancer research and how the EU regulatory system should
be updated to exploit such impulse to health networks, in view of the EU General Data
Protection Regulation and the new EU Health Data Space; how artificial intelligence
can be exploited today within health networks and to what extent it will be able to
overcome challenges such as the current lack of interoperability of electronic health
records and the language barrier across the EU; and how health networks should involve
patients and their groups, with regard to their formal role within EU health networks
as well as their ability to have a say in items such as production of clinical practice
guidelines, the design of investigator-driven clinical trials, EU regulatory decisions
on medicines and devices, health service data governance, and identification of unmet
needs.
