the cancer burden in the european union and the european … · lung cancer a special concern lung...

The cancer burden in the European Union and the European Region:

the current situation anda way forward

Presented by

Zsuzsanna JakabWHO Regional Director

for Europe

Informal Meeting of Health Ministers

Brussels, Belgium, 4–5 July 2010

Added value of the European Union (EU) in cancer control

The EU has experience in promoting joint initiatives; renewed leadership could give it the impulse needed really to make a difference in citizens’ lives.

Epidemiological situation of cancerin Europe

Summary of main trends Cancer mortality accounts for nearly 20% of all

deaths in the WHO European Region. After cardiovascular diseases (CVD), cancer is the

second leading cause of death overall. Cancer is becoming the leading cause of

premature death (before age 65) in many European countries (28 of the 53 in the Region).

Although effective interventions exist, mortality from some forms of cancer is either increasing or remaining stable.

Epidemiological situation: lung cancer a special concern

Lung cancer is the main cause of cancer deaths overall, followed by colon cancer, but breast cancer mortality is important among women.

There is concern about rising trends in lung cancer mortality in EU-12 countries (those belonging to the EU before May 2004) and among women in the EU as a whole.

Lung cancer mortality rates at regional level in the EU are higher in poorest areas (NUTS2 level –nomenclature of territorial units for statistics level 2).

Epidemiological situation of cancer in Europe: incidence and survival

An estimated 2.45 million new cancer cases occur in the EU every year.

Incidence is increasing with ageing of the population. Increasing trends are particularly high in EU-12

countries, but data tend to be sparse. Five-year survival for breast, colon and cervical

cancer is high (over 50%), and has improved, in contrast with that for lung cancer, which has remained low (around 10%).

Main causes of death in the EU

0

100

200

300

400

500

600

700

EU 15 1980 EU 15 2007 EU 12 1980 EU 12 2007

Region

SDR,

mor

talit

y by

cau

se, p

er 1

00.0

00

popu

latio

n

Cardiovascular Cancers External causes Infectious disease Respiratory system

Sta

ndar

dize

d de

ath

rate

(SD

R) b

y ca

use

per

100

000

popu

latio

n

Mortality from cancer by sex and age groups in the European Region, around 2007

0

200

400

600

800

1000

1200

1400

1600

1800

2000

0-14 15-29 30-44 45-59 60-74 75+

Age group (years)

Stan

dard

ized

rate

(dea

ths

per 1

00.0

00 p

opul

atio

n)

Total Male Female

SD

R p

er 1

00 0

00 p

opul

atio

n

Trends in mortality from cancer in Europe, all forms, 1980-2007

100

150

200

250

1980 1990 2000 2010

European RegionEU-15EU-12CISCentral Asian republics

Source: European Health for All database. WHO/Europe, 2010.

SD

R p

er 1

00 0

00 p

opul

atio

n

Note. CIS = Commonwealth of Independent States.

0

100

200

300

400

500

1980 1990 2000 2010

European RegionEU-15EU-12CISCentral Asian republics

Cancer incidence per 100 000 population


Mortality from main types of cancer by European subregion, around 2007

0

5

10

15

20

25

30

35

40

45

50

EuropeanRegion

EU-15 EU-12 CIS CARK

Subregion

Stan

dard

ised

rate

(dea

ths

per 1

00.0

00

popu

latio

n)

Stomach Colon, rectum and anus Trachea, bronchus and lung Female breast


SD

R p

er 1

00 0

00 p

opul

atio

n

10

20

30

40

50

1980 1990 2000 2010

European RegionEU-15EU-12CISCentral Asianrepublics

SDR, malignant neoplasm of trachea, bronchus and lung per 100000


Mortality trends from lung cancer in EU countries, 1970–2007

SD

R p

er 1

00 0

00,

all a

ges


20

40

60

80

100

120

1970 1975 1980 1985 1990 1995 2000 2005 1970 1975 1980 1985 1990 1995 2000 2005

EU-12EU-15

Females

Males

Lung cancer mortality rates in the EU and neighbouring countries around 2005–2007

Source: Inequalities in Health System Performance and Their Social Determinants in Europe – Tools for Assessment and Information Sharing Project. WHO/Europe, 2010.

Source: European Health for All database, WHO/Europe, 2010.

0

10

20

30

40

50

60

1980 1990 2000 2010

European RegionEU-15 EU-12CISCentral Asianrepublics

Trachea, bronchus and lung cancer incidence per 100 000

1.83.84.5

8.38.5

12.816.019.821.723.623.8

29.730.530.531.333.935.736.938.440.341.041.641.742.444.645.846.246.847.147.348.749.151.351.853.354.655.6

60.861.362.465.067.568.2

100.7

125 75 25 25 75 125

Tajikistan (2005)Turkmenistan (1997)

Uzbekistan (2005)Azerbaijan (2004)Kyrgyzstan (2005)

Albania (2002)Georgia (2001)

Cyprus (2004)Moldova (2006)

Israel (2003)Kazakhstan (2006)

Armenia (2003)Malta (2005)

Portugal (2000)Iceland (2002)

Romania (2005)Luxembourg (2004)

Sweden (2004)Ukraine (2006)

Russian FederationTFYR Macedonia (2003)

Belarus (2005)Finland (2005)

Slovakia (2003)Ireland (2005)

Bulgaria (2004)Lithuania (2005)

Latvia (2006)France (2000)Austria (2004)

Norway (2005)Estonia (2004)

Belgium (1997)Serbia (2004)Poland (2004)

Germany (2002)Netherlands (2003)

Slovenia (2004)Czech Republic (2004)United Kingdom (2003)

Italy (2002)Croatia (2005)

Denmark (2001)Hungary (2005)

Crude death rate per 100 000 population New cases per 100 000 population

75.164.3

59.456.556.1

55.752.154.6

47.455.5

67.059.2

48.642.541.442.2

50.540.340.637.837.237.235.831.636.933.4

36.941.941.8

34.128.1

30.227.821.520.723.722.5

17.919.4

7.811.3

4.05.3

2.5

Lung cancer incidence and deaths

Source: Atlas of health in Europe. WHO/Europe, 2008.

