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De Angelis R, Demuru E, Baili P, Troussard X, Katalinic A, Chirlaque Lopez MD, Innos K, Santaquilani M, Blum M, Ventura L, Paapsi K, Galasso R, Guevara M, Randi G, Bettio M, Botta L, Guzzinati S, Dal Maso L, Rossi S. Complete cancer prevalence in Europe in 2020 by disease duration and country (EUROCARE-6): a population-based study. Lancet Oncol 2024; 25:293-307. [PMID: 38307102 DOI: 10.1016/s1470-2045(23)00646-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/23/2023] [Accepted: 12/13/2023] [Indexed: 02/04/2024]
Abstract
BACKGROUND Cancer survivors-people living with and beyond cancer-are a growing population with different health needs depending on prognosis and time since diagnosis. Despite being increasingly necessary, complete information on cancer prevalence is not systematically available in all European countries. We aimed to fill this gap by analysing population-based cancer registry data from the EUROCARE-6 study. METHODS In this population-based study, using incidence and follow-up data up to Jan 1, 2013, from 61 cancer registries, complete and limited-duration prevalence by cancer type, sex, and age were estimated for 29 European countries and the 27 countries in the EU (EU27; represented by 22 member states that contributed registry data) using the completeness index method. We focused on 32 malignant cancers defined according to the third edition of the International Classification of Diseases for Oncology, and only the first primary tumour was considered when estimating the prevalence. Prevalence measures are expressed in terms of absolute number of prevalent cases, crude prevalence proportion (reported as percentage or cases per 100 000 resident people), and age-standardised prevalence proportion based on the European Standard Population 2013. We made projections of cancer prevalence proportions up to Jan 1, 2020, using linear regression. FINDINGS In 2020, 23 711 thousand (95% CI 23 565-23 857) people (5·0% of the population) were estimated to be alive after a cancer diagnosis in Europe, and 22 347 thousand (95% CI 22 210-22 483) in EU27. Cancer survivors were more frequently female (12 818 thousand [95% CI 12 720-12 917]) than male (10 892 thousand [10 785-11 000]). The five leading tumours in female survivors were breast cancer, colorectal cancer, corpus uterine cancer, skin melanoma, and thyroid cancer (crude prevalence proportion from 2270 [95%CI 2248-2292] per 100 000 to 301 [297-305] per 100 000). Prostate cancer, colorectal cancer, urinary bladder cancer, skin melanoma, and kidney cancer were the most common tumours in male survivors (from 1714 [95% CI 1686-1741] per 100 000 to 255 [249-260] per 100 000). The differences in prevalence between countries were large (from 2 to 10 times depending on cancer type), in line with the demographic structure, incidence, and survival patterns. Between 2010 and 2020, the number of prevalent cases increased by 3·5% per year (41% overall), partly due to an ageing population. In 2020, 14 850 thousand (95% CI 14 681-15 018) people were estimated to be alive more than 5 years after diagnosis and 9099 thousand (8909-9288) people were estimated to be alive more than 10 years after diagnosis, representing an increasing proportion of the cancer survivor population. INTERPRETATION Our findings are useful at the country level in Europe to support evidence-based policies to improve the quality of life, care, and rehabilitation of patients with cancer throughout the disease pathway. Future work includes estimating time to cure by stage at diagnosis in prevalent cases. FUNDING European Commission.
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Affiliation(s)
- Roberta De Angelis
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Elena Demuru
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy.
| | - Paolo Baili
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS National Cancer Institute and Foundation, Milan, Italy
| | - Xavier Troussard
- Registre Régional des Hémopathies malignes de Basse-Normandie - Laboratory of Hematology, University Hospital, Caen, France
| | | | | | - Kaire Innos
- National Institute for Health Development - Tervise Arengu Instituut, Tallinn, Estonia
| | | | - Marcel Blum
- Eastern Switzerland Cancer Registry, St Gallen, Switzerland
| | - Leonardo Ventura
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Keiu Paapsi
- National Institute for Health Development - Tervise Arengu Instituut, Tallinn, Estonia
| | | | - Marcela Guevara
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain; Navarre Institute for Health Research, Pamplona, Spain
| | - Giorgia Randi
- European Commission, Joint Research Centre, Ispra, Italy
| | - Manola Bettio
- European Commission, Joint Research Centre, Ispra, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Silvia Rossi
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
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Donat-Vargas C, Sandoval-Insausti H, Peñalvo JL, Moreno Iribas MC, Amiano P, Bes-Rastrollo M, Molina-Montes E, Moreno-Franco B, Agudo A, Mayo CL, Laclaustra M, De La Fuente Arrillaga C, Chirlaque Lopez MD, Sánchez MJ, Martínez-Gonzalez MA, Pilar GC. Olive oil consumption is associated with a lower risk of cardiovascular disease and stroke. Clin Nutr 2021; 41:122-130. [PMID: 34872046 DOI: 10.1016/j.clnu.2021.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/13/2021] [Accepted: 11/03/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND & AIMS The specific association of olive oil consumption with coronary heart disease (CHD) or stroke has not been totally established. OBJECTIVE to examine whether olive oil consumption is associated with subclinical atherosclerosis, the risk of total cardiovascular disease (CVD), CHD, and stroke. METHODS Three cohorts were included: AWHS (2318 men), SUN Project (18,266 men and women), and EPIC-Spain (39,393 men and women). Olive oil consumption was measured at baseline using validated questionnaires. RESULTS In the AWHS, 747 participants had a positive coronary artery calcium score (CACS>0), and the OR (95% CI) was 0.89 (0.72, 1.10) in those with virgin olive oil consumption ≥30 g/day (v. <10 g/day). In the SUN Project (follow-up 10.8 years) 261 total CVD cases occurred, and the HR was 0.57 (0.34, 0.96) for consumptions ≥30 g/day (v. <10 g/day). In the EPIC-Spain (follow-up 22.8 years) 1300 CHD cases and 938 stroke cases occurred; the HRs for stroke according, 0 to <10 (ref), 10 to <20, 20 to <30, and ≥30 g/day of olive oil consumption, were 0.84 (0.70, 1.02), 0.80 (0.66, 0.96), 0.89 (0.74, 1.07). A weaker association was observed for CHD. The association was stronger among those consuming virgin olive oil, instead of common (refined). CONCLUSIONS Olive oil is associated with lower risk of CVD and stroke. The maximum benefit could be obtained with a consumption between 20 and 30 g/day. The association could be stronger for virgin olive oil and might operate from the early stages of the disease.
