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

Status of cancer in Europe Status of cancer in Europe NowNow

ESMO, 9-10 October 2010 ESMO, 9-10 October 2010

Dr. Andrea MicheliDirector

Descriptive Studies and Health Planning UnitFondazione IRCCS “Istituto Nazionale dei Tumori”

Milan

GROSS DOMESTIC PRODUCT (GDP) AND CANCER INCIDENCEGROSS 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 $, 2006.

EUROPE in the WORLDEUROPE in the WORLD

GROSS DOMESTIC PRODUCT (GDP) AND CANCER MORTALITYGROSS DOMESTIC PRODUCT (GDP) AND CANCER MORTALITY

Age-Standardized incidence rates, World Standard Population per 100,000, GDP: at current prices US $, 2006.

Source: GLOBOCAN 2002, IARC & United Nations (UN)

EUROPE in the WORLDEUROPE in the WORLD

GDP AND EPIDEMIOLOGICAL CANCER DATA GDP AND EPIDEMIOLOGICAL CANCER DATA

All cancers M & FAll cancers M & FCOUNTRIES BY QUARTILE of GDP per capita ($PPP)

Incidenceper 100,000

Mortalityper 100,000

5 yrs Survival

%

GDP < 20,000(BUL, ROM, LAT, PL, LIT, HUN, EST, SK)

336 209 -

20,000 < GDP < = 30,000(PT, MT, CZK, SLO, CY, HEL, S, I) 363 172 5030,000 < GDP < = 36,000(F, D, FIN, UK, B, SW, DK) 411 171 49GDP > 36,000(A, ICE, NL, CH, IRE, N, LUX) 405 176 53

Sources: Ferlay et al. EJC, 2010. EUROCARE-4. For GDP International Monetary Fund Sources: Ferlay et al. EJC, 2010. 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-45-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 CANCERS5 YEARS RELATIVE SURVIVAL FOR ALL CANCERS

Ranked by 1995 TNEHRanked 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 5 YRS AGE-ADJUSTED COLORECTAL CANCER RELATIVE SURVIVAL, MENRELATIVE SURVIVAL, MEN

Standard: ICSS

5 YRS AGE-ADJUSTED COLORECTAL CANCER 5 YRS AGE-ADJUSTED COLORECTAL CANCER RELATIVE SURVIVAL, WOMENRELATIVE SURVIVAL, WOMEN

5-YRS ALL CANCERS RELATIVE SURVIVAL TREND IN EUROPE5-YRS ALL CANCERS RELATIVE SURVIVAL TREND IN EUROPE

Source: Verdecchia A. et al. EJC 2009

LIFE LIFE EXPECTANCY EXPECTANCY

TRENDS IN TRENDS IN EUROPEEUROPE

InequalitiesInequalitiesin health havein health have

increasedincreased

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 & inequalitiesCancer in Europe: trends & inequalities

• Incidence: 3.2 million cancer53% (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 deaths56% (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 EuropeThe burden of Cancer in Europe

0 1,000 2,000 3,000 4,000 5,000 6,000 7,000

AustraliaNetherland

IndiaBrazilKorea

MexicoSpain

CanadaItaly

ChinaFrance

UKGermany

JapanUnited States

Number of cancer publications per year

0 500,000 1,000,000 1,500,000 2,000,000 2,500,000

AustraliaNetherland

KoreaMexico

SpainCanada

Italy

FranceUK

GermanyJapan

United States

Number of new cancer cases per year

0 500,000 1,000,000 1,500,000 2,000,000 2,500,000

AustraliaNetherland

IndiaBrazilKorea

MexicoSpain

CanadaItaly

ChinaFrance

UKGermany

JapanUnited States

Scientific contributions in cancer domain Scientific contributions in cancer domain and cancer burden in 2002and cancer burden in 2002

English languageEnglish language

"the 15 most wealthy countries are ordered by decreasing gross domestic product level"

Source: Pierotti M. et al. Tumori 2009