cancer epidemiology dr jesme baird the roy castle lung cancer foundation, uk and ecpc

Cancer EpidemiologyCancer Epidemiology

Dr Jesme BairdDr Jesme BairdThe Roy Castle Lung Cancer Foundation, The Roy Castle Lung Cancer Foundation, UKUKand ECPC.and ECPC.

Projected numbers of cancer cases and Projected numbers of cancer cases and deaths from cancer in Europedeaths from cancer in Europe

20102010 20202020

CasesCases DeathsDeaths CasesCases DeathsDeaths M M 1,652,2831,652,283 1,090,1981,090,198 1,859,9101,859,910

1,241,8601,241,860 F F 1,405,6171,405,617 803,250803,250 1,504,9901,504,990

880,531880,531

B B 3,057,9003,057,900 1,893,4481,893,448 3,364,900 3,364,900 2,122,3912,122,391

Globocan 2002Globocan 2002

Cases of cancer by age and sex in Cases of cancer by age and sex in Europe in 2002Europe in 2002

MalesMales FemalesFemales

-14 15-44 45-54 55-64 65+-14 15-44 45-54 55-64 65+

Globocan 2002

Cancer deaths attributed to various factorsCancer deaths attributed to various factors

TobaccoTobacco 3030 25 - 4025 - 40AlcoholAlcohol 3 3 2 - 4 2 - 4DietDiet 3535 10 - 7010 - 70Food aditivesFood aditives <1<1 -5 - 2-5 - 2Reproductive and sexual Reproductive and sexual 7 7 1 - 13 1 - 13 behaviourbehaviourOccupationOccupation 4 4 2 - 8 2 - 8PollutionPollution 2 2 1 - 5 1 - 5Industrial productsIndustrial products <1<1 <1 - 5<1 - 5Medicines and m. proceduresMedicines and m. procedures 1 1 0.5 - 30.5 - 3Geophysical factorsGeophysical factors 3 3 2 - 4 2 - 4InfectionInfection 10?10? 1 - ? 1 - ?UnknownUnknown ? ?

Doll and Peto 1981Doll and Peto 1981

Factor or class of factorsFactor or class of factors

Percentage of all cancer deathsPercentage of all cancer deaths

Best estimateBest estimate Range of acceptableRange of acceptable

estimatesestimates

North-Western and Central-Eastern North-Western and Central-Eastern EuropeEurope

Mortality (ASR)Mortality (ASR)Incidence (ASR)Incidence (ASR)

Cancer in Europe: males, 2002Cancer in Europe: males, 2002

Globocan 2002Globocan 2002

Incidence of cancer in Europe: males 2002 Incidence of cancer in Europe: males 2002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Globocan 2002Globocan 2002

Mortality from cancer in Europe: males, Mortality from cancer in Europe: males, 20022002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Globocan 2002Globocan 2002

Cancer in Europe: females, 2002Cancer in Europe: females, 2002

Incidence (ASR)Incidence (ASR) Mortality (ASRMortality (ASR)

Globocan 2002Globocan 2002

Incidence of cancer in Europe: females Incidence of cancer in Europe: females 20022002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Globocan Globocan 20022002

Mortality from cancer in Europe: females Mortality from cancer in Europe: females 20022002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Globocan 2002Globocan 2002

Trends in cancer mortality (ASR) in EUTrends in cancer mortality (ASR) in EU

100

150

200

250

300

350

Year

MALE; EU members before May 2004

MALE; EU members since May 2004

FEMALE; EU members before May 2004

FEMALE; EU members since May 2004

WHO HFA DB 2005WHO HFA DB 2005

Most common cancer sites: estimated Most common cancer sites: estimated new cases in males, Europe 2002new cases in males, Europe 2002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Bladder8%

Colon and

rectum13%

Lung17%

Other sites38%

Prostate19%

Stomach5%

Prostate7%

Stomach11%

Colon and

rectum12%

Bladder6%

Lung26%

Other sites38%

Globocan 2002Globocan 2002

Most common cancer sites: estimated Most common cancer sites: estimated deaths in males, Europe 2002deaths in males, Europe 2002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Stomach6%

Colon and rectum11%

Prostate11%

Lung27%

Other sites41%

Pancreas4%

Prostate5%

Colon and

rectum10%

Stomach13%

Lung30%

Other sites38%

Pancreas4%

Globocan 2002Globocan 2002

Most common cancer sites: estimated Most common cancer sites: estimated new cases in females, Europe 2002new cases in females, Europe 2002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Breast30%

Colon and

rectum14%

Lung6%

Ovary4%

Corpus uteri5%

Other sites41%

Cervix uteri7%

Stomach8%

Corpus uteri7%

Colon and

rectum13%

Breast23%

Other sites42%

Globocan 2002Globocan 2002

Most common cancer sites: estimated Most common cancer sites: estimated deaths in females, Europe 2002deaths in females, Europe 2002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Stomach11%

