New figures published estimate that there will be nearly 1.3 million deaths from cancer in 2012 in the European Union (EU) – 717,398 men and 565,703 women. Although the actual numbers have increased, the rate (age-standardised per 100,000 population) of people who die from the disease continues to decline.
Writing in the cancer journal Annals of Oncology, a group of researchers from Italy and Switzerland estimate that the overall cancer death rates will be 139 per 100,000 men and 85 per 100,000 women in 2012. Compared with confirmed deaths in 2007 (the year for which there are World Health Organization mortality data for most EU countries), this represents a fall of 10% in men and 7% in women.
The study looked at cancer rates in the whole of the EU (27 member states as at 2007) and also in six individual countries – France, Germany, Italy, Poland, Spain and the UK – for all cancers, and, individually, for stomach, intestine, pancreas, lung, prostate, breast, uterus (including cervix) and leukaemias.
One of the key findings is that there will be substantial reductions in deaths from breast cancer, not just in middle-aged and older women, but also in the young. The researchers predict a drop of 9% in breast cancer deaths, corresponding to a rate of 14.9 per 100,000 women. Among young women, aged 20-49, the drop in breast cancer death rates is greater, at just over 13%, corresponding to a rate of 6.3 per 100,000 women.
One of the study’s leaders, Professor Carlo La Vecchia (MD), head of the Department of Epidemiology at the Mario Negri Institute and professor at the Faculty of Medicine, University of Milan (Italy), said: “The fact that there will be substantial falls in deaths from breast cancer, not only in middle age, but also in the young, indicates that important advancements in treatment and management are playing a major role in the decline in death rates, rather than mammographic screening, which is usually restricted to women aged 50-70 in most European countries.
In general, many important risk factors for breast cancer, including menstrual and reproductive factors, physical activity and obesity, have not changed favourably, and breast cancer incidence has probably not gone down, yet deaths from the disease are declining.”
Breast cancer remains the leading cause of female cancer deaths in the EU as a whole, including in France, Germany, Italy and Spain: 88,000 women will die from it in 2012, corresponding to almost 15% of all cancer deaths in EU women. However, in the UK and Poland, lung cancer is the leading cause of cancer death among women, with rates of 21.4 and 16.9 per 100,000 women, respectively.
In the EU as a whole, deaths from lung cancer continue to increase among women, with an overall rate of 13.44 per 100,000. However, although it is the leading cause of cancer death in men – 37.2 per 100,000 – this represents a 10% decline from 2007 when the death rate was 41.3 per 100,000. Rates will be highest in Poland at 56.8 per 100,000, and lowest in the UK at 30.1 per 100,000 men.
Rates of pancreatic cancer are rising among both men and women in the EU as a whole: up from 7.86 in 2007 to 8.01 per 100,000 in men, and from 5.24 to 5.38 per 100,000 in women. “This is somewhat surprising for men, given the decline in smoking.
Smoking and being overweight or obese are known to be risk factors for pancreatic cancer and 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 Prof La Vecchia.
Co-author Professor Fabio Levi (MD), Head of the Cancer Epidemiology Unit at the Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, (Switzerland), said: “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. The age-adjusted cancer mortality rates show a clear decrease in rates for both men and women over the past five years.
“Apart from lung cancer in women and pancreatic cancer, the fall in mortality rates from six major cancers in six 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.”
In 2003 the European Code Against Cancer set a target to reduce cancer deaths by 15% by 2015, and the researchers say that in 2012 this target may be achieved already. “The percent decline estimated by 2012 is 18% in men and 13% in women. Thus the 15% decline in cancer mortality rates may already have been achieved after 12 years in men, and appears close for women, in spite of the unfavourable trends in female lung cancer rates,” they write.
The researchers used data on cancer deaths in the European Union for the period 1970-2007 to calculate rates of death each year and to identify trends, which they used to predict death rates for 2012.
This is the second year they have predicted EU cancer deaths; last year they predicted deaths for 2011. “Estimating current cancer mortality figures is important for defining priorities for prevention and treatment,” the authors say in their report.
The World Cancer Declaration recognises that to make major reductions in premature deaths, innovative education and training opportunities for healthcare workers in all disciplines of cancer control need to improve significantly.
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