Cancer survival estimates in Europe highlight notable geographic and economic disparities. The Europe Health Observatory explores potential factors behind differences between countries.
In 2021, cancer was the second leading cause of death in the European Union, with 1.1 million deaths. This represented 21.6 percent of all deaths in the block that year.
Scientists have devoted considerable effort and resources to the search for effective cures for cancer, focusing on advancing treatments and improving early diagnosis.
Cancer survival estimates vary widely by cancer type and country.
Survival refers to the proportion of people diagnosed with cancer who remain alive after a specified period. It is commonly expressed as 1-year and 5-year survival.
The term “survival rate” is widely used, but Professor Michel Coleman, co-principal investigator of the CONCORD core analytical team and professor at the London School of Hygiene and Tropical Medicine, points out that cancer survival estimates are probabilities and not rates.
“A rate is a quantity that depends on time, like an incidence rate or a mortality rate,” he explained.
The Europe Health Observatory examines cancer survival in Europe, exploring the factors contributing to disparities between countries.
Cancer-related mortality in Europe
The data includes 24 EU countries, excluding Greece, Hungary and Luxembourg, and five other European countries: the United Kingdom, Switzerland, Norway, Iceland and Turkey. Comparisons are therefore based on these 29 countries.
Before presenting cancer survival estimates, it is important to look at cancer-related mortality in the EU and the types of cancer to which these deaths are attributed.
According to OECD and Eurostat data from 2019, lung cancer accounted for 24 percent of cancer-related deaths among men and 15 percent among women. Colorectal cancer accounted for 12 percent for both sexes.
Prostate cancer accounted for 10 percent of deaths among men, while breast cancer accounted for 16 percent among women.
Pancreatic cancer accounted for 6 percent of cancer-related deaths among men and 8 percent among women.
As we explain below and show in the table, survival estimates can vary significantly depending on the type of cancer.
We will examine some of the reasons for this phenomenon after examining estimates from 2010 to 2014, based on CONCORD-3 data, published in The Lancet in 2018 by Professor Claudia Allemani, professor of cancer epidemiology, and her colleagues at the London School of Hygiene and Tropical Medicine.
Lung cancer survival in Europe
Lung cancer survival varies widely across Europe, with Bulgaria at the bottom (7.7 percent) and Switzerland and Latvia at the top (20.4 percent), while the average of the EU-24 is 15 percent.
Other countries with notable survival rates include Iceland (20.2 percent), Austria (19.7 percent), Sweden (19.5 percent) and Norway (19 percent). .
At the bottom of the scale, after Bulgaria (7.7 percent), the lowest survival rates are observed in Lithuania (9.9 percent), Croatia (10 percent), Czechia (10. 6 percent) and Romania (11.1 percent).
Among Europe’s five largest economies, Germany leads with a survival rate of 18.3 percent, followed by France (17.3 percent) and Italy (15.9 percent) . However, Spain (13.5 percent) and the United Kingdom (13.3 percent) are below the EU average.
Although the Nordic countries generally perform well, Finland is an exception, with a survival rate of 13 percent.
Colon Cancer Survival in Europe
Colon cancer survival ranged between 51.1 percent in Croatia and 72.1 percent in Cyprus, with the EU-24 average being 60 percent.
The survival rate reached 65 percent or more in six other countries, including four Nordic countries: Iceland (68.2 percent), Belgium (67.9 percent), Switzerland (67.3 percent), Norway ( 66.7 percent) and Sweden and Finland. at 64.9 percent.
At the bottom of the ranking, Slovakia (51.8 percent), Romania (52.2 percent), Bulgaria (52.4 percent) and Poland (52.9 percent) follow Croatia at the bottom. classification.
Among the five largest European economies, Germany had the highest survival rate, at 64.8 percent, while the United Kingdom had the lowest survival rate, at 60 percent.
Prostate cancer survival is high
Survival for prostate cancer is higher than for many other types of cancer.
The EU-24 average stands at 87 percent, with twelve countries achieving survival levels above 90 percent. Cyprus recorded the highest survival rate at 99.2 percent, followed by Lithuania (94.3 percent) and Belgium (93.8 percent).
The lowest survival rate was seen in Bulgaria, at 68.3 percent, while Poland, Romania and Slovakia recorded estimates below 80 percent.
Breast cancer survival is also high
Breast cancer survival is also relatively high, with an average of 82 percent in the EU-24. Cyprus tops the rankings with a survival rate of 92.8 percent, followed closely by four Nordic countries, excluding Denmark.
