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The researchers called on European policymakers to make adequate resources available to fight pancreatic cancer, a disease that is almost always fatal and in which little progress has been made over the past 40 years.
In the latest forecast of cancer deaths in the EU and UK for 2021, published in leading cancer journal Annals of Oncology [1], researchers led by Carlo La Vecchia (MD), professor at the University of Milan (Italy), say that pancreatic death rates are expected to remain roughly stable for men, but continue to rise in women in most cases. from EU countries.
Researchers predict that 42,300 and 5,000 men in the EU and UK, respectively, will die from pancreatic cancer by the end of this year. After adjusting for differences in the age distribution of the population, the age-standardized rate (ANR) of death for males will be 8 per 100,000 and 6.5 per 100,000 in the EU and the UK -United respectively this year. [2]. This represents a 0.8% drop in death rates since 2015. Among women, six per 100,000 are expected to die from the disease in the EU, which represents a 0.6% increase since 2015. In the UK United, five in 100,000 women are expected to die, representing a 4% drop in the death rate.
In contrast, researchers predict that in nine of the ten other major cancers, death rates will decline by 7% in men and 5% in women between 2015 and 2021 in most EU countries and the UK. United.
Professor La Vecchia said: “Among the major cancers, pancreatic cancer is the fourth most common and remains the only one to show no overall decline in death rates over the past three decades in Europe in both sexes. It is important that governments and policymakers provide adequate resources for the prevention, early diagnosis and management of pancreatic cancer in order to improve these trends in the near future.
“If cancer is caught early it is easier to treat successfully, but most cases are advanced by the time of diagnosis. Avoiding smoking and excessive alcohol consumption, controlling weight and therefore diabetes are the main ways we know of to help prevent disease, but they are only part of the cases. New targeted drugs lead to improved treatment, but it is difficult to quantify their potential impact at this time. “
Researchers analyzed cancer death rates in the 27 EU member states [3] as a whole and added the UK so that it can 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, individually, for stomach, intestines, pancreas, lung, breast, uterus (including cervix), ovary, prostate, bladder and leukemia for men and women [4]. This is the eleventh consecutive year that researchers have published these forecasts. Professor La Vecchia and his colleagues collected data on deaths in databases from the World Health Organization and Eurostat from 1970 to 2016.
They predict that there will be a total of 1,443,000 deaths from the ten cancers in the EU (1,267,000) and the UK (176,000) by the end of the year. This corresponds to age-standardized death rates of 130 per 100,000 men (down 7% since 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% since 2015) and 89 per 100,000 women (down 4.5%).
Compared to a peak cancer death rate in 1988, over 4.9 million cancer deaths will be prevented in the EU and over one million deaths averted in the UK during the 33-year period to in 2021. In 2021 alone, 348,000 and 69,000 cancer deaths will be avoided in the EU and UK respectively.
Changes in smoking habits, improved food storage and better treatments are behind many reductions in death rates for cancers such as lung, stomach and breast. However, although lung cancer death rates are declining in men, they continue to rise in women in many countries, reflecting the fact that women tend to start smoking later in the 20th century than men. In the EU, lung cancer death rates are estimated at 32 per 100,000 in men (down 10%), but in women it will be 15 per 100,000 (up 7%) . The UK is different, with lung cancer death rates down 11.5% to 24 per 100,000 men and 5% with a death rate of 19 per 100,000 women.
Co-author, Dr Fabio Levi (MD), Emeritus Professor at the Faculty of Biology and Medicine, University of Lausanne (Switzerland), said: “Lung cancer death rates in men are 25% lower in the UK than in the 27 European countries due to faster and larger decreases in smoking prevalence among UK men. This is also reflected in the lower predicted death rates for all cancers among UK men. In the EU, men stop smoking, albeit later than in the UK, which explains the predicted decline in lung cancer death rates among men in these countries.
“Lung cancer death rates among UK women are higher than those in EU countries and this is reflected in the higher female death rates from all cancers in the UK. However, our forecasts show a favorable downward trend in lung cancer deaths among women in the UK, in contrast to persistent upward trends among women in the EU, where rates could reach 16 or 18 percent. 000 women over the next decade. “
Co-author, Prof. Paolo Boffetta (MD), the Annals 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 remains the second leading cause of death in Europe after cardiovascular illnesses. Although we expect death rates in many cancers to decline this year, the absolute number of deaths from the disease will continue to rise as the population ages. This underlines the growing importance of the problem for public health. Delayed diagnosis and treatment of cancer due to the COVID-19 pandemic may increase the burden of cancer over the next few years.
“The results we report this year are particularly important because they highlight the fact that the trends in pancreatic cancer and lung cancer in women do not show the positive pattern of other major cancers, which underlies the need to continue research and control efforts for these neoplasms. .
“Measures to continue to improve cancer death rates should include stopping smoking, especially among women, controlling overweight and alcohol consumption, optimizing cancer screening and early diagnosis. breast, bowel and – in central and eastern Europe – cervical cancer. Up-to-date data management should be adopted across Europe, especially in Central and Eastern Europe, and vaccinations should be widely available for women in order to eliminate cervical cancer, which is caused by human papillomavirus, and hepatitis B, which is linked to liver cancer. Effective treatment for hepatitis C will also help control liver cancer. “
In an accompanying editorial [5], Professor José Martín-Moreno, University of Valencia, Spain, and Ms Suszy Lessof, European Observatory on Health Systems and Policies, Brussels, Belgium, write that Professor La Vecchia and his colleagues deserve to to be commended for their 11 years of mortality forecasting and that “the key to understanding the past and how to approach the future is data”. They believe that analysis gives hope; however, they highlight the potential problems of COVID-19, as cancer is a “serious risk factor for patients infected with COVID-19, resulting in a higher likelihood of intensive care admission, mechanical ventilation and of mortality ”.
“The positive points [from Prof La Vecchia’s paper] – concrete evidence that there is an effective policy space which, over time, leads to positive results – should not mask the shadow of the COVID-19 pandemic. Its impact on cancer patients (and the fear of that impact) is looming. Beyond the direct harm of this new coronavirus for immunocompromised and particularly vulnerable people, there is the blow to comprehensive clinical care and the interruption of research. Perhaps most worrying in the long term is the paralysis of prevention, screening and early diagnosis programs. Since March 2020, all activity linked to the progress of the last decades has come to an abrupt halt. It is of course too early to characterize the impacts, but it seems inevitable that they will have marked, if not dramatic consequences, ”they write. They conclude: “The possible impact of the COVID-19 pandemic on actual consolidated mortality for 2020, for 2021 and beyond, requires vigilance.”
[1] “Cancer mortality forecasts in Europe for the year 2021 with a focus on pancreatic and lung cancer in women”, by G. Carioli et al. Annals of Oncology: https://doi.org/10.1016/j.annonc.2021.01.006 [2] Age-standardized rates per 100,000 population reflect the annual probability of dying. [3] At the time of this analysis, the EU had 27 Member States, with Croatia joining in 2013 and the UK leaving in 2020. However, Cyprus has been excluded from the analysis due to excessive missing data. . [4] The document contains individual tables of cancer death rates for each of the six countries. [5] “Cancer mortality predictions in Europe in 2021: room for hope in the shadow of COVID-19?” by José M. Martín-Moreno and Suszy Lessof. Annals of Oncology: https://doi.org/10.1016/j.annonc.2021.02.001Source link
