title: The burden of non-acute dying on society: dying of cancer and chronic disease in the European Union.
abstract: OBJECTIVE
  Due to the ageing of the European population, the burden of non-acute dying on society is expected to increase. The aim of this study is to estimate the number of persons dying of cancer and chronic disease in Europe, including regional differences.
  
  
  METHODS
  Death certificates of deceased persons in the European Union (EU)-27 countries in 2007 (some countries 2006 or 2004) were analysed and primary death causes were listed. These data were prepared for the general population and for the population of 65 years and older. Crude death rates (CDRs) were calculated for both groups and for all included countries.
  
  
  RESULTS
  Of 480 million deceased European people, 202 million died of cancer and chronic disease in 2007 (42%). The CDR of the EU-27 countries was 409 (95% CI 370 to 451) for cancer and other chronic diseases per 100 000 inhabitants in 2007. For the 65+ population, the CDR for the EU-27 was 1783 (95% CI 1701 to 1868) for cancer and chronic disease. Large differences across countries appeared. An inverse relationship was shown for country-specific CDRs for cancer and chronic disease versus CDRs for other death causes (R=-0.41; p=0.04).
  
  
  CONCLUSIONS
  Dying of cancer and chronic diseases involves a considerable burden on the European society. Future research should relate this information to the prevalence of symptoms and the use of palliative care services. European policy makers should take into account regional variations in developing long- and short-term palliative care strategies.
authors.affiliation: Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hasselaar
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Engels
authors.forename: Johan
authors.initials: J
authors.lastname: Menten
authors.forename: Birgit
authors.initials: B
authors.lastname: Jaspers
authors.forename: Kris
authors.initials: K
authors.lastname: Vissers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002908:Chronic Disease / Q000453:epidemiology*; D017281:Cost of Illness; D005060:Europe / Q000453:epidemiology; D005062:European Union; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D010166:Palliative Care / Q000706:statistics & numerical data*; D015995:Prevalence