Death rates from most major cancers are predicted to continue falling in Europe and the United Kingdom in 2022, say researchers reporting the latest cancer statistics. In particular, the reduction in deaths from ovarian cancer in recent years is quite striking, and is attributed to the use of oral contraceptives.
The report was published online today in the Annals of Oncology.
In the European Union (EU), age-standardized mortality rates in 2022 are predicted to fall by 6% in men and by 4% in women compared with rates in 2017, lead author Carlo La Vecchia, MD, professor of medicine, University of Milan, Italy and colleagues report.
A similar decrease is expected in the UK at a rate of 7% in men and 6% in women, relative to rates observed in 2016.
Predicted declines in mortality from ovarian cancer are particularly striking in the UK and, to a lesser extent, in the EU. For example, by the end of 2022, death rates from ovarian cancer are predicted to fall by 17% in the UK and by 7% in the EU compared with rates observed in 2016 and 2017, respectively.
Between 2010 and 2014, ovarian cancer mortality rates dropped by 26% in EU women aged 20-49 years and by 11% in both the 50-69 and 70-79 age groups.
The UK, in turn, posted a 22% reduction in ovarian cancer mortality rates between the period 2010-2014 and 2022. The authors also note that mortality rates from ovarian cancer are expected to continue falling in the foreseeable future for all age groups considered.
This reduction may be attributed to the use of oral contraceptives, suggest the authors. La Vecchia noted in a statement that the "long-term use of oral contraceptives reduces the risk of ovarian cancer by 40% in middle-aged and elderly women."
"The earlier and greater use of oral contraceptives in the UK than in most EU countries for generations of women born since the 1930s has a major role in these trends," he added.
Trends in Europe
Among European men, a 10% decline in lung cancer mortality is predicted to occur in 2022, followed by a 7% fall in death from prostate cancer and a 5% drop in colorectal cancer (CRC) mortality. Substantial declines in deaths from stomach cancer, bladder cancer, and leukemia are also predicted, while death rates of pancreatic cancer among men will remain stable.
Among European women, lung cancer mortality is predicted to increase by a nonsignificant 2% in 2022, but mortality from breast cancer will drop by 7% as will mortality from CRC by 8% compared with rates in 2017. Similarly, death from cancers of the uterus and ovary are expected to decrease by 4% and 7%, respectively, while death from pancreatic cancer is expected to increase by 3% in EU women.
Indeed, the authors predict that mortality from pancreatic cancer may surpass that from breast cancer in the combined numbers of death.
Mortality in the UK
The trends for the UK are reported separately, as it is no longer part of the European Union.
The patterns for cancer death reductions seen in the EU were similar among UK men, except for a 5% decline in pancreatic cancer, investigators observe. Among women in the UK, death from lung cancer is predicted to drop by 3% in 2022 with a larger 15% predicted decline in breast cancer mortality and a 17% predicted decline in ovarian cancer mortality.
In contrast, mortality from CRC, pancreatic, and bladder cancer showed no appreciable change between the two time periods in the UK. Death from stomach cancer and leukemia in the UK were consistent with those observed in the EU but rates of gastric cancer were consistently lower in the UK.
Indeed, "stomach cancer is the site with the longest and most consistent declines, particularly in the UK with a predicted 30% fall in women since 2016," the authors note.
They attribute this decline to a reduced prevalence of Helicobacter pylori infection and potentially also to better food conservation.
Cancer Deaths Averted
Compared with the highest peak of cancer mortality rates in 1988, the total number of cancer deaths averted since then — and including the predictions for 2022 — is impressive in both the EU and the UK. "In the EU, during this period, we estimated a total of 5,394,000 averted deaths," the authors observe. These numbers correspond to a 12% decline in the number of total cancer deaths avoided during this interval in the EU — 14% in men and 9% in women, they add.
In fact, in 2022 alone, 22% of total cancer deaths in the EU are predicted to be avoided compared with rates observed in 1988. However, the authors caution that their predicted statistics for cancer mortality should be interpreted in the light of the COVID-19 pandemic that has dominated the world over the last 2 years.
"In principle, COVID-19 may have had a harvesting effect on the fragile and/or elderly, thus leading to a fall in certified cancer deaths," the investigators point out.
On the other hand, the same pandemic has likely delayed both the diagnosis and treatment of cancer, particularly during spring 2020 (start of lockdown across the EU and UK) and to a lesser extent in 2021, leading to a subsequent rise in cancer-related mortality.
Thus, the overall cancer death estimates for the year 2022 may well be influenced by COVID-19 in either direction, the authors suggest.
The study was supported by the Italian Association for Cancer Research (AIRC), the Italian Ministry of Education, and the Italian Ministry of University and Research (MIUR). The study authors have disclosed no relevant financial relationships.
Ann Oncol. Published online January 26, 2022. Full text
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Cite this: Cancer Deaths Continue to Fall in EU and UK, Led by Ovarian Cancer - Medscape - Jan 26, 2022.