The study was carried out with a major participation of scientists from the German Cancer Research Center (DKFZ). Patients across Europe survive longer after a cancer diagnosis than they did five years ago. However, there are significant variations. The results for Germany are in the top group. In general, survival rates are highest in northern, central and southern Europe, while cancer patients in eastern Europe succumb earlier to their conditions.
EUROCARE-5 is a project of gigantic dimensions that has studied the survival of ten million cancer patients in 29 European countries. The study includes cancer cases that were diagnosed between 2000 and 2007 and deaths that were recorded until 2008. Data were provided by 209 participating European cancer registries. EUROCARE-5 covers 50 percent of the adult population and 77 percent of children in Europe.
“EUROCARE-5 documents whether, how and, above all, where advances in cancer medicine reach the population in Europe,” says Professor Hermann Brenner of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ). “A population-based study of cancer survival rates does not reflect individual results of top-level medicine but instead captures the overall performance of national health care systems.” Brenner, an epidemiologist, contributes methodological know-how to this enormous project. Scientists in his department developed the mathematical data collection methods used in the project. The study was led and coordinated by the Instituto Superiore di Sanità in Italy.
There are major differences in five-year survival rates between organs affected by cancer. For cancers of the testicles, thyroid, prostate and breast, melanomas and Hodgkin lymphomas, five-year survival after diagnosis was over 80 percent. By contrast, less than 15 percent of patients with cancers of the lung, liver, pancreas and esophagus were still alive five years after diagnosis.
The study also identified differences in cancer survival between individual countries and regions. People in northern, central and southern Europe survived longer, while cancer patients in eastern Europe (Bulgaria, Slovakia, Poland and Baltic states) succumbed sooner to their conditions. Survival rates in Great Britain and Ireland represented the average. Results from Germany reached the top group for almost all types of cancer. For children with cancer, five-year survival is also higher in Germany than the European average (81 vs. 78 percent).
On the whole, survival rates across Europe have improved in the past five years since the last study for almost all body systems affected by cancer. The researchers noted the highest increases for rectal cancer and for non-Hodgkin lymphomas.
Causes of differences in survival rates
Variations in cancer survival generally reflect the availability of financial resources for public health care. This link is particularly obvious for countries in eastern Europe. Most notably, survival rates for children with cancer and for lymphoma patients are dramatically lower – a strong indicator of a shortage in the availability of effective anticancer drugs.
However, there are also marked differences between countries with comparable health care budgets. For individual cancer types, such as non-Hodgkin lymphoma or rectal cancer, this may be caused by the fact that new, improved treatments are not yet common in all countries. Differences in socio-economic conditions as well as lifestyle factors such as smoking or obesity may also have an impact on survival rates. Differences in cancer screening programs also play a role.
“Although this Europe-wide study identifies positive trends, it also shows that there is still a large potential to further improve cancer survival rates,” Brenner says. “Improving medical supply structures as well as cancer screening programs are major steps towards this aim.”
Roberta De Angelis et al.: Cancer survival in Europe in the first decade of the 21st century: results of the EUROCARE-5 study. The Lancet Oncology 2013, DOI:10.1016/S1470-2045(13)70546-1
Gemma Gatta et al.: Childhood Cancer Survival in Europe at the Beginning of the New Millennium: results of the EUROCARE-5 population-based study. The Lancet Oncology 2013, DOI: 10.1016/S1470-2045(13)70548-5
The German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) with its more than 2,500 employees is the largest biomedical research institute in Germany. At DKFZ, more than 1,000 scientists investigate how cancer develops, identify cancer risk factors and endeavor to find new strategies to prevent people from getting cancer. They develop novel approaches to make tumor diagnosis more precise and treatment of cancer patients more successful. The staff of the Cancer Information Service (KID) offers information about the widespread disease of cancer for patients, their families, and the general public. Jointly with Heidelberg University Hospital, DKFZ has established the National Center for Tumor Diseases (NCT) Heidelberg, where promising approaches from cancer research are translated into the clinic. In the German Consortium for Translational Cancer Research (DKTK), one of six German Centers for Health Research, DKFZ maintains translational centers at seven university partnering sites. Combining excellent university hospitals with high-profile research at a Helmholtz Center is an important contribution to improving the chances of cancer patients. DKFZ is a member of the Helmholtz Association of National Research Centers, with ninety percent of its funding coming from the German Federal Ministry of Education and Research and the remaining ten percent from the State of Baden-Württemberg.