PRINT THE CODEThe European Code Against Cancer, 5th edition (ECAC5) comprises 14 recommendations that offer clear, actionable steps for individuals to contribute to cancer prevention, grounded in the latest scientific evidence. Designed for the general population in the European Union (EU), the recommendations are accessible, feasible, and easy to understand.
ECAC5 also includes 14 complementary policy recommendations on population-level measures that may reinforce individual actions. These recommendations urge policy-makers to implement policies that address social, environmental, economic, and structural barriers to healthier behaviours and uptake of preventive interventions.
To provide further details and support the implementation of the 14 recommendations, Knowledge Translation Outputs – in the form of Fact Sheets and Policy Briefs – have been developed to provide more details and explanations for each recommendation. Fact Sheets cater to both a general audience and health professionals. Policy Briefs provide detailed insights for policy-makers and key decision-makers.
The European Code Against Cancer (ECAC) is an initiative of the European Commission, launched as a first edition in 1987. The International Agency for Research on Cancer (IARC/WHO) was requested by the European Commission to produce the 4th edition of ECAC, which was published in 2014. After the adoption of Europe’s Beating Cancer Plan, IARC was re-commissioned to update ECAC for the 5th edition. The project to develop ECAC5 began in 2022, with a 4-year duration, funded by the European Commission under the EU4Health programme. ECAC5 forms a key part of the development of the World Code Against Cancer Framework, for which a series of Regional Codes Against Cancer are being developed that reflect the epidemiological factors specific to each global region.
The ECAC5 recommendations were developed by more than 60 European experts specializing in cancer prevention, epidemiology, health promotion, behavioural change, and communication. The experts were organized into five Working Groups (WGs). The experts in Lifestyle Determinants (WG1), Environmental and Occupational Determinants (WG2), Infections (WG3), and Medical Interventions (WG4) reviewed the latest scientific literature, including producing targeted systematic reviews and meta-analyses, and assessed the most relevant existing international policies that may support each of the recommendations. The experts were supported by the Iberoamerican Cochrane Centre/Research Institute of the Hospital de Sant Pau (Spain), which contributed to the update of the scientific literature, adhering to the methodology of the World Code Against Cancer Framework.
The Communication and Health Literacy Working Group (WG5) provided expert guidance on optimizing the communication of all recommendations, ensuring their coherence as a comprehensive set. In addition to this advisory role, WG5 conducted a large-scale EU study to evaluate the recommendations for individuals, identifying the most effective communication formats to enhance public recall of cancer risk factors.
A Scientific Committee, comprising representatives of major national cancer institutes and governmental agencies across the EU, assessed and approved the recommendations, ensuring that they reflect the latest evidence and are supported by the necessary authoritative policies relevant to the socioeconomic and health systems context of EU Member States. In addition, an Advocacy Group formed by representatives of influential cancer prevention and control entities in the EU, provided further insights and guidance. The ECAC5 project Secretariat was composed of IARC researchers, with support from World Cancer Research Fund International and the European Commission, alongside the Chairs of the five ECAC5 Working Groups, in the Coordination Group.