Cancer survival increases in Europe, but international differences remain wide

The EUROCARE project analysed cancer survival data from 45 population-based cancer registries in 17 European countries, revealing wide international d ifferences in cancer survival. We calculated 5-year relative survival for 1 836 287 patients diagnosed with one of 13 cancers during the period 1978-1 989. The data, from 20 cancer registries in 13 countries, were grouped into four regions: Finland, Sweden, Iceland (Northern Europe); Denmark, England and Scotland (UK and Denmark); France, The Netherlands, Germany, Italy and Switzerland (Western Europe); Estonia and Poland (Eastern Europe), and bro ken down into four periods (1978-1980, 1981-1983, 1984-1986, 1987-1989). Fo r each cancer, mean European and regional survival was estimated as the wei ghted mean of 5-year relative survival in each country. Survival increased with time for all tumours, particularly for cancers of testis (12% increase , i.e. from 79.9 to 91.9%), breast, large bowel, skin melanoma (approximate ly 9-10%), and lymphomas (approximately 7%). For most solid tumours, surviv al was highest in Northern Europe and lowest in Eastern Europe, and also lo w in the UK and Denmark. Regional variation was less marked for the lymphom as. Survival improved more in Western than Northern Europe, and the differe nces between these regions fell for bowel cancer (from 8.0% for those diagn osed in 1978-1980 to 2% for those diagnosed in 1987-1989), breast cancer (f rom 7.4% to 3.9%), skin melanoma (from 13.4% to 11.0%) and Hodgkin's diseas e (from 7.2 to 0.6%). For potentially curable malignancies such as Hodgkin' s disease, large bowel, breast and testicular cancers, there were substanti al increases in survival, suggesting an earlier diagnosis and more effectiv e treatment. The persisting regional differences suggest there are correspo nding differences in the availability of diagnostic and therapeutic facilit ies, and in the effectiveness of healthcare systems. (C) 2001 Elsevier Scie nce Ltd. All rights reserved.