Cancer survival in Europe: good results for Italy

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Italy is one of the best countries in Europe for cancer survival, as emerges from EUROCARE, a project started in 1989 under the initiative of two Italian research institutes, Fondazione IRCCS Istituto Nazionale Tumori  (INT) in Milan and Istituto Superiore di Sanità (ISS) in Rome, with the participation of a large number of Cancer Registries throughout Europe. As we can read on EUROCARE website, “the aims of the study are: to provide an updated description of cancer survival time trends and differences across European countries, to measure cancer prevalence, and to study patterns of care of cancer patients.” The research was able to cover more than 50% of the European adult population (461 million) and 77% of the infant (59 million), over 29 countries including Italy, to compare the 5-year survival for more than 10 million adults and 60 415 children between 2000 and 2007.

At the beginning of December 2013, the fifth round of EUROCARE, a study called EUROCARE 5, has been published on The Lancet Oncology to present the last results on cancer survival in European countries, showing the good position of Italy concerning the health conditions of patients, both adults and children, five years after disease. EUROCARE 5 is a wide collaborative research project and it represents the picture of Europe in terms of cancer survival.

The photograph taken by EUROCARE 5 is positive, but what about the practical consequences of this project on the European health policies? On 5th December 2013, the EUROCARE team presented these latest results on cancer survival in Europe to the European Parliament in order to discuss how we can improve the health services where they are deficient, with public health programs at the national level. No evidence-based public health interventions can be planned and monitored without accurate and timely data from population-based cancer registries. “That’s why, one of the most important issues we have discussed is the new European privacy policy for the protection of personal data,” says Roberta De Angelis, Head of the Cancer Epidemiology Unit in the National Centre of Epidemiology (CNESPS) at ISS, and first author of the study on adults, “in particular concerning the access to personal data of patients in order to carry out scientific studies. In this regard, all the representatives participating in the round table (the European Commission, cancer patients associations and advocacy groups, scientific societies, cancer registries) agree that health research would be seriously impeded by the new proposal on the General Data Protection Regulation and that public health research shall be granted with an exemption from consent, in order to permit the collection of complete, accurate and high quality data.”

The results show that, in general, in Europe the number of adult patients who survive at least 5 years after diagnosis has increased, even if there are still differences between countries. EUROCARE 5 involved the Italian cancer registries covering approximately 35% of the national population. Italy shows a higher survival than the European average for all ten tumors analyzed by geographic area. The major differences are observed for cancers of the stomach (32% of survival in Italy, versus the 25% in Europe), kidney (67% vs. 61%), prostate (89% vs. 83%), colon (61% vs. 57%) and breast (86% vs. 82%).

 “We observe the same trend about cancer survival in young population too,” says Gemma Gatta, Head of Evaluative Epidemiology at INT and first author of the EUROCARE 5 paper  about cancers in children, “even if the tumors that arose in younger children (0-14 years) generally have a better prognosis than adults”. Therefore, Italy has confirmed its position of excellence even in the survival of children, where for example the 5-year survival for lymphocytic leukemia (the most common cancer in children) during the period 2005-2007 was 87%, compared to a European average of 86%. Furthermore, EUROCARE 5 has proved that mortality from leukemia and Non-Hodgkin lymphomas, which include more than one third of all childhood cancers, declined during the reporting period of about 4-6% per year.

The study provided interesting results regarding the differences among European countries and it includes data from 7 eastern European countries, providing for the first time a good representation of the health situation in this region. EUROCARE 5 pointed out the delay of these countries, likely related to the lack of public resources for cancer control, and an inadequate access of the population to screening programs, early diagnosis and optimal treatments.

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Mortality trends in Europe have been decreasing in recent years, differently from what happened in the United States with the rise in the so-called “deaths of despair” among low educated middle-aged white Americans. Most of all, such trends in Europe show no interruptions due to the economic crisis. This is the conclusion of a study published on PNAS by LIFEPATH, a project funded by the European Commission, which investigates the biological pathways underlying social differences in healthy ageing.