European cancer deaths falling, but variations remain
New figures show there was a steady decline in cancer deaths in the European Union between 1990-1994 and 2000-2004.
Overall, deaths from all cancers fell by nine per cent in men and by eight per cent in women between these two periods, with middle-aged people experiencing the greatest decrease.
Researchers at the University of Milan in Italy and the University of Lausanne in Switzerland found that the number of deaths among men fell from 185.2 to 168 per 100,000 of the population, while the number of deaths among women fell from 104.8 to 96.9 per 100,000.
The decrease has been driven largely by falls in tobacco consumption - which has led to a large drop in lung and other tobacco-related cancers, particularly in men - and by a steady decline in gastric cancers and, more recently, bowel cancers. Breast and cervical cancers have been partly responsible for the decline.
But the report - which is published in the Annals of Oncology - also reveals that while the overall picture is promising, there are large variations in death rates between different countries and between men and women.
Some countries have experienced a rise in deaths from mouth, pharynx or oesophageal cancer and lung cancer in women, which corresponds to rising levels of alcohol or tobacco consumption in those areas, and increased prevalence of overweight and obesity in northern Europe.
Dr Cristina Bosetti, head of the Unit of Cancer Epidemiology at the Mario Negri Department of Epidemiology, commented: "The key message of our paper is that the favourable trends in cancer mortality in Europe have continued over the most recent years. This is due mainly to the falls in lung and other tobacco-related cancers in men, the persistent decline in gastric cancer, but also appreciable falls in colorectal cancer.
"Screening and early diagnosis have contributed to the decline in cervical and breast cancer, although the fall in breast cancer mortality is mainly due to improved treatment. Therapeutic advancements have also played a role in the reduced mortality from testicular cancer, Hodgkin lymphoma and leukaemias, although the declines have been delayed and are smaller in eastern Europe."
The report reveals that cancer mortality rates in men from 2000 to 2004 were highest in Hungary (255.2 per 100,000), the Czech Republic (215.9 per 100,000), Slovakia (212.8), Croatia (212.5) and Poland (209.8 per 100,000), and lowest in Albania (114.3), Sweden (125.8 per 100,000), Finland (130.9 per 100,000) and Switzerland (136.9 per 100,000).
The study authors pointed out that some European countries have around a twofold greater rate of cancer mortality than others, a trend that reflects the different spread of cigarette smoking in the past.
They concluded: "Further reduction of tobacco smoking remains the key priority for cancer control in Europe.
"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."
Certain key findings are particularly relevant to Britain, such as the discovery that Scotland has experienced a noticeable rise in deaths from oesophageal cancer, which is strongly linked to tobacco, alcohol, and the interaction between the two.
The highest mortality rates for oesophageal cancer in men between 2000 and 2004 were in Scotland (10.9 per 100,000) and England and Wales (8.5 per 100,000), compared with less than three per 100,000 in Albania, Macedonia, Malta, Greece, Bulgaria, Italy and Finland.
In women, the highest rates of oesophageal cancer were in Scotland (four per 100,000), England and Wales (three per 100,000) and Ireland (3.2 per 100,000), compared with less than 0.4 per 100,000 in Belarus, Greece and Ukraine.
Breast cancer mortality has declined by an average of 13 per cent across the EU at all ages and by 25 per cent between the ages of 35 and 44. The report authors said that the key factors behind improvements in the UK were enhanced treatments and, in recent years, screening.
The report authors noted: "In the UK and most other western European countries, mortality rates have been substantially declining over the last two decades, whereas they have been stable or upwards in Russia and most eastern European countries."
Similarly, prostate cancer deaths have fallen in the UK over the last decade as a result of better treatments and patient management.
Dr Julie Sharp, Cancer Research UK's science information manager, said: "This study provides a useful comparison of mortality rates in different European countries. The results highlight that in many countries, progress is being made at reducing death rates for some cancers thanks to improvements to early diagnosis, screening and treatments.
"Cancer Research UK has committed extra investment to all of these areas in our research strategy to ensure that we reduce the death rates from cancer across the UK."