London School of Hygiene & Tropical Medicine

Epidemiologist to sound warning note to policymakers for future of east-west divide

New survival figures for cancer in Europe have revealed a 'substantial and increasing' gap between eastern and western Europe, delegates at ECCO 12, the European Cancer Conference in Copenhagen will hear today.

The EUROCARE-3 study, 'Cancer survival in Europe at the end of the 20th Century', examines survival five years after diagnosis for 1.8 million adults and 24,000 children who were diagnosed during 1990-94 and followed to the end of 1999. The full findings will appear shortly in Annals of Oncology, but a preview of the highlights will be presented at the conference today by one of the report's authors, Professor Michel Coleman, Professor of Epidemiology and Vital Statistics at the London School of Hygiene & Tropical Medicine.

Cancer survival rates across Europe are improving generally, particularly for breast cancer, delegates will hear. However, patients in the poorer countries of eastern Europe still have far lower survival rates for most cancers than patients in the richer countries of western and northern Europe. This pattern was identified in the EUROCARE-2 study, published in 1999, among patients diagnosed in the late 1980s and followed up to 1994, but now it is even more pronounced.

Overall survival was generally below the European average in five eastern European countries (Czech Republic, Estonia, Slovakia, Slovenia and Poland [which had the lowest survival rate]) and in Denmark, England, Scotland Wales, Malta and Portugal among participating western European countries. Sweden tended to have the highest survival rates among the five Nordic countries, while the areas of France and Switzerland covered by the study often had the highest survival rates among western European countries.

The all-cancers survival index for both men and women in the three participating UK countries (England, Scotland and Wales) was below the European average. For men, the survival index was between 33 and 37% (against a European average of 38%) and for women, it was between 47 and 51% (against a European average of 52%). On a more positive note, the UK countries generally have higher than average survival rates for melanoma, testicular cancer and Hodgkin's disease.

Professor Coleman will sound a warning note for the future of the east-west divide: 'The survival trends reflect a substantial and increasing gap in the overall prognosis of cancer between eastern and western Europe', he will advise. 'Since all five eastern European countries participating in EUROCARE may well join the EU in 2004, this raises a major new problem of inequality in health within the EU. The wide differences are likely to reflect differences in both stage at diagnosis and the availability of and access to health resources, both of which are amenable to intervention. They represent a benchmark for reducing inequalities in cancer survival across Europe in the future'.

Michel P Coleman
Professor of Epidemiology and Vital Statistics
Non-Communicable Disease Epidemiology Unit
London School of Hygiene and Tropical Medicine, Keppel Street, GB-London WC1E 7HT Tel +44 20 7927 2478; Fax +44 20 7436 4230

Ends.

To interview Professor Michel Coleman, please contact the London School of Hygiene & Tropical Medicine's Press Office on 020 7927 2073 (before 24 September) and the ECCO 12 Press Office thereafter (+45 3252 4163 or +455 3252 4179).