*

* The former Yugoslav Republic of Macedonia.


0

10

20

30

40

1980 1990 2000 2010


SDR, females, malignant neoplasm of breast, per 100 000

6.79.412.5

19.820.423.0

37.739.2

47.749.052.1

60.461.262.263.664.6

70.272.472.6

81.482.484.285.4

99.2100.0

106.3107.5107.9110.4113.5114.9117.6119.3

124.3130.8

138.2140.1142.6142.6143.6147.9150.1151.3152.6

100 50 0 50 100 150 200 250

Tajikistan (2005)Turkmenistan (1997)

Uzbekistan (2005)Kyrgyzstan (2005)

Albania (2002)Azerbaijan (2004)

Kazakhstan (2006)Georgia (2001)Moldova (2006)Armenia (2003)Romania (2005)

Ukraine (2006)Poland (2004)Belarus (2005)

TFYR Macedonia (2003)Russian Federation

Serbia (2004)Slovakia (2003)

Lithuania (2005)Latvia (2006)

Portugal (2000)Estonia (2004)

Bulgaria (2004)Cyprus (2004)Croatia (2005)

Slovenia (2004)Czech Republic (2004)

Israel (2003)Belgium (1997)

Ireland (2005)Austria (2004)Iceland (2002)Norway (2005)

Italy (2002)Germany (2002)

France (2000)Malta (2005)

Hungary (2005)Netherlands (2003)

United Kingdom (2003)Denmark (2001)

Finland (2005)Luxembourg (2004)

Sweden (2004)


34.630.930.9

49.241.541.039.434.9

36.242.2

38.429.8

25.736.432.7

46.527.5

38.236.7

40.023.5

28.632.228.8

36.131.926.0

40.329.4

23.824.024.8

31.328.626.824.823.117.4

12.26.87.76.14.53.2

Female breast cancer incidence and deaths


*


2

3

4

5

6

7

8

9

10

11

1980 1990 2000 2010


SDR, females, malignant neoplasm of cervix uteri, per 100 000


0

2

4

6

8

10

12

1970 1975 1980 1985 1990 1995 2000 2005

EU-12EU-15


Trends in premature mortality from cervical cancer in EU countries, 1970–2007

SD

R p

er 1

00 0

00 fe

mal

es a

ged

0–64

yea

rs

4.24.74.95.15.55.65.7

7.17.4

9.29.69.89.8

10.510.911.211.311.611.812.212.5

13.613.8

14.515.315.415.8

16.916.917.0

17.617.818.1

19.019.119.719.8

20.724.624.925.2

26.927.4

28.9

20 15 10 5 0 5 10 15 20 25 30

Albania (2002)Finland (2005)

Tajikistan (2005)Azerbaijan (2004)

Israel (2003)Cyprus (2004)

Turkmenistan (1997)Netherlands (2003)Uzbekistan (2005)

United Kingdom (2003)Sweden (2004)Belgium (1997)

Malta (2005)Georgia (2001)Austria (2004)France (2000)

Luxembourg (2004)Italy (2002)

Iceland (2002)Ireland (2005)Norway (2005)

Kyrgyzstan (2005)Croatia (2005)

Armenia (2003)Denmark (2001)Germany (2002)

Kazakhstan (2006)Russian Federation

Belarus (2005)Poland (2004)

Moldova (2006)Latvia (2006)

Portugal (2000)Ukraine (2006)

Slovenia (2004)Czech Republic (2004)

Slovakia (2003)Hungary (2005)

TFYR Macedonia (2003)Estonia (2004)Serbia (2004)

Bulgaria (2004)Lithuania (2005)Romania (2005)


11.816.2

9.111.9

8.04.4

7.96.6

7.5

4.78.6

4.38.8

11.49.2

7.07.8

7.44.2

5.56.1

4.65.8

3.13.7

2.11.31.3

2.33.9

6.01.0

4.3

3.53.63.129 42.63.4

2.11.9

1.11.5

2.21.3

Female cervical cancer incidence and deaths


*


Integrated action plan on noncommunicable diseases

(NCDs)

Population-wide health promotion to tackle the main NCD risk factors:

Tobacco Poor diet Excessive alcohol intake Physical inactivity

Early detection

Mammography

Cervical cancer screening

Colorectal cancer

… already introduced in all countries, although target populations and recommended frequency vary considerably

… screening introduced in only a few countries in the European Region

Cancer research across Europe

Need for coordinated and comprehensive cancer registries across the EU, covering (a representative sample of) all populations

Latest data on EU-wide cancer incidence and mortality are incomplete and outdated

Thorough review of European directives on research and data protection

Regional leadership, technical excellence and synergistic

collaboration among partners

With political leadership from the EU and Member States, and technical leadership from WHO, cancer control can make real progress in the coming years.

Thank you…Merci beaucoup…

Dank u wel…

the cancer burden in the european union and the european … · lung cancer a special concern lung...

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