A report published in March 2022 issue of the Annals of Oncology by Prof. Carlo La Vecchia of the Department of Clinical Sciences and Community Health, Università degli Studi di Milano in Milan, Italy and colleagues confirms predicted declining mortality rates for most major cancers and total cancers in both sexes in European Union (EU) estimated at 6% for men and 4% for women over the past 5 years. Pancreatic cancer is becoming the third cause of cancer deaths in EU. The most notable good news is that female lung cancer is finally showing a slowdown in mortality rates underscoring the importance and effectiveness of tobacco control policies. Ovarian cancer shows favourable predicted trends largely contributed to the use of oral contraceptives and it should continue falling in the near future, since these falls are also seen in young and middle-aged women.
The authors wrote in the background that they publish cancer mortality predictions for the current year since 2011. Data for 2017 for most EU countries are now available. Consequently, they updated and validated EU dataset. In 2022, the COVID-19 pandemic may have an impact on cancer mortality mainly in the elderly people across Europe and the projections cannot account for this, and should be considered when interpreting the present data.
In their work, the authors present cancer mortality predictions for the 10 major causes of cancer mortality and total cancer in the year 2022 for the EU comprised of 27 countries as of 2021, as well as the UK which has been examined separately since Brexit in 2021 and the 5 most populous EU countries. The authors additionally focused on ovarian cancer.
Cancer mortality rates, though not absolute numbers of deaths, have been decreasing over the last three decades in Europe. The authors estimated projections and the number of avoided deaths for total cancer mortality and 10 major cancer sites, between 1989 and 2022, for the EU, the UK, France, Germany, Italy, Poland and Spain using cancer death certification and population data since 1970 from the World Health Organization and Eurostat.
In the EU, the authors predict 1 269 200 cancer deaths in 2022; corresponding age-standardised rates (world) fall 6% to 126.9 deaths/100 000 in men and 4% to 80.2/100 000 women since 2017.
Male lung cancer is expected to fall 10% reaching 30.9/100 000. The rise in female lung cancer mortality slowed (+2% to 13.8/100 000).
The authors estimated 369 000 (23%) avoided deaths in 2022 alone and a total of 5 394 000 (12%) deaths since the peak rate in 1988.
Stomach, colorectal, breast and prostate cancers showed substantial declines, between 5% and 16% over the past 5 years.
Pancreatic cancer remained stable in men (8.1/100 000) and rose 3% in women (5.9/100 000), becoming the third cause of cancer mortality in the EU (87 300 deaths), overtaking breast cancer (86 300 deaths).
The fall in uterine cancers slowed down (−4%) to 4.7/100 000.
Bladder cancer fell 9% in men, but was stable in women.
Leukaemias fell more than 10%.
Ovarian cancer mortality declined over the past decade in all considered countries. EU predicted rates were 4.3/100 000 (−13%) in all ages, 1.2/100 000 (−26%) at 20-49 years, 15.3/100 000 (−11%) at 50-69 years and 32.3/100 000 (−11%) at 70-79 years.
The authors concluded that fall in total cancer mortality in men and women were predicted in the EU. This is consistent with the patterns reported for the USA, which had lower rates and faster falls. Nearly 5.4 million (12%) avoided cancer deaths are predicted over 1989-2022 in the EU, with 369 000 (23%) in 2022 alone.
In the EU, lung and colon cancer were still the leading causes of cancer death. Pancreatic cancer is predicted to surpass breast cancer, becoming the third cause of cancer death in the EU, largely due to it being the only major cancer with a lack of therapeutic progress in men and unfavourable trends in women. The UK has a lower total cancer mortality rate in men, but a higher one in women. The differences between the rates in total cancer mortality between the EU and the UK are strongly dependant on the historic prevalence of the consumption of tobacco—the main avoidable risk factor responsible for nearly 27% of cancer deaths in the European region—in successive generations of men and women. In the detailed analysis of ovarian cancer, mortality rates have been falling in the EU and are expected to fall down in the foreseeable future for all the age groups considered. Favourable trends had already been registered and predicted for the EU and other high income countries with rates and trends for the EU being similar to those seen in the USA, and a clear gradient in rates, from high rates in North East Europe to low ones in South West Europe observed.
Dalmartello M, La Vecchia C, Bertuccio P, et al. European cancer mortality predictions for the year 2022 with focus on ovarian cancer. Annals of Oncology 2022;33(3):330-339.