title: Survival of women with cancers of breast and genital organs in Europe 1999-2007: Results of the EUROCARE-5 study.
abstract: BACKGROUND
  Survival differences across Europe for patients with cancers of breast, uterus, cervix, ovary, vagina and vulva have been documented by previous EUROCARE studies. In the present EUROCARE-5 study we update survival estimates and investigate changes in country-specific and over time survival, discussing their relationship with incidence and mortality dynamics for cancers for which organised screening programs are ongoing.
  
  
  METHODS
  We analysed cases archived in over 80 population-based cancer registries in 29 countries grouped into five European regions. We used the cohort approach to estimate 5-year relative survival (RS) for adult (⩾15years) women diagnosed 2000-2007, by age, country and region; and the period approach to estimate time trends (1999-2007) in RS for breast and cervical cancers.
  
  
  RESULTS
  In 2000-2007, 5-year RS was 57% overall, 82% for women diagnosed with breast, 76% with corpus uteri, 62% with cervical, 38% with ovarian, 40% with vaginal and 62% with vulvar cancer. Survival was low for patients resident in Eastern Europe (34% ovary-74% breast) and Ireland and the United Kingdom [Ireland/UK] (31-79%) and high for those resident in Northern Europe (41-85%) except Denmark. Survival decreased with advancing age: markedly for women with ovarian (71% 15-44years; 20% ⩾75years) and breast (86%; 72%) cancers. Survival for patients with breast and cervical cancers increased from 1999-2001 to 2005-2007, remarkably for those resident in countries with initially low survival.
  
  
  CONCLUSIONS
  Despite increases over time, survival for women's cancers remained poor in Eastern Europe, likely due to advanced stage at diagnosis and/or suboptimum access to adequate care. Low survival for women living in Ireland/UK and Denmark could indicate late detection, possibly related also to referral delay. Poor survival for ovarian cancer across the continent and over time suggests the need for a major research effort to improve prognosis for this common cancer.
authors.affiliation: Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: milena.sant@istitutotumori.mi.it.
authors.forename: Milena
authors.initials: M
authors.lastname: Sant
authors.affiliation: Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Chirlaque Lopez
authors.affiliation: Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Agresti
authors.affiliation: Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitariam, University Hospitals of Granada, Granada, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Sánchez Pérez
authors.affiliation: Saarland Cancer Registry, Saarbrücken, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: Department of Health Promotion and Postgraduate Education, National Institute of Public Health - National Institute of Higiene, Warsaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Bielska-Lasota
authors.affiliation: Bulgarian National Cancer Registry, National Hospital of Oncology, Sofia, Bulgaria.
authors.forename: Nadya
authors.initials: N
authors.lastname: Dimitrova
authors.affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
authors.forename: Kaire
authors.initials: K
authors.lastname: Innos
authors.affiliation: Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Katalinic
authors.affiliation: Cancer Registry of Norway, Institute of Population-Based Cancer Research, Department of Research, Oslo, Norway.
authors.forename: Hilde
authors.initials: H
authors.lastname: Langseth
authors.affiliation: Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
authors.affiliation: Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Rossi
authors.affiliation: Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands; MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
authors.forename: Sabine
authors.initials: S
authors.lastname: Siesling
authors.affiliation: Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Minicozzi
keywords: Breast cancer; Cervical cancer; Corpus uteri cancer; Europe; Ovarian cancer; Population-based; Survival; Vaginal cancer; Vulval cancer