Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980.
BACKGROUND
After a peak in the late 1980s, cancer mortality in Europe has declined by ~10% in both sexes up to the early 2000s. We provide an up-to-date picture of patterns and trends in mortality from major cancers in Europe.


METHODS
We analyzed cancer mortality data from the World Health Organization for 25 cancer sites and 34 European countries (plus the European Union, EU) in 2005-2009. We computed age-standardized rates (per 100,000 person-years) using the world standard population and provided an overview of trends since 1980 for major European countries, using joinpoint regression.


RESULTS
Cancer mortality in the EU steadily declined since the late 1980s, with reductions by 1.6% per year in 2002-2009 in men and 1% per year in 1993-2009 in women. In western Europe, rates steadily declined over the last two decades for stomach and colorectal cancer, Hodgkin lymphoma, and leukemias in both sexes, breast and (cervix) uterine cancer in women, and testicular cancer in men. In central/eastern Europe, mortality from major cancer sites has been increasing up to the late 1990s/early 2000s. In most Europe, rates have been increasing for lung cancer in women and for pancreatic cancer and soft tissue sarcomas in both sexes, while they have started to decline over recent years for multiple myeloma. In 2005-2009, there was still an over twofold difference between the highest male cancer mortality in Hungary (235.2/100,000) and the lowest one in Sweden (112.9/100,000), and a 1.7-fold one in women (from 124.4 in Denmark to 71.0/100,000 in Spain).


CONCLUSIONS
With the major exceptions of female lung cancer and pancreatic cancer in both sexes, in the last quinquennium, cancer mortality has moderately but steadily declined across Europe. However, substantial differences across countries persist, requiring targeted interventions on risk factor control, early diagnosis, and improved management and pharmacological treatment for selected cancer sites.
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan. Electronic address: cristina.bosetti@marionegri.it.
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Bosetti
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
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Bertuccio
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
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Malvezzi
Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
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Levi
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan.
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Chatenoud
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan.
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Negri
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
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La Vecchia
D005060:Europe / Q000453:epidemiology; D005062:European Union; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality*; D015996:Survival Rate; D016896:Treatment Outcome; D014944:World Health Organization
Europe; joinpoint analysis; mortality; neoplasms; trends