Modern oncology offers increasingly sophisticated prevention tools, but their effectiveness is determined by how quickly we can implement them in society.
The 5th edition of the European Code Against Cancer (ECAC5) is a comprehensive document created by the International Agency for Research on Cancer (IARC/WHO) with the support of the European Commission. It is a collection of 14 recommendations for citizens, based on solid scientific evidence (EBM), on how to help prevent cancer, including avoiding tobacco, managing body weight, and participating in vaccination programs and organized screening. An innovation in the 5th edition is the addition of 14 guidelines for policymakers to systematically support the creation of a health-promoting environment. It is estimated that strict adherence to the Code's guidelines could prevent up to 40-50% of cancer cases and 44% of cancer deaths in Europe. This document serves as an absolute foundation for evidence-based medicine (EBM), setting gold standards for protection against cervical cancer and other cancers of the reproductive organs, or head and neck.
European Recommendations vs. Low Risk Awareness
One of the key recommendations of the updated Code is the widespread vaccination of girls and boys against the human papillomavirus (HPV). ECAC5 explicitly extends this recommendation to gender-neutral vaccinations to build herd immunity more quickly and strongly, and to provide direct protection against HPV-dependent cancers, including in men. Vaccinating both sexes improves health equity, as population-level immunity protects everyone.
Despite such powerful tools and clear guidelines, general awareness of the main cancer risk factors across the European Union remains dramatically low. A 2021 study of 8,171 adults in eight EU countries found that spontaneous awareness of ECAC recommendations ranged from just 2% to 21% depending on the member state.
The latest research experiments conducted during the creation of ECAC5 further demonstrated that when asked, citizens could spontaneously name an average of only 2.4 out of 16 key cancer risk factors.
However, studies show that including clear information about avoidable risk factors in the European Code Against Cancer increases this awareness among EU citizens, though the short-term increase is relatively small. As researchers note, the impact of ECAC5 itself on lasting changes in health behaviors must be the subject of future evaluations.
The Polish Reality – A Race Against Time Where We're Falling Behind
Guidelines are one thing, but Polish practice reveals a huge systemic gap. Poland currently has one of the lowest HPV vaccination rates in the entire European Union. The percentage of vaccinated girls in our country is estimated at only 7.5–10%. For comparison, in countries with developed programs (such as the UK, Australia, or Scandinavian countries), vaccination rates reach 80-90%.
Why are these numbers so alarming? Prognostic models and population studies indicate that to achieve so-called herd immunity and be able to consider the complete elimination of cervical cancer (and other HPV-dependent cancers), the vaccination rate for both girls and boys must consistently exceed the 80% threshold. At the current pace in Poland, building such population immunity will take decades. Until then, the current generation of twenty- and thirty-somethings remains in a zone of extremely high risk.
Vaccines are a powerful investment in the future of medicine and are often used as an adjunct in the treatment process itself, but they do not solve the "here and now" problem for a large portion of the population who did not receive the vaccine in adolescence. The risk of developing cervical cancer or head and neck cancers for today's twenty-, thirty-, and forty-somethings remains dramatically high.
Molecular Diagnostics: A Shield for Today
Given such low immunization rates, modern medicine cannot simply tell patients to wait. Since the mass effects of vaccination will be seen in a decade or more, we must offer patients an immediate solution today. This is molecular diagnostics.
Molecular diagnostics are based on the screening detection of human papillomavirus genetic material (DNA). From a patient's perspective, this test visually and physically resembles a standard cervical smear. The difference lies not in how the sample is collected, but in the analytical power in the laboratory. Instead of looking for damaged cells under a microscope (which means the disease is already developing), a molecular test looks for the DNA of high-risk viruses long before it causes any structural changes. The updated European Code Against Cancer (ECAC5) clearly recommends participation in organized screening programs that utilize HPV tests. Regular – ideally annual – HPV testing allows for early detection of infection, long before it causes significant damage to the body. Early detection at the molecular level enables treatment at the stage of precancerous changes, which are 100% curable.
What do tests offer in practice?
Hard clinical data expose the weakness of medicine relying solely on old standards. A significant limitation of traditional screening programs based on cytology is their low sensitivity and specificity.
According to scientific research supported by the National Consultant in Gynecological Oncology, Prof. Dr. Hab. Zbigniew Kojs, in the case of precancerous conditions (cervical intraepithelial neoplasia/CIN) – a state where epithelial cells are already undergoing abnormal changes due to chronic HPV infection but are not yet symptomatic – traditional cytology does not provide satisfactory results. It can miss nearly half of developing precancerous changes, especially in cases of glandular epithelial changes that are difficult to detect.
Molecular DNA tests solve this problem, offering nearly 100% sensitivity in detecting oncogenic types of the virus, giving the patient absolute certainty about their health status.
Dual Action of Medicine 3.0
Medicine 3.0 represents a fundamental paradigm shift in healthcare. Traditional "Medicine 2.0" acts reactively – the patient intervenes only when symptoms appear, and only then is a DiLO (Oncological Diagnostics and Treatment) card issued, when the disease is already visible, significantly more difficult, and more expensive to treat. The entire period preceding medical intervention, when the patient appeared healthy (had no noticeable alarming symptoms) and diagnosis and treatment would have been much less complicated, is overlooked in this care process.
Since the Polish healthcare system in oncology is forced to invest billions in delayed hospital treatment – because patients with cancer who do reach the system must be treated – and building population immunity through vaccination will take decades, patients are left to passively wait for a diagnosis.
Medicine 3.0 is a proactive, highly personalized approach focused on early prevention. Instead of saving lives late in the course of a disease, sometimes a very severe one, Medicine 3.0 emphasizes maximizing the duration of life in full health. It utilizes big data analysis, continuous biomarker monitoring, and modern digital technologies to delay or completely prevent oncological diseases. In oncology, this means moving away from waiting for symptoms towards automated surveillance and regular, targeted testing, such as annual molecular HPV tests, before the virus causes any harm. The Wellysa platform is also based on this approach. By focusing on early diagnostics, monitoring health parameters with proactive prevention, and specialist care in high-risk cases, we help to extend the period of full health as much as possible.
Vaccinations are an absolute standard of protection, but in Polish realities, they absolutely require supplementation with annual testing. A double shield is essential, building the safety of future generations while physically protecting your health today. Prevention is not a date on the calendar. Get vaccinated if you can, but above all – get tested regularly.
