Cancer Mortality Rates on the Downswing in Europe

Roxanne Nelson

February 28, 2012

February 28, 2012 — Nearly 1.3 million people will die from cancer this year in the European Union (EU), according to an analysis published online today in the Annals of Oncology. However, even though the actual numbers have increased, the rate continues to decline.

The overall 2012 cancer mortality rates are estimated to be 139 per 100,000 men and 85 per 100,000 women. This is a decrease of 10% in men and 7% in women over 2007 — the most recent World Health Organization (WHO) mortality data for most EU countries.

The age-adjusted cancer mortality rates show a clear decrease.

"Although actual numbers of deaths are slightly higher than those recorded for 2007, this is because a greater number of people are living into old age in the EU," explained study coauthor Fabio Levi, MD, head of the cancer epidemiology unit at the Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois, and the University of Lausanne, Switzerland.

"The age-adjusted cancer mortality rates show a clear decrease in rates for both men and women over the past 5 years," Dr. Levi said in a statement.

Substantial Declines in Mortality

One of the key findings of this analysis, the authors report, is that there will be substantial declines in breast cancer mortality. This decrease will be observed not just in older and middle-aged women, but also in young women. They predict that overall breast cancer deaths will decrease by 9%, corresponding to a rate of 14.9 per 100,000 women. Among young women between 20 and 49 years of age, the reduction in breast-cancer-specific mortality is higher, at more than 13%, which corresponds to a rate of 6.3 per 100,000 women.

However, breast cancer continues to be the leading cause of cancer death in women. It is estimated that 88,000 women will succumb to breast cancer this year, accounting for nearly 15% of all cancer-related deaths of women in the EU.

The exception is the United Kingdom and Poland, where lung cancer is the leading cause of cancer death in women, with estimated rates of 21.4 and 16.9 per 100,000, respectively. Another key finding is that rates of pancreatic cancer are rising in the EU in both men and women. For men, rates are expected to rise from 7.86 per 100,000 in 2007 to 8.01 per 100,000 in 2012; for women, rates are expected to rise from 5.24 to 5.38 per 100,000.

"Apart from lung cancer in women and pancreatic cancer, the fall in mortality rates from 6 major cancers in 6 major European countries and in the EU as a whole essentially reflects the decline in tobacco smoking in men, and the continuing progress in cancer prevention, early detection, and treatment," said Dr. Levi.

Slight Increase in Pancreatic Cancer Mortality

Using the WHO mortality database, Dr. Levi and colleagues estimated the 2012 numbers of deaths and age-standardized rates from all cancers and from selected cancer sites — the stomach, intestine, pancreas, lung, prostate, breast, and uterus (including cervix), and leukemias. This was done for the EU as a whole and its 6 most populated countries — France, Germany, Italy, Poland, Spain, and the United Kingdom. They also estimated numbers and death rates separately for breast cancer mortality for 3 age groups: 20 to 49 years, 50 to 69 years, and 70 to 79 years.

The total number of cancer deaths in the EU in 2012 is estimated to be 1,283,101 (717,398 men and 565,703 women); in 2007, it was 1,261,134 (706,619 men and 554,515 women).

It is estimated that lung cancer will account for the largest number of deaths in men in 2012 (183,592, which is 26% of total male cancer mortality), with a standardized rate of 37.2 per 100,000. This is 10% lower than the 2007 rate of 41.3 per 100,000 (183,019 deaths).

For women, the favorable total cancer trends are primarily related to decreased breast cancer mortality and declining rates of stomach cancer (–23%), leukemias (–12%), and uterus and colorectal cancer (–11%). However, it is estimated that from 2007 to 2012, lung cancer mortality will increase in women, from 12.6 per 100,000 to 13.4 per 100,000 (78,658 deaths), as will mortality from pancreatic cancer (3%).

For men, it is estimated that mortality rates will decline from 2007 to 2012 for stomach cancer (–20%), leukemias (–11%), lung and prostate cancer (–10%), and colorectal cancer (–7%). But as with trends for women, a slight increase (2%) in pancreatic cancer mortality rates is expected in 2012.

"This is somewhat surprising for men, given the decline in smoking," said study coauthor Carlo La Vecchia, MD, in a release. "Smoking and being overweight or obese are known to be risk factors for pancreatic cancer, so the increasing prevalence of obesity may be a reason. Another may be better diagnosis and certification."

"We do not know the causes of 70% of pancreatic cancers, but this rise is certainly not reassuring," said Dr. La Vecchia, who is head of the Department of Epidemiology at the Mario Negri Institute and professor in the Faculty of Medicine, University of Milan.

Variation Among Nations

Mortality rates for different cancers varied in the 6 countries. The highest rates for breast cancer mortality were in Germany (16.5 per 100,000 women), whereas the lowest were in Spain (11.7 per 100,000 women). Estimated mortality rates for cancer of the uterus are about 3 times higher in Poland (7.7 per 100,000 women) than in Germany (2.4 per 100,000).

Although the trend for prostate cancer mortality was favorable in all the studied countries, with estimated mortality rates ranging from 8.0 and 12.8 per 100,000 men, the highest rates were seen in the United Kingdom and Poland, and the lowest in Italy.

The study was funded by the Swiss Cancer League and the Italian Association for Cancer Research. Coauthor Matteo Malvezzi, PhD, from the Department of Epidemiology at the Istituto di Ricerche Farmacologiche ''Mario Negri'' and the Department of Occupational Health, Section of Medical Statistics, University of Milan, Italy, reports receiving a fellowship from the Italian Foundation for Cancer Research. The other authors have disclosed no relevant financial relationships.

Ann Oncol. Published online February 28, 2012. Abstract

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