Dr Jesme Baird The Roy Castle Lung Cancer Foundation, UK and ECPC. 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 2020 Cases Deaths Cases Deaths M 1,652,283 1,090,198 1,859,910 1,241,860 F 1,405,617 803,250 1,504,990 880,531 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 Females Globocan 2002

Cancer deaths attributed to various factors Percentage of all cancer deaths Factor or class of factors Range of acceptable estimates Best estimate Tobacco 30 25 - 40 Alcohol 3 2 - 4 Diet 35 10 - 70 Food aditives <1 -5 - 2 Reproductive and sexual 7 1 - 13 behaviour Occupation 4 2 - 8 Pollution 2 1 - 5 Industrial products <1 <1 - 5 Medicines and m. procedures 1 0.5 - 3 Geophysical factors 3 2 - 4 Infection 10? 1 - ? Unknown ? Doll and Peto 1981

North-Western and Central-Eastern Europe Tudi znotraj Evrope so razlike v incidenci in umrljivosti

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 2002

Mortality from cancer in Europe: females 2002 North-Western Europe Central-Eastern Europe Globocan 2002

Trends in cancer mortality (ASR) in EU Over the last two decades, trends in mortality were systematically less favourable in new than old EU member states. Most of the unfavourable trends are due to recognised and hence potentially avoidable causes of cancer, including tobacco, alcohol, dietary habits, pollution + inadequate screening, diagnosis and treatment – application of available knowledge.. WHO HFA DB 2005

Most common cancer sites: estimated new cases in males, Europe 2002 Central-Eastern Europe North-Western Europe Globocan 2002

Most common cancer sites: estimated deaths in males, Europe 2002 North-Western Europe Central-Eastern Europe Globocan 2002

Most common cancer sites: estimated new cases in females, Europe 2002 North-Western Europe Central-Eastern Europe Globocan 2002

Most common cancer sites: estimated deaths in females, Europe 2002 North-Western Europe Central-Eastern Europe Globocan 2002

Trends in mortality from lung cancer (ASR) in males in selected European countries In general, the epidemic of mortality in men appears to have peaked and changed into regression. WHO HFA DB

Trends in mortality from lung cancer (ASR) in females in selected European countries For women the patterns are different and the outlook is rather alarming. In the majority of european countriestrends are still rising in all age groups, so that the mortality epidemic can be expected to accelerate. 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 The observed RR ranges from 20 for lung cancer to two-three fold increased risk 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 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 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