Among the five largest European economies, the difference in survival is minimal, ranging from 85.2 percent in Spain to 86.7 percent in France.
Lithuania and Romania recorded the lowest survival rate, both below 75 percent.
Survival remains extremely low for pancreatic and liver cancers
Survival for pancreatic and liver cancers in the EU remains very low compared to many other cancers.
For pancreatic cancer, the survival rate varied between 5.5 percent in Malta and 13.7 percent in Latvia, with the EU-24 average being around 9 percent. The UK had the sixth lowest survival rate at 6.8 percent.
Liver cancer survival ranged from 4.2 percent in Estonia to 20.7 percent in Belgium, with an approximate average of 12 percent in the EU-24.
Once again, the UK recorded the lowest survival rate for this type of cancer, at 13 per cent, while Italy ranked second with 20.3 per cent.
Stomach cancer survival is just over one in four people
Survival for stomach cancer is better than that for pancreatic and liver cancers, but it remains relatively low, at just over one in four people (27%) in the EU-24.
The survival rate varied between 16 percent in Bulgaria and 37.5 percent in Belgium. Cyprus, Austria and Germany also reported survival estimates above one in three.
Conversely, survival was 20 percent or less in Denmark and Croatia. The UK ranks fifth, with an estimated survival rate of 20.7 percent.
Survival rate of four in ten people for ovarian cancer
The ovarian cancer survival estimate in the EU-24 averaged 39.2 percent.
Sweden recorded the highest survival rate at 46.5 percent, followed closely by Cyprus, Latvia and Norway, where estimates exceeded 45 percent.
In contrast, Malta and Ireland recorded the lowest survival rates, with figures below a third. Among the top five economies, the United Kingdom had the lowest estimate, at 36.2 percent.
Melanoma cancer survival exceeds 80 percent
Melanoma cancer survival varied widely, from 60.7 percent in Turkey to 93.6 percent in Switzerland, with the EU-24 average being 83 percent.
Besides Germany, Austria and the Netherlands, all Nordic countries reported higher survival rates, exceeding 87 percent.
At the bottom of the scale, Bulgaria and Poland follow Turkey, with survival estimates below 70 percent.
Lymphoma survival hits 60 percent
Survival for lymphoma, a type of blood cancer, was on average 61 percent in the EU-24. Romania and Bulgaria reported the lowest survival rates, below 45 percent, while Switzerland, Latvia and Iceland recorded the highest survival rates, exceeding 71 percent.
Why does survival vary between cancer types?
“They are very different diseases,” said Coleman, a professor of epidemiology, in an interview with L’Observatoire de l’Europe Health.
“Depending on where the cancer occurs and the type of nearby organ, they are more or less fatal depending on the cell type, genetic makeup and nearby organs,” he added.
For example, he noted, a tumor that appears in the brain is more likely to kill someone than a tumor that appears in the foot.
However, the survival gap is not solely due to differences between diseases. Other factors include variations in the availability and progress of treatments, as well as the stage at which the cancer is diagnosed, Coleman said.
“If a cancer is very early and localized, it stands to reason that survival will be better with a given treatment than if survival is very advanced and widespread at the time of diagnosis,” he said.
Why does cancer survival vary significantly between countries?
Regarding differences in survival estimates between countries, Coleman offered two key explanations.
First, they are linked to differences in age at diagnosis, which have a considerable influence on the probability of survival. The stage varies considerably between countries for a given cancer.
Second, the availability and access to different more or less effective treatments also varies between countries.
“For example, radiotherapy, used or significant as a potentially curative treatment for almost half of all cancers, is much more widely available in the wealthier countries of Western and Northern Europe than is the case in the least developed countries in Eastern and, in some cases, Southern Europe,” he said.
Regarding why survival rates are lower in the UK than in Germany and France, Dr Volker Arndt from the German Cancer Research Center (DKFZ) told L’Observatoire de l’Europe Santé : “this difference is likely linked to differences in healthcare capacity and the way the healthcare system is organized, including waiting times.”
Allemani, also a co-principal investigator at CONCORD, emphasized the critical role of treatment availability, noting that while early diagnosis is essential, it is insufficient without access to effective treatment.
She also highlighted the importance of cancer registration in Europe, warning that many registries, particularly in Eastern Europe, are currently under threat.
