Cancer mortality varies wildly across the EU, new registry finds

The first Country Cancer Profiles under the European Cancer Inequalities Registry presented on Wednesday (1 February) indicated worrying inequalities in cancer mortality rates across the EU and within its member states.

There is almost a two-fold difference in cancer mortality across countries, and there are wide disparities in cancer mortality across gender, the Profiles, covering all 27 EU countries, Norway and Iceland, found. They were presented by the European Commission and the Organisation for Economic Co-operation and Development (OECD).

“This first set of Country Cancer Profiles […] clearly highlight the large and unacceptable inequalities that exist between EU member states,” Health Commissioner Stella Kyriakides told the 2023 Cancer Conference in Stockholm on Wednesday.

“In fact, between and even within countries, mortality rates, risk factors and access to care vary hugely, depending on socioeconomic status, gender or age,” she added.

The reasoning for those differences is explained by varying exposure to risk factors for cancer, as well as the different capacity of health systems to provide timely and free access to early diagnosis, and high-quality cancer care and treatment.

“In a European Health Union that seeks to protect everyone, such inequalities are not acceptable,” Kyriakides stressed.

The challenges EU countries face in providing high-quality cancer care also vary.

Some countries are well equipped but face shortages in qualified health care staff, while others have a high number of qualified physicians, but lack, for example, radiation therapy equipment. 

“As an example, screening is key to improve early detection: however, coverage for breast cancer screening differs widely, from 6 to 90%, and from about 25 to 80% for cervical cancer,” Kyriakides said.

To reduce the inequalities, countries are encouraged to identify challenges and share best practices among themselves. 

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Gender and socioeconomic inequalities

Significant disparities also exist within countries, especially within different gender and socio-economic groups. 

When it comes to gender, cancer mortality rates are 75% higher among men than women across the EU countries.

The highest disparities are seen in Baltic countries, Portugal, and Spain, which an OECD official attributed to risk factors such as food, smoking rates or alcohol consumption. Nordic countries – Norway, Iceland, Ireland, and Iceland – display relatively smaller differences among genders.

Broad socio-economic inequalities in cancer mortality also exist in terms of education or income.

Overall risk factors tend to be more prevalent among men and among low-income and low-education groups. For example, mortality from cancer is up to 2.5 times higher among low-educated men than highly educated ones.

Other findings showed that cancer, representing 26% of all deaths in the bloc, is the second cause of mortality after circulatory diseases. In total, some 1.2 million people died from cancer in EU countries. The deadliest of all cancers remains lung cancer. 

The Profiles showed that EU countries spent nearly €170 billion on cancer care in 2018. Overall, spending on prevention increased in recent years but it still only accounts for 3.4% of overall health spending.

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The ways for improvement

There are several ways to improve the situation and close existing gaps, according to the OECD.

This focuses on different stages, starting from prevention and encouraging healthier lifestyles, followed by improved accessibility to early diagnosis and improving quality of cancer care. 

The country-specific situation will be monitored every year, to have “a regular overview of how the situation is moving,” a senior commission official said on Monday during off-record media briefing. He added that the registry will help to address and reduce inequalities across Europe as well as prioritise investments according to the findings. 

“There’ll be the follow-up process of looking at the financial instruments to see how we can encourage countries who have a deficit in terms of the inequalities to develop projects that could address those inequalities,” the official said.

The cancer inequalities registry and the country profiles are a flagship initiative under Europe’s beating cancer plan. Last week another project was launched – the cancer imaging initiative – enabling artificial intelligence to play a role in reading cancer images. 

Thirty other initiatives are to be delivered over the coming year.

Those include the Commission’s proposal for a Council recommendation on vaccine-preventable cancers, along with an update of the 2009 Council recommendation on smoke-free environments to increase the protection of citizens against tobacco and help deliver on the target of a Tobacco-Free Generation by 2024.

[Edited by Zoran Radosavljevic]

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