Transcript IS CANCER EPIDEMIOLOGY DIFFERENT IN WESTERN THAN IN

Cancer Epidemiology
Dr Jesme Baird
The Roy Castle Lung Cancer Foundation, UK
and ECPC.
Projected numbers of cancer cases and
deaths from cancer in Europe
2010
Cases
Deaths
2020
Cases
Deaths
M 1,652,283 1,090,198
F 1,405,617 803,250
1,859,910
1,504,990
1,241,860
880,531
B 3,057,900 1,893,448
3,364,900
2,122,391
Globocan 2002
Cases of cancer by age and sex in Europe in
2002
Males
-14
15-44
45-54
Females
55-64
65+
-1 4
1 5 -4 4
4 5 -5 4
5 5 -6 4
65+
Globocan 2002
Cancer deaths attributed to various factors
Percentage of all cancer deaths
Factor or class of factors
Tobacco
Alcohol
Diet
Food aditives
Reproductive and sexual
behaviour
Occupation
Pollution
Industrial products
Medicines and m. procedures
Geophysical factors
Infection
Unknown
Best estimate
Range of acceptable
estimates
30
3
35
<1
7
25 - 40
2 - 4
10 - 70
-5 - 2
1 - 13
4
2
<1
1
3
10?
?
2- 8
1- 5
<1 - 5
0.5 - 3
2- 4
1- ?
Doll and Peto 1981
North-Western and Central-Eastern
Europe
Cancer in Europe: males, 2002
Incidence (ASR)
Mortality (ASR)
Globocan 2002
Incidence of cancer in Europe: males 2002
North-Western Europe
Central-Eastern Europe
Globocan 2002
Mortality from cancer in Europe: males, 2002
North-Western Europe
Central-Eastern Europe
Globocan 2002
Cancer in Europe: females, 2002
Incidence (ASR)
Mortality (ASR)
Globocan 2002
Incidence of cancer in Europe: females 2002
North-Western Europe
Central-Eastern Europe
Globocan
Mortality from cancer in Europe: females 2002
North-Western Europe
Central-Eastern Europe
Globocan 2002
Trends in cancer mortality (ASR) in EU
3 50
3 00
2 50
MALE ; E U m em bers before May 2004
MALE ; E U m em bers s inc e May 2004
2 00
F E MALE ; E U m em bers before May 2004
F E MALE ; E U m em bers s inc e May 2004
1 50
03
20
00
20
97
19
94
19
91
19
88
19
85
19
82
19
79
19
76
19
73
19
19
70
1 00
Y ea r
WHO HFA DB 2005
Most common cancer sites: estimated new
cases in males, Europe 2002
Central-Eastern Europe
North-Western Europe
S to m a c h
5%
B la d d e r
B la d d e r
8%
6%
O th e r
P ro s ta te
7%
s ite s
C o lo n
38%
and
re c tu m
O th e r
s ite s
S to m a c h
38%
11%
13%
C o lo n
and
Lung
re c tu m
17%
12%
P ro s ta te
Lung
19%
26%
Globocan 2002
Most common cancer sites: estimated deaths in
males, Europe 2002
North-Western Europe
Central-Eastern Europe
P anc reas
4%
S tomac h
P a n cre a s
P ro s ta te
4%
5%
6%
Other
sites
C o lo n
C olon and
O th e r
rec tum
site s
11%
38%
and
re ctu m
10%
41%
S to ma ch
P rostate
13%
11%
Lung
Lung
27%
30%
Globocan 2002
Most common cancer sites: estimated new
cases in females, Europe 2002
North-Western Europe
Central-Eastern Europe
O va ry
C o rp u s
C o rp u s
4%
u te ri
u te ri
C e rvix
5%
7%
u te ri
Lung
6%
7%
O th e r
O th e r
site s
site s
42%
S to ma ch
8%
41%
C o lo n
and
re ctu m
C o lo n
14%
and
re ctu m
13%
B re a st
30%
B re a st
23%
Globocan 2002
Most common cancer sites: estimated deaths in
females, Europe 2002
North-Western Europe
Central-Eastern Europe
C e rv ix
Ovary
6%
u te ri
P anc reas
6%
6%
Lung
8%
Other
Lung
sites
11%
S to ma ch
O th e r
46%
11%
site s
45%
C olon and
rec tum
C o lo n
14%
and
re ctu m
14%
B reast
17%
B re a st
16%
Globocan 2002
Trends in mortality from lung cancer (ASR) in
males in selected European countries
WHO HFA DB
Trends in mortality from lung cancer (ASR) in
females in selected European countries
WHO HFA DB
25-30% of all cancer sites in the developed
world are causally linked to smoking :
Lung (87-91% in males and 57-86% in
females)
Oral cavity (including lip and tongue)
Nasal cavity and paranasal sinuses
Larynx
Pharynx and oesophagus
Stomach
Liver
Pancreas
Urinary tract (bladder, ureter and renal pelvis)
Uterine cervix
Myeloid leukaemia
IARC 2002
Trends in incidence of colon cancer in selected
European countries, 1953-97
Five-year (relative, age standardised)
survival (%) for colon cancer by sex
Males
Females
N ordi c countri e s
S outh a nd W e st Europe
U K (pre se nte d for Engl a nd, S cotl a nd, W a l e s)
Ea ste rn Europe
D a ta cove ri ng l e ss tha n 100% of country
EUROCARE-3 Study
Diet, overwight and physical activity
 A poor diet, often combined with sedentary
lifestyle and obesity, increase the risk of
colon, breast, prostate, endometrial and other
cancers
 Up to 30% of cancers probably related to diet and
nutrition
World Cancer Report 2003
Incidence of and mortality (ASR, 2002) from
breast cancer in selected European countries
North-Western Europe
Central-Eastern Europe
Globocan 2002
Trends in incidence of breast cancer (ASR) in
selected European countries
Risk factors associated with the
development of breast cancer
family history and genetic factors
previous history of breast cancer in one breast
fibrocystic disease (atypical hyperplasia)
ionizing radiation
age at menarche and menopause
age at first delivery, number of children
nulliparity
oral contraceptives and hormone replacement
therapy
Risk factors associated with the
development of breast cancer
Life-style related factors
diet
alcohol
physical activity
Five-year (relative, age standardised)
survival (%) for breast cancer
Nordic countries
S outh and W est Europe
UK (presented for England, S cotland, W ales)
Eastern Europe
Data covering less than 100% of country
EUROCARE-3 Study
Incidence of and mortality (ASR, 2002) from
cervical cancer in selected European countries
North-Western Europe
Central-Eastern Europe
Globocan 2002
Differences between NW and CE Europe (1)
Incidence of cancer in men is higher in NWEurope,
but mortality is higher in CEEurope.
In females, incidence is higher in NWEurope, but
mortality is similar in both regions.
Mortality in NWEurope has been decreasing since
mid-1980s, it started to decline in CEEurope only
recently.
Differences between NW and CE Europe (2)
Differences in the common cancer sites
In CEEurope, the most important causes of
cancer death
In Men - lung, stomach and colorectal cancer
In females - breast, stomach, colorectal and
cervical cancer
Mortality from cancer (ASR, both sexes) in
three neighbouring countries in Europe