title: Variations in cancer survival and patterns of care across Europe: roles of wealth and health-care organization.
abstract: Cancer survival varies markedly across Europe. We analyzed variations in all-cancer 5-year relative survival in relation to macroeconomic and health-care indicators, and 5-year relative survival for three major cancers (colorectal, prostate, breast) in relation to application of standard treatments, to serve as baseline for monitoring the efficacy of new European initiatives to improve cancer survival. Five-year relative survival data were from the European cancer registry-based study of cancer patients' survival and care (EUROCARE-4). Macroeconomic and health system data were from the Organisation for Economic Co-operation and Development, and European Observatory on Health Care Systems. Information on treatments given was from EUROCARE studies. Total national health spending varied widely across Europe and correlated linearly with survival (R = 0.8). Countries with high spending had high numbers of diagnostic and radiotherapy units, and 5-year relative survival was good (>50%). The treatments given for major cancers also varied; advanced stage at diagnosis was associated with poor 5-year relative survival and low odds of receiving standard treatment for breast and colorectal cancer.
authors: Evaluative Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy. gemma.gatta@istitutotumori.mi.it.
authors: Gemma
authors: G
authors: Gatta
authors: Annalisa
authors: A
authors: Trama
authors: Riccardo
authors: R
authors: Capocaccia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics / Q000401:mortality / Q000628:therapy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000191:economics / Q000401:mortality / Q000628:therapy; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics / Q000401:mortality* / Q000628:therapy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000191:economics / Q000401:mortality / Q000628:therapy; D012959:Socioeconomic Factors; D016019:Survival Analysis; D015996:Survival Rate; D055815:Young Adult