Colon and

rectum14%

Breast16%

Other sites45%

Lung8%

Cervix uteri6%

Lung11%

Colon and rectum14%

Other sites46%

Breast17%

Pancreas6%

Ovary6%

Globocan 2002Globocan 2002

Trends in mortality from Trends in mortality from lung cancerlung cancer (ASR) in (ASR) in malesmales in selected European in selected European countriescountries

WHO HFA DBWHO HFA DB

Trends in mortality from Trends in mortality from lung cancerlung cancer (ASR) in (ASR) in femalesfemales in selected European in selected European countriescountries

WHO HFA DBWHO HFA DB

25-30% of all cancer sites in the 25-30% of all cancer sites in the developed world are causally linked to developed world are causally linked to smoking :smoking :

Lung (87-91% in males and 57-86% in Lung (87-91% in males and 57-86% in females)females)

Oral cavity (including lip and tongue)Oral cavity (including lip and tongue)

Nasal cavity and paranasal sinusesNasal cavity and paranasal sinuses

LarynxLarynx

Pharynx and oesophagusPharynx and oesophagus

StomachStomach

LiverLiver

PancreasPancreas

Urinary tract (bladder, ureter and renal Urinary tract (bladder, ureter and renal pelvis)pelvis)

Uterine cervixUterine cervix

Myeloid leukaemiaMyeloid leukaemia IARC 2002

Trends in incidence of colon cancer in Trends in incidence of colon cancer in selected European countries, 1953-97selected European countries, 1953-97

Five-year (relative, age Five-year (relative, age standardised) survival (%) for colon standardised) survival (%) for colon cancer by sexcancer by sex

EUROCARE-3 StudyEUROCARE-3 Study

Nordic countriesSouth and West EuropeUK (presented for England, Scotland, Wales)Eastern EuropeData covering less than 100% of country

MalesMales FemalesFemales

Diet, overwight and physical activityDiet, overwight and physical activity

A A poor dietpoor diet, often combined with , often combined with sedentary sedentary lifestylelifestyle and and obesity,obesity, increase the risk of increase the risk of colon, breast, prostate, endometrial and other colon, breast, prostate, endometrial and other cancerscancers

Up to 30% of cancers probably related to diet and Up to 30% of cancers probably related to diet and nutritionnutrition

World Cancer Report 2003World Cancer Report 2003

Incidence of and mortality (ASR, 2002) Incidence of and mortality (ASR, 2002) from breast cancer in selected European from breast cancer in selected European countriescountries

Globocan 2002Globocan 2002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Trends in incidence of breast cancer (ASR) Trends in incidence of breast cancer (ASR) in selected European countriesin selected European countries

Risk factors associated with the Risk factors associated with the development of breast cancerdevelopment of breast cancer

family history and genetic factorsfamily history and genetic factorsprevious history of breast cancer in one breastprevious history of breast cancer in one breastfibrocystic disease (atypical hyperplasia)fibrocystic disease (atypical hyperplasia)ionizing radiationionizing radiation

age at menarche and menopauseage at menarche and menopauseage at first delivery, number of childrenage at first delivery, number of childrennulliparitynulliparityoral contraceptives and hormone replacement oral contraceptives and hormone replacement therapytherapy

Risk factors associated with the Risk factors associated with the development of breast cancerdevelopment of breast cancer

dietdietalcoholalcoholphysical activityphysical activity

Life-style related factorsLife-style related factors

Nordic countriesSouth and West EuropeUK (presented for England, Scotland, Wales)Eastern EuropeData covering less than 100% of country

Five-year (relative, age Five-year (relative, age standardised) survival (%) for breast standardised) survival (%) for breast cancercancer

EUROCARE-3 StudyEUROCARE-3 Study

Incidence of and mortality (ASR, 2002) from Incidence of and mortality (ASR, 2002) from cervical cancer in selected European cervical cancer in selected European countriescountries

Globocan 2002Globocan 2002

North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe

Differences between NW and CE Differences between NW and CE EuropeEurope (1) (1)

Incidence of cancer in men is higher in Incidence of cancer in men is higher in NWEurope, but mortality is higher in NWEurope, but mortality is higher in CEEurope.CEEurope.

In females, incidence is higher in NWEurope, In females, incidence is higher in NWEurope, but mortality is similar in both regions.but mortality is similar in both regions.

Mortality in NWEurope has been decreasing Mortality in NWEurope has been decreasing since mid-1980s, it started to decline in since mid-1980s, it started to decline in CEEurope only recently.CEEurope only recently.

Differences between NW and CE Differences between NW and CE EuropeEurope (2) (2)

Differences in the common cancer Differences in the common cancer sitessites

In CEEurope, the most important causes of In CEEurope, the most important causes of cancer deathcancer death

In Men - In Men - lunglung, stomach and colorectal cancer, stomach and colorectal cancer

In females - In females - breastbreast, stomach, colorectal and , stomach, colorectal and cervical cancercervical cancer

Mortality from cancer (ASR, both sexes) Mortality from cancer (ASR, both sexes) in three neighbouring countries in Europein three neighbouring countries in Europe