Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Large differences in cancer survival between European countries

05.12.2013
The Lancet Oncology: Cancer survival still varies widely between European countries despite major improvements in cancer diagnosis and treatment during the first decade of the 21st century, according to the latest EUROCARE-5 reports covering over 50% of the adult and 77% of the childhood population of Europe.

The findings, published in The Lancet Oncology, analysed data from cancer registries covering all or part of 29 countries* to compare 5-year survival from diagnosis for more than 9 million adults and 60 415 children diagnosed between 2000 and 2007.

“The good news is that the number of adults surviving for at least 5 years after diagnosis has risen steadily over time in all European regions, reflecting major advances in cancer management such as organised cancer screening programmes and improved treatments. But there continues to be big disparities between countries, and international survival differences are narrowing for only a few cancers such as breast, rectum, prostate, and melanoma of the skin”**, explains study co-leader Dr Roberta De Angelis from the Istituto Superiore di Sanità in Rome.

Countries with lowest survival for most cancers (Bulgaria, Estonia, Latvia, Lithuania, Poland, and Slovakia) are in eastern Europe. Here survival is below the European average, particularly for cancers with a better prognosis. For example: colon (49% vs 57%), rectum (45% vs 56%), non-Hodgkin’s lymphoma (NHL; 50% vs 59%), and melanoma of the skin (74% vs 83%).

But the gulf in survival between east and west is closing, with evidence that some eastern European countries with previously poorer survival are catching up. For example, improvements in breast cancer survival in eastern Europe between 1999 and 2007 (70% to 75%) have reduced the gap with the best performing countries (northern Europe) over the same time periods (82% to 85%).

Adults in the UK and Ireland continue to have shorter survival than the European average for many common cancers, particularly colon (52% vs 57%), ovary (31% vs 38%), and kidney (48% vs 61%), but have about average survival rates for rectum, breast, prostate, melanoma of the skin, and lymphomas.

Nordic countries (with the exception of Denmark), central European countries such as Austria, Belgium, France, Germany, Switzerland, and Netherlands, and some countries in southern Europe, particularly Italy, Portugal, and Spain, have the best survival for most cancers. For more detailed findings for 10 common cancers in adults by country and European area see table 2 pages 5–6.

Some cancers showed particularly large increases in survival between 1999 and 2007— prostate (73% to 82%), rectum (52% to 58%), and NHL (54% to 60%)—reflecting better cancer management.

According to Dr De Angelis, “The most likely reasons for improved survival for NHL and rectal cancer are more effective drugs and better surgical techniques, whilst earlier diagnosis, as well as detection of indolent cancers and over-diagnosis, owing to the increasing use of prostate-specific antigen (PSA) testing, explains the dramatic increase in numbers of patients surviving prostate cancer”**.

In a second study of children aged 0–14 years, survival at 5 years from diagnosis for all cancers combined is generally good with 79% now surviving (2005–2007), up from 76% in 1999–2001.

“The most striking increases in childhood cancer survival have been in eastern Europe where survival rose from 65% in 1999–2001 to 70% in 2005–2007”, explains study co-leader Dr Gemma Gatta from the Istituto Nazionale Tumori in Milan, Italy. “But we still found large survival differences within European areas, ranging from a low of 70% in eastern Europe to 80% or more in northern, central, and southern Europe.”**

For cancers of the blood (eg, leukaemias) and for NHLs, that account for more than a third of childhood cancers, the risk of death within 5 years of diagnosis fell by an average 4–6% each year. But not all the major childhood cancers have seen such improvements. For example, survival for tumours of the central nervous system, the second most common type, remains poor (58%). “No survival gains were observed for other relevant childhood cancers such as neuroblastoma, nephroblastoma, Hodgkin’s lymphomas and osteosarcoma (the most common type of bone cancer)”, adds Dr Gatta.

The authors suggest a number of possible reasons for the considerable between-country variation in survival rates, saying that, “The main factors influencing poorer survival in eastern Europe include a shortage of public funding for cancer control, lack of national cancer plans, and inadequate access to screening programmes and up-to-date treatment protocols. The main cause of suboptimum survival for UK and Danish adult patients seems to be delayed diagnosis.”**

They add, “Developing and extending twinning programmes and pairing medical institutions in high-income countries with those in low-income and middle-income countries could help narrow the survival gaps across Europe for childhood cancers.”**

They conclude: “Interpreting cancer survival differences is complex. Longer survival may be due to better treatments or to earlier diagnosis that improves the efficacy of existing treatments. However other factors such as tumour biology, lifestyle, presence of other concomitant diseases, and diagnostic intensity (increasing the frequency of indolent tumours) can directly or indirectly influence survival. Accurate clinical information is necessary for rigorous assessment of cancer care and to inform health interventions. Routine collection of clinical information by population-based cancer registries should be sustained and facilitated by adequate legislation.”**

Writing in a linked Comment, Professor Alastair Munro from the University of Dundee School of Medicine in the UK points out that in order to understand the patterns that emerge we need more detailed information, “Registries should record more sociodemographic information and more details about investigation, staging, treatment, recurrences, and second-line treatment. Investigators should actively seek information about long-term consequences of treatment and precise information about causes of death… Until more is known about the individual attributes of patients, the interpretation of the EUROCARE studies will be far from straightforward.”

NOTES TO EDITORS:
* Denmark, Finland, Iceland, Norway, Sweden (northern Europe); England, Northern Ireland, Scotland, Wales and Ireland (United Kingdom [UK] and Ireland); Austria, Belgium, France, Germany, Switzerland, Netherlands (central Europe); Croatia, Italy, Malta, Portugal, Slovenia, Spain (southern Europe); Bulgaria, Czech Republic, Estonia, Latvia, Lithuania, Poland, Slovakia (eastern Europe).

**Quotes direct from authors and cannot be found in text of Articles.

Dr Roberta De Angelis, Istituto Superiore di Sanità, Rome, Italy. T) +39 06 49904289 E) roberta.deangelis@iss.it

Dr Milena Sant, Istituto Nazionale Tumori, Milan, Italy. T) +39 02 23903519 E) milena.sant@istitutotumori.mi.it

Dr Gemma Gatta, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. T) +39 02 23903518 E) gemma.gatta@istitutotumori.mi.it

Comment: For Professor Alastair Munro, University of Dundee School of Medicine, Scotland, UK please contact Roddy Isles Dundee University Press Office T) +44(0)1382 (3)84910 or +44(0)7800 581902 E) r.isles@dundee.ac.uk or a.j.munro@dundee.ac.uk

Weitere Informationen:

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70546-1/abstract

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70548-5/abstract

Rüdiger Labahn | idw
Further information:
http://www.uni-luebeck.de

More articles from Studies and Analyses:

nachricht Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

nachricht Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Future electronic components to be printed like newspapers

A new manufacturing technique uses a process similar to newspaper printing to form smoother and more flexible metals for making ultrafast electronic devices.

The low-cost process, developed by Purdue University researchers, combines tools already used in industry for manufacturing metals on a large scale, but uses...

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

A smart safe rechargeable zinc ion battery based on sol-gel transition electrolytes

20.07.2018 | Power and Electrical Engineering

Reversing cause and effect is no trouble for quantum computers

20.07.2018 | Information Technology

Princeton-UPenn research team finds physics treasure hidden in a wallpaper pattern

20.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>