Status of cancer in Europe Now ESMO, 9-10 October 2010 Dr. Andrea Micheli Director Descriptive Studies and Health Planning Unit Fondazione IRCCS “Istituto Nazionale dei Tumori” Milan

GROSS DOMESTIC PRODUCT (GDP) AND CANCER INCIDENCE Source: GLOBOCAN 2002, IARC & United Nations (UN) Age-standardized incidence rates, World Standard Population per 100,000, GDP: at current prices US $, EUROPE in the WORLD

GROSS DOMESTIC PRODUCT (GDP) AND CANCER MORTALITY Age-Standardized incidence rates, World Standard Population per 100,000, GDP: at current prices US $, Source: GLOBOCAN 2002, IARC & United Nations (UN) EUROPE in the WORLD

GDP AND EPIDEMIOLOGICAL CANCER DATA All cancers M & F COUNTRIES BY QUARTILE of GDP per capita ($PPP) Incidence per 100,000 Mortality per 100,000 5 yrs Survival % GDP < 20,000 (BUL, ROM, LAT, PL, LIT, HUN, EST, SK) ,000 < GDP < = 30,000 (PT, MT, CZK, SLO, CY, HEL, S, I) ,000 < GDP < = 36,000 (F, D, FIN, UK, B, SW, DK) GDP > 36,000 (A, ICE, NL, CH, IRE, N, LUX) Sources: Ferlay et al. EJC, EUROCARE-4. For GDP International Monetary Fund

GDP and age-standardized incidence rates for all cancers. Men Sources: Human Development Report 2009; Ferlay et al. 2008

GDP and age-standardized mortality rates for all cancers. Men Disks are proportional to the public health expenditure ($ PPP) Sources: Human Development Report 2009; Ferlay et al. 2008

EUROCARE-4 5-year relative survival, all cancers countries are ordered by Total Expenditure on Health Europe Berrino F. et al, The Lancet Oncology, 2007

5 YEARS RELATIVE SURVIVAL FOR ALL CANCERS Ranked by 1995 TNEH Source: Verdecchia A. et al. European Journal of Public Health, 2008

Standard: ICSS 5 YRS AGE-ADJUSTED BREAST CANCER RELATIVE SURVIVAL

Standard: ICSS 5 YRS AGE-ADJUSTED COLORECTAL CANCER RELATIVE SURVIVAL, MEN

Standard: ICSS 5 YRS AGE-ADJUSTED COLORECTAL CANCER RELATIVE SURVIVAL, WOMEN

5-YRS ALL CANCERS RELATIVE SURVIVAL TREND IN EUROPE Source: Verdecchia A. et al. EJC 2009

LIFE EXPECTANCY TRENDS IN EUROPE Inequalities in health have increased increased Source: United Nations Population Division

IncidenceIncidence: number of new cases is expected to continue to increase in the next years INVESTMENT IN PRIMARY PREVENTION IS THE KEY Survival: expected to improve as in last decade but with lower performance in Low Income Countries COSTS REDUCTION YET KEEPING THE SAME OUTCOME IS THE KEY Prevalence: expected to explode in next years LONGTERM SURVIVORS NEEDS MUST BE CONSIDERED Mortality: expected to reinforce the tendency in its reduction but with lower rate in some countries DEVELOPMENT OF CANCER PLANS IS THE KEY TO AVOID AVOIDABLE DEATHS Source: Pierotti M. et al. Tumori 2009 Cancer in Europe: trends & inequalities

Incidence: 3.2 million cancer 53% (1.7 million) in men and 47% (1.5 million) in women colorectal cancers (436,000 cases, 13.6% of the total) breast cancer (421,000, 13.1%) lung cancer (391,000, 12.2%) prostate cancer (382,000, 11.9%) Mortality: 1.72 million deaths 56% (1 million) in men and 44% (0.7 million) in women lung cancer (342,000 deaths, 19.9% of the total), colorectal cancer (212,000 deaths, 12.3%), breast cancer (129,000, 7.5%) stomach cancer (117,000, 6.8%) Source: Ferlay et al. EJC 2010 The burden of Cancer in Europe

Number of cancer publications per yearNumber of new cancer cases per year Scientific contributions in cancer domain and cancer burden in 2002 English language "the 15 most wealthy countries are ordered by decreasing gross domestic product level" Source: Pierotti M. et al. Tumori 2009