As Cyprus prepares to assume the final stage of the European Union Trio Presidency (following Poland and Denmark), we–the Minister of Health of Cyprus, together with scientific leadership from the Maria Sklodowska-Curie National Research Institute of Oncology and the International Agency for Research on Cancer (IARC)–reaffirm our shared commitment to placing cancer prevention at the forefront of the European health agenda.
Over 40% of the cancer burden in Europe is attributable to modifiable risk factors, with the highest cancer mortality rates observed in Central and Eastern European countries.1,2 Continuously rising cancer incidence mainly due to demographic changes, combined with unfortunate low participation in screening and still too high prevalences of behavioral risk factors, continues to drive excess mortality. In Poland, for example, less than 40% of eligible women attend population-based breast cancer screening.3 Meanwhile, tobacco smoking remains common among adolescents aged 13–15 in the region, and the rapid increase in the use of emerging nicotine and tobacco products raises serious public health concerns. Achieving the goal of a ‘tobacco-free generation’ by 2040, as outlined in Europe’s Beating Cancer Plan, may therefore prove especially challenging.4
The European Code Against Cancer (ECAC) offers a comprehensive, evidence-based response. Developed under the leadership of IARC, the current edition of the Code comprises 12 actionable recommendations on cancer risk reduction, including not smoking, limiting alcohol consumption, regular physical activity, and participation in vaccination and screening programmes (Panel 1).5 Yet despite its quality and potential, ECAC remains insufficiently known and underused, particularly in the populations most affected.
Panel 1. Current European Code Against Cancer recommendations.
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1.
Do not smoke. Do not use any form of tobacco.
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2.
Make your home smoke free. Support smoke-free policies in your workplace.
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3.
Take action to be a healthy body weight.
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4.
Be physically active in everyday life. Limit the time you spend sitting.
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5.Have a healthy diet:
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•Eat plenty of whole grains, pulses, vegetables and fruits.
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•Limit high-calorie foods (foods high in sugar or fat) and avoid sugary drinks.
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•Avoid processed meat; limit red meat and foods high in salt.
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•
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6.
If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention.
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7.
Avoid too much sun, especially for children. Use sun protection. Do not use sunbeds.
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8.
In the workplace, protect yourself against cancer-causing substances by following health and safety instructions.
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9.
Find out if you are exposed to radiation from naturally high radon levels in your home. Take action to reduce high radon levels.
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10.For women:
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•Breastfeeding reduces the mother’s cancer risk. If you can, breastfeed your baby.
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•Hormone replacement therapy (HRT) increases the risk of certain cancers. Limit use of HRT.
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•
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11.Ensure your children take part in vaccination programmes for:
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•Hepatitis B
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•Human papillomavirus (HPV)
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•
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12.Take part in organised cancer screening programmes for:
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•Bowel cancer (men and women)
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•Breast cancer (women)
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•Cervical cancer (women).
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•
Prevention was one of the three central themes of the Polish Presidency of the Council of the EU in the first half of 2025. On 27 May in Warsaw, we convened the 1st European Summit on Cancer Prevention and Control, bringing together policymakers, researchers, clinicians and civil society to forge a stronger collective vision. The upcoming launch of the new—fifth edition of ECAC over the next months, offers a unique opportunity to translate that vision into action.
As the Trio Presidency moved forward, we see a unique opportunity to reframe cancer prevention as a shared European responsibility that goes far beyond individual behaviors. As European countries representing diverse regions of the EU, we are committed to using this momentum to support long-term investment in preventive health. This includes strengthening data systems for cancer risk factor surveillance, improving national cancer registries, and ensuring that public health institutions are equipped to act effectively on ECAC recommendations.
The forthcoming edition of the European Code Against Cancer has the potential to serve as a strategic reference point for national health policies and a practical tool to support EU-level action. Its successful implementation requires not only scientific credibility, but also broad visibility, political support, and societal engagement. Cancer prevention must be recognized not as a complementary element, but as a central pillar of sustainable cancer control in Europe.
Therefore, we call on EU institutions, member states, and professional societies to adopt a shared dissemination and implementation strategy. This includes national action plans, integration of ECAC into school and medical education, sustained public engagement campaigns and equity-focused monitoring of reach and impact. We also invite journalists and media to fight fake cancer news but help ensure the Code reaches all population groups–and does not remain a silent document.
Note: The endorsement of this letter by the Ministry of Health of Cyprus reflects support for its overall public health message and should not be interpreted as a formal statement of the official priorities of the Presidency of the Council of the European Union.
Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer/World Health Organization.
Contributors
Paweł Koczkodaj: conceptualization, data curation, formal analysis, investigation, project administration, supervision, validation, writing–original draft, and writing–review & editing.
Michael Damianos, Beata Jagielska, Elisabete Weiderpass, Joachim Schüz: supervision, writing–original draft, and writing–review & editing.
Declaration of interests
The authors have no competing interests.
Acknowledgements
Funding: This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
References
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