Researchers have called on European policymakers to provide adequate resources to tackle pancreatic cancer, a disease that is almost always fatal and where little progress has been made over the past 40 years.
In the latest predictions for cancer deaths in the EU and the UK for 2021, published in the leading journal Cancer History of Oncology [1] today (Monday), researchers led by Carlo La Vecchia (MD), a professor at the University of Milan (Italy), say that pancreatic death rates are expected to remain around men, but will continue rising in women in most EU countries. .
The researchers estimate that 42,300 and 5,000 men in the EU and UK respectively died from pancreatic cancer by the end of this year. Following adjustment for differences in age distribution in the population, the average age rate (ASR) of deaths in men will be eight per 100,000 and 6.5 per 100,000 in the EU and UK respectively this year [2]. This represents a 0.8% decline in mortality rates since 2015. Among women, six per 100,000 are expected to die from the disease in the EU, representing a 0.6% increase from 2015. In the UK, that five women per 100,000 die, representing a 4% decline in the death rate.
In comparison, the researchers predict that death rates in nine out of ten of the other major cancers will decline by 7% in men and 5% in women between 2015 and 2021 in most EU countries and the UK.
Professor La Vecchia said: “Among the major cancers, pancreatic cancer is the fourth most common and remains the only one that has not seen a complete fall in mortality rates over the last three decades in the Department. Europe in all genders It is important that governments and policymakers provide sufficient resources for the prevention, early diagnosis and management of pancreatic cancer to improve these trends in the near future.
“If the cancer is found early, it is easier to treat successfully, but most cases are positive before the time of diagnosis. Avoiding smoking and excessive alcohol consumption, weight control and, as a result, diabetes are the main known methods of preventing the disease, but they make up only a small proportion of cases.New, targeted drugs lead to some improvement in treatment , but it is difficult to quantify the current impact. “
The researchers analyzed cancer mortality rates in the 27 EU Member States [3] as a whole and contributed to the UK being able to compare with previous years when the UK was still a member of the EU. They also looked at the six most populous countries – France, Germany, Italy, Poland, Spain and the UK – for all cancers, and, on their own, for stomach, tissue, pancreas, lungs, breast, uterus (including cervix), ovary, prostate, bladder and leukaemias for men and women [4]. This is the first year in a row that the researchers have published these predictions. Professor La Vecchia and his colleagues collected mortality data from World Health Organization and Eurostat databases from 1970 to 2016.
They estimate that a total of 1,443,000 died from the ten cancers in the EU (1,267,000) and the UK (176,000) by the end of the year. This is in line with average mortality rates of 130 per 100,000 men (down 7% from 2015) and 81 per 100,000 women (down 5%) in the EU. In the UK, death rates will be 114 per 100,000 men (down 7.5% from 2015) and 89 per 100,000 women (down 4.5%).
Compared to the high rate of cancer deaths in 1988, more than 4.9 million cancer deaths will be prevented in the EU and more than a million deaths will be prevented in the UK in the 33-year period up to 2021. In 2021 alone , 348,000 deaths and 69,000 preventable cancers in the EU and the UK respectively.
Changes in smoking patterns, better food storage and better treatments are driving many of the reductions in mortality rates for cancers such as lung, stomach and breast. However, while lung cancer mortality rates are falling in men, they are still rising in women in many countries, indicating that women tended to start smoking later in the twentieth century. during the men. In the EU, lung cancer mortality rates are estimated at 32 per 100,000 in men (down 10%), whereas in women it is 15 per 100,000 (up 7%). The UK is different, with lung cancer mortality rates down 11.5% at 24 per 100,000 men and down 5% with a death rate of 19 per 100,000 women.
The co-author, Dr Fabio Levi (MD), professor emeritus at the Faculty of Biology and Medicine, University of Lausanne (Switzerland), said: “Lung cancer mortality rates in men are 25% lower in the UK than in than 27 European countries as a result of an earlier and greater reduction in the frequency of smoking in UK men, as evidenced by the lower expected mortality rates for all cancers in UK men .In the EU, men stop smoking, albeit longer than in the UK, which explains the expected drop in male lung cancer mortality rates in those countries.
“Lung cancer mortality rates in UK women are higher than those in EU countries and this is reflected in higher female mortality rates from all cancers in the UK. However, our forecast shows a trend a favorable decline in female lung cancer deaths in the UK, in contrast, with continued trends in EU women where rates could reach 16 or 18 per 100,000 women in the next decade. “
Co-author, Professor Paolo Boffetta (MD), an History of Oncology associate editor for epidemiology. Professor and associate director for population sciences at Stony Brook University, New York (USA), and professor at the University of Bologna (Italy), said: “Cancer is the second leading cause of death in Europe after an infection While we predict that mortality rates in many cancers will fall this year, the total number of deaths from the disease will continue to rise as a result of aging numbers. ‘Reaffirms the growing importance of public health.Delayed diagnosis and treatment of cancer due to COVID-19 pandemics could increase the cancer burden over the next several years.
“The results we are reporting this year are particularly important as they confirm that trends in deaths from pancreatic cancer and female lung cancer do not reflect the positive pattern of other major cancers, as a basis for the need for more efforts to study and control these neoplasms. .
“Measures to continue to improve cancer mortality rates should include smoking cessation, especially in women, controlling overweight and alcohol, making the most of of screening and early diagnosis for breast, bowel and – in central and eastern Europe – cervical cancer as well, data management needs to be adopted across Europe, especially in central and eastern Europe, and vaccines should be widely available for women to eradicate cervical cancer, which is caused by the human papilloma virus, and against hepatitis B, which is linked to liver cancer. contributes to the control of liver cancer. ”
In accompanying editorial [5], Professor José Martín-Moreno, of the University of Valencia, Spain, and Ms Suszy Lessof, of the European Observatory on Health Systems and Policies, Brussels, Belgium, wrote that the Professor La Vecchia and colleagues are to be commended for their 11 years of mortality prediction and that it is “the key to understanding the past and how to deal with future data” . They think the analysis is encouraging; however, they highlight potential complications from COVID-19 because cancer is a “high risk factor for patients with COVID-19 infection, behaving as a higher probability of ICU admission, mechanical ventilation and mortality ”.
“The positive things [from Prof La Vecchia’s paper] – the hard evidence that there is scope for effective action which, over time, leads to positive outcomes – which should not obscure the shadow of COVID-19 pandemic. Its impact on cancer patients (and fears of that impact) is mounting. Beyond the direct harm of this new crown of viruses to vaccinated and particularly vulnerable people, there is a blow to holistic clinical care and research disruption. The paralysis of prevention, screening and early diagnosis programs is probably the biggest long-term concern. Since March 2020, all the activity linked to progress over the last few decades has come to a halt. It is, of course, too early to identify the effects, but it is inevitable that they will have marked, if not dramatic, outcomes, ”they conclude:“ The impact COVID-19 pandemic disease may have a truly confirmed mortality 2020, for 2021 and beyond, requires vigilance. ”
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[1] “Predicting European cancer mortality for the year 2021 with a focus on pancreatic and female lung cancer”, by G. Carioli et al. History of Oncology: https: /
[2] Age status levels per 100,000 of the population reflect an annual probability of death.
[3] At the time of this analysis, the EU had 27 member states, with Croatia merging in 2013 and the UK leaving in 2020. However, Cyprus was excluded from the study due to too much missing data. .
[4] The paper contains separate records of cancer mortality rates for each of the six countries.
[5] “Cancer mortality predictions in Europe in 2021: a place for hope under the shadow of COVID-19?” with José M. Martín-Moreno and Suszy Lessof. History of Oncology: https: /