Survival in Europe (http://www.eurocare.

it/

EUROCARE
EUROPEAN CANCER REGISTRY BASED STUDY ON SURVIVAL AND CARE OF CANCER PATIENTS EUROCARE is the widest collaborative research project on cancer survival in Europe. The project started in 1989 under the initiative of two research institutes, Istituto Nazionale Tumori (Milan, Italy) www.istitutotumori.mi.it and Istituto Superiore di Sanit (Rome, Italy) www.iss.it, with the participation of a large number of population-based Cancer Registries throughout Europe.

EUROCARE

EUROPEAN CANCER REGISTRY BASED STUDY ON SURVIVAL AND CARE OF CANCER PATIENTS Aims of the study wer and still are: to provide an updated description of cancer survival time trends and differences across European countries, to measure cancer prevalence, and to study patterns of care of cancer patients.

EUROCARE 1-4 Project (period) EUROCARE-1 (1978 > 84) EUROCARE-2 (1985 > 89) EUROCARE-3 (1990 > 94) Nb cases Nb CR's Nb cancer / Nb countries sites 30 / 12 27 42 42 44

800,000

1,300.000 45 / 17 1,800,000 56 / 22

EUROCARE-4 2,900,000 90 / 22 (1995-99 > 2002)

EUROCARE-3 & 4 Geographic coverage 22 countries 90 CRs

Nordic countries South and West Europe UK (England, Scotland, Wales) Eastern Europe

EUROCARE 5
The fifth and current edition, EUROCARE-5, includes data on more than 21 million cancer diagnoses provided by 116 Cancer Registries in 30 European countries. Aims : To update the existing EUROCARE data bank, by including data of patients diagnosed up to 2007. Follow up will be updated to the most recent possible dates (e.g. on 31/12/2008) in order to analyse both long and short term survival rates of cases diagnosed more recently. To analyse survival of cancer patients by means of conventional and more innovative methods: e.g. cohort relative survival; period survival analysis to estimate survival of patients with recent diagnosis; mixture survival model to estimate the proportion of patients cured.

EUROCARE 5
To compare diagnostic and therapeutic procedures for cancer patients in Italy with those in other European countries at high survival by means of high resolution studies (HR). To increase and promote the use of cancer survival registry data. The EUROCARE results will be diffused among the medical, public health and scientific communities, to the public in general, to tumour patients and to health planners.

EUROCARE-5 Geographic coverage 30 countries 116 CRs

EUROCARE-4 1995-99 Five-year Age Standardised Relative survival All cancers

Countries ranked by survival, colored according their TNEH*
0 20 40 60 80 100

SWITZERLAND SWEDEN NORWAY FINLAND FRANCE GERMANY BELGIUM NETHERLAND ICELAND AUSTRIA ITALY SPAIN EU4 POOL UK NORTH IRELAND MALTA UK SCOTLAND PORTUGAL IRELAND UK WALES UK ENGLAND DENMARK SLOVENIA CZECH POLAND

* TNEH: Total National Expenditure for Health

All cancers combined (EUROCARE 4)

5-year age-adj. relative survival trend in male Polish Slovakia Estonia Slovenia Scotland Wales Denmark English Italian Europe Spanish Finland Norway German French Dutch Swiss Sweden Iceland
0 10 20 1.8 -2.3 6.6 5.2 7.2 3.5 4.5 8.7 9.2 7.9 6.3 8.8 8.9 6.6 12.1 6.7 10.5 7.5 8.5 30 40 50 60
1984 1993-1984

5-year age-adj. relative survival trend in female Polish Estonia Slovakia Scotland Wales Slovenia English Europe Italian Norvay Iceland Finland German Spanish Dutch Sweden Swiss French
0 10 20 30 40 50 3.9 3.9 4.5 6.4 4.0 7.5 7.5 6.8 7.4 4.7 4.5 7.3 6.4 9.5 6.3 5.2 6.5 8.0 60
1984 1993-1984

Relative survival

Relative survival

EUROCARE-4 1995-99 Five-year Age Standardised Relative survival colorectum cancer

countries grouped by region
EUROCARE-4 1995-99 Five-year Age standardised survival by regions
0 20 40 60 80 100

countries ranked by TNEH

five-year AAS by TNHE -colorecum
0 20 40 60 80 100

DENMARK FINLAND ICELAND NORWAY SWEDEN IRELAND UK ENGLAND UK NORTH IRELAND UK SCOTLAND UK WALES AUSTRIA BELGIUM FRANCE GERMANY ITALY MALTA NETHERLAND PORTUGAL SPAIN SWITZERLAND CZECH POLAND SLOVENIA EU4 POOL

C o l o r e c t u m

SWITZERLAND GERMANY NORWAY ICELAND FRANCE DENMARK BELGIUM NETHERLAND SWEDEN AUSTRIA ITALY UK ENGLAND UK NORTH IRELAND UK SCOTLAND UK WALES MALTA FINLAND IRELAND SPAIN PORTUGAL CZECH POLAND SLOVENIA EU4 POOL

EUROCARE-4: 5-year survival of lung cancer patients

0 20 40 60 80 100

DENMARK FINLAND ICELAND NORWAY SWEDEN IRELAND UK ENGLAND UK NORTH IRELAND UK SCOTLAND UK WALES AUSTRIA BELGIUM FRANCE GERMANY ITALY MALTA NETHERLAND PORTUGAL SPAIN SWITZERLAND CZECH POLAND SLOVENIA EU4 POOL

L u n g

EUROCARE-4: 5-year survival of breast cancer patients

0 20 40 60 80 100

DENMARK FINLAND ICELAND NORWAY SWEDEN IRELAND UK ENGLAND UK NORTH IRELAND UK SCOTLAND UK WALES AUSTRIA BELGIUM FRANCE GERMANY ITALY MALTA NETHERLAND PORTUGAL SPAIN SWITZERLAND CZECH POLAND SLOVENIA EU4 POOL

B r e a s t

Breast cancer, five-year survival by age USA vs. Europe, women diagnosed 1990-94
100
Relative survival (%)

81 78

85 82

86 78

88 78

85 72

80 60 40 20 0
15-44

USA (SEER) Europe (EUROCARE)

45-54 55-64 65-74 Age at diagnosis (years) 75-99

Relative excess risk death of women diagnosed with Comparison between of EUROCARE HIGH RESOLUTION (4478) and SEER-US (13172) Relative Risk adjusted by age, stage, number of examined nodes and surgery (yes/no) breast cancer in Europe (EUROCARE) vs. US (SEER), 1990-92
Breast Cancer cases diagnosed in 1990-91

Model 1 Model 2 Model 3 age + + follow-up stage n examined nodes SEER EUROCARE 1 1.37* 1 1.12* 1 1.07

Age : <55, 56-65, 66+ Follow-up : 1,2,3,4,5 years Stage: T1N0M0, T2-3N0M0, T1-3N+M0, T4M0, M1, not specified N examined nodes : 1-9, 10-14, 15+, not available
*= p<=0.05

EUROCARE : 5-year relative survival trends 1983-94

100 90 80 70 60 50 40 30 20 10 0 83-85 86-88 89-91 Testis Melanoma Thyroid Hodgkin Breast Corpus Prostat , e Cervix Bladder Larynx Kidney Colon NHL Rectum Oral Ovary Oropharynx Hypopharynx Stomach Brain Lung Oesophagus PancreasLiver 92-94

The cancer survival gap between elderly and middle aged patients in Europe is widening

The advantage of women in cancer survival

The cure of cancer: A European perspective

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