Cancer survival in Europe-first international comparison of Irish cancer survival

Figures released today by the EUROCARE group show survival of cancer patients in Ireland during 2000-2002 to be above the European average for men but below the average for women. This study, in which the National Cancer Registry was the Irish participant, is the first to directly compare cancer survival in Ireland with that in other European countries.

This study, which covered 21 countries, describes the most recent available survival experience of European cancer patients and compares the numbers surviving five years after diagnosis. Survival in Ireland was broadly similar to that in the UK, poorer than in Scandinavian countries and better than in Eastern Europe. The study notes that survival was "generally highest for those in northern European countries and lowest for those in eastern European countries" —although the eastern European countries had the largest improvements.

A second paper covering the diagnosis years 1995-1999 also notes that the most common cancers (colorectum, lung, breast, and prostate) and ovarian cancer had similar variation in survival with geography: highest in Nordic countries (except Denmark) and central Europe, intermediate in southern Europe, lower in UK and Ireland, and lowest in eastern Europe. Survival for melanoma, cancer of the testis, and Hodgkin's disease varied much less with geography, although survival was low for Hodgkin's disease in Ireland and for melanoma in Poland and Wales. This study suggests that about half of the variation in survival across Europe could be explained by differences in health spending. It also concludes, based on patients diagnosed in those years, that:

If all countries attained the mean survival (57%) of Norway, Sweden, and Finland ... about 12% fewer cancer deaths (about 150 000) would occur in the 5 years after diagnosis.

In Ireland, for patients followed during the period 2000 to 2002, survival was better than the European average for cancer of the cervix and for myeloid leukaemia, while for cancers of stomach, bowel, breast and for lymphoma survival was significantly worse. The authors conclude that differences in survival can be due to a variety of reasons, including factors related to cancer services (e.g., organisation, training and skills of health-care professionals, application of evidence-based guidelines, and investment in diagnostic and treatment facilities), and clinical factors (e.g., tumour stage and biology). But they caution that survival represents the end result of the complex interplay of these factors, whose individual contribution to survival cannot be distinguished easily.

Ongoing work in the National Cancer Registry shows that survival for most cancers continues to improve in Ireland — for example, breast cancer patients diagnosed during 1999-2003 had a 5-year relative survival 8% points higher than those diagnosed 1994-1998. But clearly there is some way to go before we can attain the survival performance of the best European countries.

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