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European cancer mortality decreased overall from 2000 to 2004
Mortality decreased by 9% in men and 8% in women.
A review of data collected in 34 European countries showed that cancer mortality declined between 1990 to 1994 and 2000 to 2004, due in large part to reductions in deaths from lung cancer in men and from breast and cervical cancer in women.
Carlo La Vecchia, MD, of the department of epidemiology, Mario Negri Institute for Pharmacological Research, Italy, and colleagues abstracted official death certification statistics from 25 cancer locations, including the Russian Federation and the Ukraine. Belgium, where data was only available until 1997, and some smaller nations like Andorra were not included in the study. Data were only available through 2001 for Denmark and 2003 for Belarus, Italy, Macedonia and Portugal.
La Vecchia and colleagues found a persistent favorable trend toward improved mortality in all major European countries except Romania. From 2000 to 2004, Hungary had the highest mortality rate among men per 100,000 people (255.2), followed by the Czech Republic (215.9) and Poland (209.8). Sweden had the lowest mortality rate per 100,000 at 125.8, followed by Finland (130.9) and Switzerland (136.9).
The highest mortality rate for women per 100,000 was in Denmark (141.0), followed by Hungary (131.5) and Scotland (123.1). Spain had the lowest rate for women (78.9), followed by Greece (79.7) and Portugal (80.9).
The researchers said the results again reflected the different spread of cigarette smoking among men and women in various European countries in the past.
“Thus, further reduction of tobacco smoking remains the key priority for cancer control in Europe,” they wrote. “Interventions in alcohol drinking, aspects of nutrition, including overweight and obesity, and more widespread adoption of screening, early diagnosis and therapeutic advancements for treatable cancers would contribute to further reduce European cancer burden in the near future.”
Among men, lung cancer–specific mortality peaked at 53.3 per 100,000 in the late 1980s, declining to 44.0 per 100,000 by the early part of this decade. The mortality rate decreased by 17% from 1995 to 1999 and another 10% from 2000 to 2004. The researchers said lung cancer deaths among men decreased in every country except Portugal, where rates were low to begin with.
Breast cancer mortality declined among women by 13% between 1990 to 1994 and 2000 to 2004. The drop was even greater among women aged 35 to 64 years (17%). Mortality rates have been decreasing in western countries but have been stable or trending upward in the east, leading to a relatively stable rate of mortality.
“Improved treatment through anti-estrogens and chemotherapy had a major role in the favorable breast cancer mortality trends in Western Europe, but a favorable impact of screening mammography is also likely over recent years,” the researchers wrote.
They said in many countries it is impossible to distinguish between deaths from cervical cancer and deaths from endometrial cancer using death certificates alone, but downward trends in deaths from uterine cancer are probably due to a decline in cervical cancer deaths.
“The long-term decline in (cervix) uterine cancer mortality has continued over the last decade (from 1990-1994 and 2000-2004), with a fall from 7.1 per 100,000 to 5.7 per 100,000 (–19%) in overall mortality rates and from 12.5 per 100,000 to 10.1 per 100,000 (–19%) at age 35 to 64 years,” the researchers wrote. “This is essentially due to a wider adoption of cervical screening programs in Western and Northern Europe.”
La Vecchia C. Ann Oncol. 2009;doi:10.1093/annonc/mdp530.
