EUROCARE-5 Shows Increased Cancer Survival and Persisting Regional Disparities
As reported in The Lancet Oncology by De Angelis et al, the population-based EUROCARE-5 study has shown improved cancer survival over time in all European regions, although regional disparities remain.
Study Details
In this retrospective observational study, data from 107 cancer registries including more than 10 million patients with cancer diagnosed up to 2007 and followed through 2008 were analyzed to assess survival patterns in 29 European countries. Analyses included 5-year relative survival for multiple cancers diagnosed between 2000 and 2007 weighted by age and country, country-specific survival for common cancers, and 5-year survival differences in these cancers across the time period of 1999–2001 to 2005–2007.
Overall Trends
Five-year relative survival generally increased steadily over time in all European regions (northern Europe, Ireland/UK, southern Europe, central Europe, eastern Europe). Overall, survival was generally low in eastern Europe and below the European mean, particularly for cancers with good or intermediate prognosis. Survival was highest for northern, central, and southern Europe. Survival usually decreased with age, although differences were observed by region and cancer type.
Largest Changes
For all of Europe, the largest increases in 5-year relative survival from 1999–2001 to 2005–2007 were for prostate cancer (73.4% to 81.7%), non-Hodgkin lymphoma (53.8% to 60.4%), and rectal cancer (52.1% to 57.6%). For prostate cancer, survival was high in most countries except those in eastern Europe, while the increase in survival was greatest in eastern Europe. For non-Hodgkin lymphoma, survival was highest in northern Europe and lowest in eastern Europe, with the greatest improvements seen in northern and central Europe. For rectal cancer, survival was better for women than for men and was highest in central and northern Europe, intermediate in southern Europe and UK/Ireland, and much lower in eastern Europe.
Other Cancers
Five-year survival for stomach cancer increased from 23.3% to 25.1%, with highest survival in southern and central Europe, intermediate survival in northern Europe, and lowest survival in eastern Europe and UK/Ireland. For colon cancer, survival increased from 54.2% to 58.1%, with similar changes in each region. For lung cancer, survival increased from 11.6% to 13.4%, with geographic differences being small and similar changes being observed in each region. For skin melanoma, survival increased from 82.4% to 85.2%, with the largest increase seen in eastern Europe.
For breast cancer, survival increased from 78.4% to 82.4%, with survival in most eastern European countries being 10% to 15% lower than other European countries and the steepest increases being observed in eastern Europe and UK/Ireland. For ovarian cancer, the European mean age-standardized 5-year survival was 37.6%, and ranged from 31.0% in UK/Ireland to 41.1% in northern Europe, with survival not changing significantly over time in Europe overall. For kidney cancer, survival increased from 56.4% to 60.5%; survival was highest in southern and central Europe and intermediate in most other countries.
The investigators concluded: “The major advances in cancer management that occurred up to 2007 seem to have resulted in improved survival in Europe. Likely explanations of differences in survival between countries include: differences in stage at diagnosis and accessibility to good care, different diagnostic intensity and screening approaches, and differences in cancer biology. Variations in socioeconomic, lifestyle, and general health between populations might also have a role. Further studies are needed to fully interpret these findings and how to remedy disparities.”
Roberta De Angelis, MSc, of Istituto Superiore di Sanità, Rome, is the corresponding author for The Lancet Oncology article.
The study was funded by the Italian Ministry of Health, European Commission, Compagnia di San Paolo Foundation, and Cariplo Foundation.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
