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Persisting cancer mortality gap between western and eastern Europe
Claudia Santucci1, Linia Patel1, Matteo Malvezzi1
1Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Celoria 22, 20133 Milan, Italy.
European Journal of Cancer (Oxford, England : 1990)
|February 21, 2022
Summary
Cancer mortality declined significantly in Western Europe but not in Eastern Europe, where rates remain higher. Lifestyle factors and healthcare access explain the persistent disparities in cancer deaths between these regions.
Area of Science:
- Public Health
- Epidemiology
- Oncology
Background:
- Cancer mortality trends in Europe over the past three decades show favorable patterns in Western Europe (WE).
- However, cancer mortality patterns and trends have been less favorable in most Eastern European (EE) countries.
- Significant disparities persist in cancer mortality rates between WE and EE.
Purpose of the Study:
- To compute and compare cancer mortality rates in Western and Eastern European countries.
- To analyze trends in cancer mortality over time using joinpoint regression models.
- To identify key determinants contributing to the differences in cancer mortality between WE and EE.
Main Methods:
- Utilized the World Health Organization's official mortality database.
- Calculated age-standardized cancer mortality rates for men and women in WE and EE.
- Employed joinpoint regression models to identify significant changes in mortality trends.
Main Results:
- Cancer mortality declined by 1-1.4% annually in WE since 1990, reaching 125.4/100,000 men and 81.3/100,000 women in 2016.
- EE rates only began declining around the 2000s in men and remained stable in women, reaching 171.9/100,000 men and 98.2/100,000 women.
- Excess mortality in EE increased from 32% to 37% in men and 15% to 21% in women compared to WE, with significant differences in lung, upper respiratory tract, stomach, intestinal, and uterine cancers. Prostate cancer rates increased in EE while decreasing in WE.
Conclusions:
- Differences in lifestyle factors (smoking, alcohol) and variations in cancer diagnosis and management contribute to the persistent cancer mortality gap between WE and EE.
- There is no current evidence to suggest that this gap is closing.
- Over 55,000 deaths could have been avoided in EE in 2016 if mortality rates had mirrored those in WE.
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