[The European countries confronting cancer: a set of indicators assessing public health status].
BACKGROUND
We now know that efficient public policies for cancer control need to be global and take into account each and all the factors involved: economics and level of development, style of life and risk factors, access to screening, effectiveness of the care-providing system. A very simple scorecard is proposed, based on publicized public health indicators, which allows a comparison between European countries.


METHODS
We extracted 49 indicators from public databases and literature concerning 22 European countries. We made correlation calculations in order to identify relevant indicators from which a global score was extracted. Using a hierarchical clustering method we were then able to identify subsets of homogeneous countries.


RESULTS
A 7 indicator scorecard was drawn up: national gross product, scientific production, smoking rate, breast screening participating rate, all cancer mortality rate (male population), 5 years relative survival for colorectal cancer and life expectancy at birth. A global score shows: 1) the better positioned countries: Switzerland, Sweden, Finland and France; 2) the countries where cancer control is less effective: Estonia, Hungary, Poland and Slovakia. Three subsets of countries with a fairly similar profile were identified: a high level of means and results group; a high level of means but a medium level of results group; and a low level of means and results group.


CONCLUSIONS
This work emphasizes dramatically heterogeneous situations between countries. A follow-up, using a reduced but regularly updated set of public health indicators, would help induce an active European policy for cancer control.
Borella
Laurent
L
Institut national du cancer, 28, avenue Hoche, 94320 Thiais, France. laurent.borella@wanadoo.fr
D001943:Breast Neoplasms / Q000175:diagnosis; D015179:Colorectal Neoplasms / Q000401:mortality; D004467:Economics / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D009369:Neoplasms / Q000401:mortality / Q000517:prevention & control*; D011634:Public Health; D012106:Research / Q000706:statistics & numerical data; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D015996:Survival Rate