Transcript Diapositiva 1

Kielce, Polish conference on cancer, 13/15 June 2011
Cancer inequalities
in Europe
Dr. Andrea Micheli
Director
Descriptive Study and Health Planning Unit
Fondazione IRCCS “Istituto Nazionale dei Tumori”
Milan
EUROCHIP-1..3
Cancer is an element of our societies
Why? To fight inequalities
What? Translational research project
How? Economy of scale: EU
From actions to common actions
Tanks to Magdalena
Cancer - inequalities - Europe
Macro-economic approach background
European vision
LIFE EXPECTANCY IN EU-27, ICE, N, and CH
2005-2009
Source: United Nations
Population Division
LIFE
EXPECTANCY
TRENDS IN
EUROPE
Inequalities
in health
increased
Source: United Nations
Population Division
GDP AND LIFE EXPECTANCY AT BIRTH
Life expectancy at birth
$PPP
yrs
I) GDP < = 20,000
II) 20,000 < GDP < = 30,000
III) 30,000 < GDP < = 36,000
IV) GDP > 36,000
73.3
79.1
79.6
80.0
I, Bulgaria, Romania, Latvia, POLAND, Lithuania, Hungary, Estonia, Slovakia
II, Portugal, Malta, Czech Republic, Slovenia, Cyprus, Greece, Spain, Italy
III, France, Germany, Finland, United Kingdom, Belgium, Sweden, Denmark
IV, Austria, Iceland, The Netherlands, Switzerland, Ireland, Norway, Luxembourg
Sources: United Nations Population Division. For GDP International Monetary Fund
GROSS DOMESTIC PRODUCT (GDP) AND
CANCER INCIDENCE
Age-standardized incidence rates, World Standard Population per 100,000, GDP: at current prices US $, 2006.
Source: GLOBOCAN 2002, IARC & United Nations (UN)
GROSS DOMESTIC PRODUCT (GDP) AND
CANCER MORTALITY
Age-Standardized incidence rates, World Standard Population per 100,000, GDP: at current prices US $, 2006.
Source: GLOBOCAN 2002, IARC & United Nations (UN)
GDP and age-standardized incidence rates for all cancers. Men
Sources: Human Development Report 2009; Ferlay et al. 2008
GDP and age-standardized mortality rates for all cancers. Men
Disks are proportional to the public health expenditure ($ PPP)
Sources: Human Development Report 2009; Ferlay et al. 2008
EUROPE
Gross Domestic Product (GDP), Total National Health Expenditure
(TNHE) and Public Health Expenditure (PHE)
GDP
TNEH
($PPP)
PHE ($PPP)
($PPP)
Switzerland
Norway
Austria
Denmark
Netherlands
Germany
Sweden
France
Italy
England
Finland
Wales
Spain
Scotland
Slovenia
Czech Rep
Slovakia
Poland
Estonia
Switzerland
Norway
Austria
Denmark
Netherlands
Germany
Sweden
France
Italy
England
Finland
Wales
Spain
Scotland
Slovenia
Czech Rep
Slovakia
Poland
Estonia
Switzerland
Norway
Austria
Denmark
Netherlands
Germany
Sweden
France
Italy
England
Finland
Wales
Spain
Scotland
Slovenia
Czech Rep
Slovakia
Poland
Estonia
0
10000
20000
30000
0
1000
2000
3000
0
500
1000
1500
2000
Countries are ranked by GDP in 1995
Source: Verdecchia A. et al.
EUROCARE-4
5-year relative survival, all cancers
countries are ordered by Total Health Expenditure
Poland
Europe
Berrino F. et al, The Lancet Oncology, 2007
5 YEARS RELATIVE SURVIVAL FOR ALL CANCERS
EUROCARE 3
Ranked by 1995 TNEH
Source: Verdecchia A. et al. European Journal of Public Health, 2008
GDP AND EPIDEMIOLOGICAL CANCER DATA
All cancers M & F
COUNTRIES BY QUARTILE of
GDP per capita ($PPP)
Incidence
per 100,000
Mortality
per 100,000
Survival
%
LOWEST GDP < 20,000
336
209
-
363
172
50
411
171
49
405
176
53
(BG, RO, LV, PL, LT, HU, EE, SK)
20,000 < GDP < = 30,000
(PT, MT, CZ, SI, CY, EL, ES, IT)
30,000 < GDP < = 36,000
(FR, DE, FI, UK, BE, SE, DK)
HIGHEST GDP > 36,000
(AT, IS, NL, CH, IE, NO, LU)
Sources: Ferlay et al. EJC, 2010. EUROCARE-4. For GDP International Monetary Fund
Against cancer inequalities:
indications from Europe
• Produce cancer plans (and follow them)
• Promote cancer information, i.e. cancer
registration
• Organize screening programs for cancer
of cervix, breast and colorectum
• And invest in primary prevention actions
Health Strategies in Europe. Lisbon, 12-13 July 2006. Coleman M., modified
Health
Strategies
Europe.
Health Strategies in Europe. Lisbon,
12-13
July 2006. in
Coleman
M. Lisbon, 12-13 July 2006. Coleman M.
L. von Karsa et al. Cancer Screening in the European Union. First Report.
L. von Karsa et al. Cancer Screening in the European Union. First Report.
L. von Karsa et al. Cancer Screening in the European Union. First Report.
Lung cancer in Poland and EU-27, males
Rate per 100,000
Rate per 100,000
per 100
WORLD Standard Population, per 100.000
Source: GLOBOCAN 2008, WHO. For Survival: EUROCARE-4. Sant et al. EJC 2009.
Smoking trends in European countries (M+F)
Source: WHO, Health For All Europe, 2011
Cancer inequalities:
promote health
NO smoking
Eat better, five portion per day
Reduce alcohol consumption
Increase physical activity, 30’ of
walking per day