Researchers, led by Professor Carlo La Vecchia (MD) of the Department of Epidemiology at the Mario Negri Institute and the Faculty of Medicine, University of Milan (Italy), and Professor Fabio Levi (MD), Head of the Cancer Epidemiology Unit at the Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, (Switzerland), used data on cancer deaths in the European Union for the period 1970-2007 to calculate rates of death each year and to identify trends which they used to predict death rates for 2011.
They looked at overall rates in the EU (the EU was defined as the 27 member states as of January 2007), and also individual rates in six major EU countries: France, Germany, Italy, Poland, Spain and the UK.
They predicted there would be 1,281,466 cancer deaths in the EU in 2011 (721,252 men and 560,184 women), compared to 1,256,001 (703,872 men and 552,129 women) in 2007. When these figures are converted into world standardised rates per 100,000 of the population, this means there will be a fall from 153.8 per 100,000 to 142.8 per 100,000 in men, and from 90.7 to 85.3 in women – a drop of 7% in men and 6% in women – since 2007.
However, the number of women dying from lung cancer is increasing steadily everywhere apart from in the UK, which has had the highest rates in women for a decade and is now seeing a levelling off. In the EU as a whole, world standardised death rates from lung cancer in women have gone up from 12.55 per 100,000 of the female population in 2007 to 13.12 in 2011. Lung cancer has overtaken breast cancer as the first cause of cancer death in Polish women, as well as in women from the UK. The number of women who will die from lung cancer this year in the UK is 15,632 (compared to 14,900 in 2007); this represents a slight drop in the death rate from 20.57 per 100,000 women in 2007 to 20.33 in 2011. In Poland, 6,343 women will die from lung cancer this year compared to 5,643 in 2007, and this represents an increase in the death rate from 15.53 per 100,000 women to 16.60 in 2011.
The overall downward trend in cancer death rates is driven mainly by falls in breast cancer mortality in women, and lung and colorectal cancer in men. “Lung, colorectal and breast cancers are the top causes of cancer deaths, and these are showing major changes,” said Prof La Vecchia.
Declines in mortality from other major cancers such as stomach, uterus, prostate and leukaemia are likely to be seen in 2011, say the researchers. A worrying increase in deaths from pancreatic cancer in women, which had been observed in 2004, appears to have levelled off.
“Pancreatic cancer mortality is favourably influenced by the decline in smoking in men, but unfavourably influenced by the increased prevalence of obesity and diabetes,” said Prof La Vecchia.
In their study the authors write: “A substantial decline in total cancer mortality rates has been observed since the late 1980s in men and since even earlier in women in the EU. Between 1990-94 and 2000-04 the rates declined by 9% in men…. and by 8% in women….In men the decline has continued in 2007 and will likely carry on up to 2011, and the greatest drop is predicted in Germany. For women too, the declines persist, but the trend in Polish women is less favourable. Given that Poland has the highest total cancer mortality rates in both sexes, the lack of improvement is particularly worrying. In France the predicted decline is also modest, although the 2011 rate in French women remains the second lowest after Spain. This is due to the recent unfavourable trends in lung cancer among French and Spanish women.”
Prof La Vecchia concluded: “Despite these favourable trends in cancer death rates in Europe the number of cancer deaths remains approximately stable, due to the ageing of the population. Further, there is a persisting gap in cancer mortality between central and eastern European countries compared to western Europe, and this is likely to persist for the foreseeable future.”
The researchers plan to repeat the study to predict cancer deaths for 2012. They believe that such predictions can help countries to plan their allocation of resources and strategies for preventing, treating and managing cancer.
“European cancer mortality predictions for the year 2011”. Annals of Oncology. doi:10.1093/annonc/mdq774
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