EUROCARE results show large variations in survival from blood cancers between European countries
Dr Milena Sant - Istituto Nazionale Tumori, Milan, Italy
What is the headline information of your presentation?
I presented the latest EUROCARE final results which will be published very soon in a special issue of the European Journal of Cancer which will contain thirteen articles, site specific or system specific articles, with survival by stage, by morphology, by, of course, specifically by cancer and agent.
Is your presentation looking at disparities across Europe?
The main aim of EUROCARE is surveillance of cancer trends across Europe. So the main finding of this last EUROCARE 5 is a large variability in survival, in five year relative survival, between countries. With the variability was more marked for cancers with a relatively good prognosis such as cancers of the breast, colorectal cancer, prostate cancer. The variability was less marked or there was no variability for very poor prognosis cancers like lung cancer, oesophageal cancer or pancreatic cancer. There was a huge variability between countries and between regions and, in general, countries from Northern Europe had higher survival than the rest of Europe; the countries of Northern and Central Europe, but especially in Northern Europe, had a better survival. The worst survival was found for Eastern European countries, practically for all cancers we examined there at approximately 45 cancer sites.
Is this mainly in relation to wealth?
With money, money is the main cause of disparities. There is a direct relationship between the total national expenditure on health and cancer survival, with some exceptions because the UK and Denmark with high income, high GDP and high total national expenditure have poor survival compared to similar countries, to neighbour countries and to countries with similar characteristics of wealth.
What is the reason for this?
Probably the problem is in the organisation of care, of cancer care, of care services. But this is something that has been taken into serious account, for instance in the UK but also in Denmark. Actually some actions were taken after the publication of the first EUROCARE results. After the publication of the first EUROCARE results, in the UK the national Health Department nominated a National Cancer Director and also injected more than £500 million in the national health system with the aim to centralise cancer services to implement multidisciplinary care and also to reduce, of course, the fragmentation of cancer services and also to reduce the delay between referral from symptoms to specialist oncological care, which is a point identified by the local experts.
If the UK is not doing as well, is this too soon to have an effect?
Yes, the UK is still doing worse than other countries and also Denmark is still doing worse. Another action they implemented in the UK was the launch of the so-called International Cancer Benchmark Project which collects data from several national cancer registries and is aimed especially to understand the reasons for the poor survival, for instance, in Denmark and the UK. Survival in the UK and in Denmark is growing faster than in other countries, so this is the good news.
What can be done about the disparities with Eastern Europe?
In Eastern Europe the disparities are directly related to the low total national expenses on health and also to the low GDP, with some exceptions. For instance the Czech Republic had a consistently higher survival rate than the average Eastern European mean, also a higher expense on health.
