Cancer Death Rates Continue to Fall in Europe, Except For...

Pam Harrison

February 23, 2021

Cancer death rates overall continue to fall among both men and women in Europe, with the notable exception of pancreatic cancer in both sexes and lung cancer among women living in the European Union, notes an update report.

"Among the major cancers, pancreatic cancer...remains the only one showing no overall fall in death rates over the past three decades in Europe in both sexes," coauthor Carlo La Vecchia, MD, University of Milan, Milan, Italy, said in a statement.

"It is important that governments and policymakers provide adequate resources for the prevention, early diagnosis, and management of pancreatic cancer in order to improve these trends in the near future," he added.

The report was published online February 22 in Annals of Oncology.

Death certification data from the World Health Organization database were analyzed to estimate total mortality from cancer as well as cancer death rates at 10 major tumor sites.

The investigators regarded the European Union as including 27 member nations. The United Kingdom is no longer part of the European Union, following Brexit; estimates were made for the United Kingdom separately.

Predicted declines in death rates from other cancers in the European Union between 2015 and 2021 include the following:

The researchers predict that by the end of 2021, the number of deaths from the 10 most common cancers analyzed will reach 1,443,000 in the European Union and 176,000 in the United Kingdom.

Compared to the peak mortality rate from cancer, recorded in 1988, over 4.9 million cancer deaths will have been averted in the European Union and over one million deaths averted in the United Kingdom over a 33-year period through 2021.

"The favourable trends in cancer mortality documented in previous years are confirmed," the researchers emphasize.

"The results we report this year are particularly important because they stress the fact that trends in mortality from pancreatic cancer and female lung cancer do not show the positive pattern of other major cancers," coauthor Paolo Boffetta, MD, Stony Brook University, Stony Brook, New York, said in a statement.

Trends in Pancreatic and Lung Cancers

The team predicts that 42,300 men in the European Union will die from pancreatic cancer by the end of 2021, as will 5000 men in the United Kingdom.

This represents a fractional (-0.8%) decline in death from pancreatic cancer among EU men since 2015; among EU women, death from pancreatic cancer increased slightly (+0.6%) from the same point in time.

Women in the United Kingdom experienced a 4% decline in death from pancreatic cancer over the same period.

The only decline in death from pancreatic cancer in the European Union occurred among persons younger than 50 years, particularly men, the authors note.

Smoking is a major risk factor for pancreatic cancer, accounting for about 20% of diagnoses, the team points out.

"The absence of falls [in pancreatic cancer death rates] for males, in sharp contrast with all other tobacco-related cancers in European men, is...surprising," they observe.

For lung cancer, death rates in the European Union have fallen by approximately 10% among men, although they have risen by 6.5% among women.

Indeed, "lung cancer rates are the highest of any cancer site in EU women," the investigators note.

Lung cancer patterns in the United Kingdom are more similar to those in the United States than in those in the European Union, the authors acknowledge. For example, male lung cancer rates are at least 25% lower in United Kingdom than in the European Union because more men in the United Kingdom stopped smoking earlier than men in the European Union did.

Lung cancer rates among UK women are higher than rates in the European Union, they add. Nevertheless, "the UK shows a favourable lung cancer trend, in contrast with persistent upward trends in EU women," the investigators state.

COVID-19 and Cancer

The current analysis "gives cause for hope," but these findings should not mask the potential effect that the COVID-19 pandemic will likely have on cancer patients everywhere, comment Jose Martin-Moreno, MD, University of Valencia, Valencia, Spain, and Suszy Lessof, MBA, European Observatory on Health Systems and Policies, Brussels, Belgium, in an accompanying editorial.

"Beyond the direct harm of this new coronavirus to immunocompromised and particularly vulnerable people, there is the blow to comprehensive clinical care and the interruption of research," the editorialists write.

Furthermore, cancer patients who contract SARS-CoV-2 are at higher risk for mortality from the infection than COVID patients who do not cancer, although susceptibilty differs for patients with different tumor types, they point out.

"At the same time, the presence of cancer is a severe risk factor for COVID-19 infection patients, carrying as it does a higher probability of ICU admission, mechanical ventilation and mortality," the authors point out.

Since March 2020, all of the activity linked to progress over recent decades has come to a screeching halt. Dr Jose Martin-Moreno and Suszy Lessof

Most worrying, the editorialists add, is the "paralysis" that has occurred in prevention programs, screening, and early diagnosis because of the pandemic. "Since March 2020, all of the activity linked to progress over recent decades has come to a screeching halt," Martin-Moreno and Lessof warn.

"It is, of course, too early to characterise the impacts, but it seems inevitable [that the pandemic] will have marked, if not dramatic, consequences," they emphasize.

The authors and editorialists have disclosed no relevant financial relationships.

Ann Oncol. Published online February 22, 2021. Full text, Editorial

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