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Affiliation(s)
- Carolina Donat-Vargas
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Unit of Nutritional and Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - José L Peñalvo
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Maria Concepción Moreno Iribas
- Research Network on Health Services in Chronic Diseases (REDISSEC), Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - Pilar Amiano
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, San Sebastián, Spain; Biodonostia Health Research Institute, Epidemiology and Public Health Area, San Sebastián, Spain.
| | - Maira Bes-Rastrollo
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; CIBEROBN (CIBER of Obesity and Nutrition), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - Esther Molina-Montes
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Department of Nutrition and Food Science, University of Granada, Granada, Spain; Biomedical Research Center, Institute of Nutrition and Food Technology (INYTA) "José Mataix", University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.
| | - Belén Moreno-Franco
- University of Zaragoza, Zaragoza, Spain; CIBERCV and Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain.
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO), And Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain.
| | | | - Martín Laclaustra
- University of Zaragoza, Zaragoza, Spain; CIBERCV and Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain.
| | - Carmen De La Fuente Arrillaga
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; CIBEROBN (CIBER of Obesity and Nutrition), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - Maria Dolores Chirlaque Lopez
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Murcia Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain.
| | - Maria-José Sánchez
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Andalusian School of Public Health (EASP), Granada, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.
| | - Miguel Angel Martínez-Gonzalez
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; CIBEROBN (CIBER of Obesity and Nutrition), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - Guallar-Castillón Pilar
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
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Sant M, Chirlaque Lopez MD, Agresti R, Sánchez Pérez MJ, Holleczek B, Bielska-Lasota M, Dimitrova N, Innos K, Katalinic A, Langseth H, Larrañaga N, Rossi S, Siesling S, Minicozzi P. Survival of women with cancers of breast and genital organs in Europe 1999-2007: Results of the EUROCARE-5 study. Eur J Cancer 2015; 51:2191-2205. [PMID: 26421822 DOI: 10.1016/j.ejca.2015.07.022] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 07/08/2015] [Accepted: 07/20/2015] [Indexed: 01/30/2023]
Abstract
BACKGROUND Survival differences across Europe for patients with cancers of breast, uterus, cervix, ovary, vagina and vulva have been documented by previous EUROCARE studies. In the present EUROCARE-5 study we update survival estimates and investigate changes in country-specific and over time survival, discussing their relationship with incidence and mortality dynamics for cancers for which organised screening programs are ongoing. METHODS We analysed cases archived in over 80 population-based cancer registries in 29 countries grouped into five European regions. We used the cohort approach to estimate 5-year relative survival (RS) for adult (⩾15years) women diagnosed 2000-2007, by age, country and region; and the period approach to estimate time trends (1999-2007) in RS for breast and cervical cancers. RESULTS In 2000-2007, 5-year RS was 57% overall, 82% for women diagnosed with breast, 76% with corpus uteri, 62% with cervical, 38% with ovarian, 40% with vaginal and 62% with vulvar cancer. Survival was low for patients resident in Eastern Europe (34% ovary-74% breast) and Ireland and the United Kingdom [Ireland/UK] (31-79%) and high for those resident in Northern Europe (41-85%) except Denmark. Survival decreased with advancing age: markedly for women with ovarian (71% 15-44years; 20% ⩾75years) and breast (86%; 72%) cancers. Survival for patients with breast and cervical cancers increased from 1999-2001 to 2005-2007, remarkably for those resident in countries with initially low survival. CONCLUSIONS Despite increases over time, survival for women's cancers remained poor in Eastern Europe, likely due to advanced stage at diagnosis and/or suboptimum access to adequate care. Low survival for women living in Ireland/UK and Denmark could indicate late detection, possibly related also to referral delay. Poor survival for ovarian cancer across the continent and over time suggests the need for a major research effort to improve prognosis for this common cancer.
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Affiliation(s)
- Milena Sant
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Maria Dolores Chirlaque Lopez
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Roberto Agresti
- Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Italy
| | - Maria José Sánchez Pérez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitariam, University Hospitals of Granada, Granada, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Magdalena Bielska-Lasota
- Department of Health Promotion and Postgraduate Education, National Institute of Public Health - National Institute of Higiene, Warsaw, Poland
| | - Nadya Dimitrova
- Bulgarian National Cancer Registry, National Hospital of Oncology, Sofia, Bulgaria
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | | | - Hilde Langseth
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Department of Research, Oslo, Norway
| | - Nerea Larrañaga
- Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy
| | - Sabine Siesling
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands; MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Pamela Minicozzi
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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