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Beyond Moonshot: European Cancer Patients Need Immediate Groundshot

The USA “Cancer Moonshot” initiative aims to eradicate cancer in the future, but back on Earth here in Europe, a “groundshot” initiative could tackle issues faced by cancer patients right now — both globally and in the US — by making better use of services that are already available. A Lancet Oncology commission, called the European Groundshot Initiative, was recently published [1].

The term “cancer groundshot” was coined by Bishal Gyawali, MD, PhD, who argued that

a “cancer groundshot” could have a greater public health impact on global cancer outcomes in the next 10 years than any would-be innovations from high-tech moonshots [2]. He explained that the term “groundshot” refers to using cost-effective and proven measures in the prevention and treatment of cancer — on a global scale.

In part, it was a reaction to the headlines and hype surrounding the Cancer Moonshot initiative, launched in 2016 under the Obama administration [3]. Its major focus was a high-cost research strategy that included genomics, precision therapy, immunotherapy, and artificial intelligence.

Individuals and institutions began to develop their own versions of Moonshots, aside from the one initiated by the federal government.

The past year has been one of recovery and rebuilding. However, it has also exposed the inequalities in cancer care across Europe more starkly than ever. That’s why, during the European Cancer Summit 2022, a Lancet Oncology Commission ‘European Groundshot’ was launched with 12 evidence-based recommendations (See Figure). They provide a roadmap to achieving a 70% survival rate, on average, for all cancer patients in Europe by 2035. Likewise, the European Cancer Pulse, also launched this year, is an innovative and interactive data visualisation tool tracking inequalities in cancer.

Demanding that cancer be a priority for European and national policymakers was a key thread throughout this year’s Summit. Whether using lessons learnt from Covid-19, leveraging new technologies, or riding on the momentum of multiple actions at EU and national levels, participants committed to achieving this goal.

The European cancer community acknowledged that we need to play the long game, ensuring continuity between political mandates, and holding policymakers to account. We need them to create the right conditions and provide sufficient financing as we prepare for emerging demographic shifts and new technologies that can improve prevention, screening, early detection, treatment, and survivorship.


  1. Lawler M, et al Lancet Oncol. 2023 Jan;24(1):e11-e56.
  2. Mutebi M, et al. Am Soc Clin Oncol Educ Book. 2022 Apr;42:1-16.
  3. Aelion CM, et al. Lancet Oncol. 2016 May;17(5):e178-80


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