Cancer mortality rates, though not absolute numbers of deaths, have been decreasing over the last three decades in Europe. Estimated projections and the number of avoided deaths for total cancer mortality and 10 major cancer sites, between 1989 and 2022, for the European Union (EU), the UK, France, Germany, Italy, Poland and Spain using cancer death certification and population data since 1970 from the World Health Organization and Eurostat have been made.
In the EU, 1 269 200 cancer deaths in 2022 are predicted; corresponding age-standardized rates (world) fall 6% to 126.9 deaths/100 000 in men and 4% to 80.2/100 000 women since 2017. Male lung cancer is expected to fall 10% reaching 30.9/100 000. The rise in female lung cancer mortality slowed (+2% to 13.8/100 000). Stomach, colorectal, breast and prostate cancers have shown substantial declines, between 5% and 16% over the past 5 years. Pancreatic cancer remained stable in men (8.1/100 000) and rose 3% in women (5.9/100 000), becoming the third cause of cancer mortality in the EU (87 300 deaths), overtaking breast cancer (86 300 deaths). The fall in uterine cancers has slowed down (-4%) to 4.7/100 000. Bladder cancer fell 9% in men but was stable in women. Leukemias fell more than 10%. Ovarian cancer mortality declined over the past decade in all considered countries. EU predicted rates were 4.3/100 000 (-13%) all ages, 1.2/100 000 (-26%) at 20-49, 15.3/100 000 (-11%) at 50-69 and 32.3/100 000 (-11%) at 70-79 years.
There are predicted additional declines in cancer mortality rates for 2022. The slowdown in female lung cancer mortality reflects some levelling of smoking in women. Favourable ovarian cancer trends are likely to continue and are largely attributable to the spreading oral contraceptive use and some impact of improved diagnosis and management.
Cancer does not affect all races equally, either in terms of incidence or outcome. US statistics suggest that African Americans are more likely to die of cancer than people of any other racial or ethnic group. From 1997 to 2001, the average annual death rate for all cancers combined was greatest for African Americans, followed by white Americans, Hispanics, American Indians/Alaska Natives, and Asians/Pacific Islanders. Many countries, including the US and the UK are aiming to reduce the incidence of cancer and the associated mortality by public health initiatives such as those designed to improve lifestyles.
The incidence of cancer varies widely in the EU, both between and within tumor types, as a result of factors such as variations in environmental exposure to carcinogens. Below are incidence and prevalence figures for cancer across the EU. The incidence and prevalence of different cancers at 5 years varies widely between countries, even allowing for the differences in population size.
These figures are an important indication of the overall cancer burden on EU society, which is a function of both the incidence and prevalence of the diseases, with many prolonged systemic treatments.
We are now witnessing significant improvements in cancer outcomes. However, more importantly, the cancer burden of the common cancers such as breast and colorectal has increased significantly in EU populations in recent years. Prevalence figures at 5 years indicate that more than 4 million people are affected, with this number likely to increase substantially with the increase in size of the EU, and with improvements in treatment.
The results of cancer treatment have improved dramatically over the past two decades. These improvements include better organisation of services, greater investment in support services such as X-rays and pathology, and improved screening services enabling prevention and earlier diagnoses. This is in addition to the major advances in cancer treatments in multiple fields.