ESMO 2020 — Expert Commentary — A picture of Europe: estimation of European cancer burden for 2020


  • Daniela Ovadia — Agenzia Zoe
  • Oncology Conference reports
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Manola Bettio leads the Cancer Information group at the Joint Research Center, the European Commission's science and knowledge service. She has been coordinating the computation of cancer incidence and mortality estimates for the year 2020 and for European countries, in the framework of the European Cancer Information System (ECIS). The project is run by the European Commission’s Joint Research Centre in collaboration with the WHO’s International Agency for Research on Cancer.

  • In 2020, the cancer burden in EU-27 is estimated to have 2.7 million new cases (all types, excluding nonmelanoma skin cancer) and 1.3 million deaths.
  • Overall in the Member States, 1 in 2 men and 1 in 3 women are estimated to develop cancer during their lifetime (0-84 years), and 1 in 4 men and 1 in 6 women are estimated to die from the disease.
  • Female breast cancer is the most commonly diagnosed cancer (28.7% of all cancer diagnoses in women), whereas the most common cause of cancer death is from lung cancer (20.4% of all cancer deaths).
  • The increasing cancer burden can be attributable to several factors, including population growth and aging as well as the changing prevalence of certain cancer risk factors linked to social and economic development.
  • Of note, incidence and mortality rates are not moving in the same direction: we observe generally decreasing trends of cancer mortality rates and stable or slightly decreasing trends of cancer incidence rates.
  • Some cancer sites reported decreasing mortality rates from the 1990s in EU countries, in particular in lung cancer among men, breast cancer among women, and colorectal cancer in both men and women.
  • Early diagnosis through cancer screening programs, advances in treatments, and implementation of prevention actions contributed to improving cancer survival.
  • Moreover, for selected cancers, there is a big variability in the level of incidence and mortality rates among European countries.
  • This variability is mainly associated with the changing prevalence of major risk factors of cancer linked to social and economic development (e.g., smoking patterns in the different countries for tobacco-related cancers, awareness campaigns, and/or implementation of screening programs).
  • As a matter of fact, estimates of the cancer burden can be very useful for policymakers and health planners to better allocate resources for implementing cancer screening programs, diagnostic procedures, treatments, or preventive actions to avoid new cancer diagnoses.
  • For more than 30 years since the first “Europe against cancer” program was launched, actions taken at the EU level have helped to extend and save lives.
  • In this context, ECIS, developed and maintained by the European Commission’s Joint Research Centre, is a good example of support for decision-makers and researchers across the EU and beyond.
  • Population-based cancer registries are a source of information for monitoring cancer burden, but there are many issues related to data coverage, e.g., not all EU countries are covered by cancer registries, and some countries have only partial coverage of regionally based cancer registries.
  • As far as the EU is concerned, these data cover around 55% of the EU population — there is definitely room for improvement, especially considering that the cost of cancer reg­istration accounts for a very minor portion of the total cost of cancer care.
  • Finally, regarding COVID-19, the available time trends and the applied methodology could not account for the possible impact of the pandemic on the projected rates; future exercises to evaluate a discrepancy between the predicted and observed rates will allow quantification of this impact.
  • However, the first studies in EU already show delays in cancer diagnoses and treatments because of the pandemic that are likely to increase cancer deaths, especially in selected EU countries.

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