Cancer control in Europe: A proposed set of European Cancer Health Indicators

Cancer is a major health problem in Europe. The number of cases diagnosed annually (incidence) has been growing steadily for at least the last 20 years. 1 This increase reflects increasing life expectancy at birth with a consequent shift in the age-distribution of the population toward the elderly, as it has been observed in all industrialised countries. 2 On the other hand, in most of these countries the age-adjusted incidence and mortality rates for some major cancers such as the tobacco-related cancers and stomach cancer are no longer increasing. 4] There is now greater information on the increasing numbers of patients living with a previous cancer diagnosis (prevalence) in European populations. This assists efforts to estimate future demand for medical services. ancer is related not only to age but also to life-style (e.g. historical smoking habits and diet) and environmental and socio-economic factors. 7 Less wealthy countries tend to have both low life expectancy at birth and low survival for cancer patients. 8 However, the relationship between wealth and cancer is complex. The least wealthy European countries -those in the lowest tertile of the distribution by country of Gross Domestic Product (GPD) per person (table 1) -have the lowest survival rates and the lowest prevalence, but also low incidence of cancer and high cancer mortality. For countries of roughly average wealth -those in the middle tertile -levels of