Iceland has highest rates of cure of cancer and Poland has lowest, study shows

BMJ 2009; 338 doi: (Published 27 March 2009) Cite this as: BMJ 2009;338:b1262
  1. Roger Dobson
  1. 1Abergavenny

    The number of patients considered cured of cancer in Europe is rising, but there are wide geographical differences, a study has shown.

    Data from a long running study of cancer survival in Europe show that the number of people estimated to be cured, rather than surviving for at least five years after diagnosis, is steadily increasing (European Journal of Cancer 2009:45:901-1094).

    The researchers define cured as a patient who has been treated successfully for cancer and who has a life expectancy equal to that of the rest of the population of the same sex and age.

    The proportion of patients estimated to be cured of lung, stomach, and colorectal cancers increased from 6% to 8%, 15% to 18%, and 42% to 49% between 1988-1990 and 1997-1999, analysed in the EUROCARE-4 (European Cancer Registry Based Study on Survival and Care of Cancer Patients) working group study.

    “Increases in the estimated proportion of European patients cured of lung, stomach, and colorectal cancers are noteworthy. The proportion cured is not affected by lead time—earlier diagnosis without improvement in life expectancy—so these trends suggest genuine progress in cancer control,” says Riccardo Capocaccia of the National Centre for Epidemiology, Surveillance, and Health Promotion in Rome and guest editor of the EUROCARE-4 special issue of the journal.

    For all cancers combined, the highest cure rates were in Iceland (47%) for men, and France and Finland (59%) for women. In Poland the least men (21%) and women (38%) were cured.

    “Geographic variation in the estimated proportion of patients diagnosed in 1988-1999 who were cured ranged from about 4% to 10% for lung cancer, from 9% to 27% for stomach cancer, from 25% to 49% for colon and rectum cancer, and from 55% to 73% for breast cancer,” says Dr Capocaccia.

    Denmark, the Czech Republic, and Poland had the lowest proportion of patients cured of lung cancer (less than 5%), and France and Spain had the highest (more than 10%). For colorectal cancer, less than 30% were cured in Poland, the Czech Republic, and Slovenia but 49% were cured in France. In Finland, France, Spain, and Sweden about 73% of patients were cured of breast cancer, but the proportion was less than 60% in Czech Republic, Poland, and Slovenia.

    Results also show that survival of elderly people (70-99 years) was lower than for middle aged patients (55-69 years). Differences in survival between the oldest and middle aged patients were mainly concentrated in the first year after diagnosis.

    Results show too that age adjusted relative survival after five years was more in women than men for 21 out of 26 types of cancer for which survival was estimated in both sexes. Women had significantly lower survival only for cancers of the biliary tract, bladder, and larynx.

    For all cancers combined, and after adjustment for age and the different patterns of cancer in each sex, women had a two percentage point overall advantage in five year survival (52% v 50%). The survival advantage for women younger than 64 was four percentage points.

    In children, adolescents, and young adults, survival for five years for all cancers combined was 81% in children (0-14 years) and 87% in adolescents and young adults (15-24 years). From 1995-1999 to 2000-2002, the risk of death within five years of diagnosis fell significantly for young patients, by 8% in children and 13% in adolescents and young adults.


    Cite this as: BMJ 2009;338:b1262

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