Cancer Death Rates In Europe Will Continue To Fall, New Predictions For 2012
Researchers from Italy and Switzerland estimate nearly 1.3 million people (717,398 men and 565,703 women) will die from cancer in the EU in 2012. They show how they arrived at these, and more detailed figures, in the 28 February online issue of the cancer journal Annals of Oncology.
Estimating such figures, both overall and for individual cancers, is important for helping countries define priorities for prevention and treatment, they write in their background information.
The team looked at cancer rates for all of the EU, which comprised 27 member countries in 2007, and for each of six EU countries: France, Germany, Italy, Poland, Spain and the UK.
They calculated rates of deaths both overall for all cancers, and individual cancers, including leukaemias and cancers of the lung, stomach, intestine, pancreas, breast, uterus (including cervix), and prostate.
Using recognized models, and drawing on cancer death and population data from the World Health Organization (WHO) database, the researchers estimate the overall cancer death rate for 2012 will be 139 per 100,000 men and 85 per 100,000 women.
Compared with confirmed deaths from five years ago, in 2007, this represents a fall of 10% in deaths among men and 7% among women. (2007 is the year for which WHO cancer death figures cover most EU countries.)
One key finding is an estimated large drop of 9% in the number of women dying from breast cancer in 2012, corresponding to a rate of 14.9% per 100,000 women.
This includes older, middle-aged women, and younger women, where among the 20-49 age group the fall is predicted to be 13% reduction in numbers, corresponding to a rate of 6.3 per 100,000 women.
In the EU as a whole, breast cancer reamains the leading cause of cancer deaths among women. In 2012, an estimated 88,000 women are expected to die from it, corresponding to nearly 15% of all cancer deaths among females in the EU.
Study co-leader Dr Carlo La Vecchia, a professor at the Faculty of Medicine, and head of the Mario Negri Institute's Department of Epidemiology, both at the University of Milan in Italy, told the press:
"In general, many important risk factors for breast cancer, including menstrual and reproductive factors, physical activity and obesity, have not changed favourably, and breast cancer incidence has probably not gone down, yet deaths from the disease are declining."
He said the big fall in breast cancer deaths across all age groups is because of advances in treatment and management of the disease, "rather than mammographic screening, which is usually restricted to women aged 50-70 in most European countries".
At the individual country level, there are some contrasts. For instance, in France, Germany, Italy and Spain, the leading cause of cancer deaths among women is breast cancer, but in the UK and Poland, it is lung cancer. In those countries, lung cancer rates are 21.4 and 16.9 per 100,000 women, respectively.
For lung cancer across the EU as a whole, deaths among women continue to rise, with an overall rate of 13.44 per 100,000.
But the picture is different among men across the EU: while it remains the leading cause of death in men, at a rate of 37.2 per 100,000, there has been a 10% decline since 2007, when the rate was per 100,000.
Poland is expected to have the highest rate of lung cancer death in 2012, with an anticipated rate per 100,000 of 56.8, and the UK is expected to have the lowest, with an expected rate of 30.1 per 100,000.
One cancer where the rates of death, and not just the numbers, are rising, among both men and women and in the EU overall, is pancreatic cancer.
For the EU as a whole, rates of death to pancreatic cancer rose from 7.86 in 2007 to 8.01 per 100,000 among men, and from 5.24 to 5.38 per 100,000 among women.
La Vecchia said this was "somewhat surprising" for men, given the decline in smoking, a known risk factor for pancreatic cancer.
However, another risk factor for pancreatic cancer is being overweight or obese, and here prevalence is rising, so perhaps this explains the rise in pancreatic cancer deaths.
"Another [reason] may be better diagnosis and certification. We do not know the causes of 70% of pancreatic cancers, but this rise is certainly not reassuring," said La Vecchia.
Speaking about the overall figures, co-author Dr Fabio Levi, a professor and head of the Cancer Epidemiology Unit at the Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, in Switzerland, said:
"Although actual numbers of deaths are slightly higher than those recorded for 2007, this is because a greater number of people are living into old age in the EU."
"The age-adjusted cancer mortality rates show a clear decrease in rates for both men and women over the past five years," he added.
Levi explained that apart from lung cancer in women and pancreatic cancer, the fall in cancer deaths for the six major cancers in six major countries of the EU and across the EU as a whole, essentially reflects the falling rates of smoking among men, and continued improvements in how we prevent, detect and treat cancer.
In a 2003 Annals of Oncology paper, MJ Quinn, La Vecchia and colleagues, in parallel with an update to the European Code Against Cancer, reviewed cancer mortality trends in the EU and projected these would fall to 15% by 2015.
In this latest paper, the researchers say that in 2012, this level may be reached, when the estimated decline is expected to be 18% in men and 13% in women.
Written by Catharine Paddock PhD
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