Combined European cancer statistics have shown the dangers of late diagnosis.
Two articles from the EUROCARE group published in Lancet Oncology compare survival rates by country. In all of the malignancies monitored, men were at greater risk of dying.
Overall, the five-year survival rate for all cancers combined was significantly higher in women (55.8%) compared with that of men (47.3%). Put bluntly, this means that the average European male is more likely to be dead five years after diagnosis while the average European female is likely to still be alive. Men from Eastern Europe and the UK, especially Scotland, fare the worst.
The poor figures from the UK allow Britain’s cancer tsar Mike Richards to suggest a reason for the deficit. In an editorial in the Lancet Oncology, he says ‘Findings from the high-resolution studies indicated that the poor results from the UK were attributable mainly to patients having more advanced disease at diagnosis than patients in other European countries. For policymakers, this conclusion is clearly of great importance, because it indicates that particular emphasis should be put on achieving earlier diagnosis.’
This exactly what organisations like the EMHF and the Men’s Health Forum England have been seeking to draw attention to. The supposition is that the male reluctance to seek medical help may be leading them to present later with serious symptoms.
European men are at bigger risk than US men. Indeed, in the US men (66.3%) have, on the face of it, better five-year survival rates than women (62.9%). However, this is entirely due to the US’s success at treating prostate cancer. As the second of the two papers puts it: ‘when excluding prostate cancer, the survival (of men) decreased to 38.1% in Europe and 46.9% in the USA, so that, in men, over half of the difference in survival between Europe and the USA can be attributed to prostate cancer.’ In other words, if you ignore prostate cancer, there’s a similar survival defecit between US men and women as between European men and women.
Summary of the findings
One article looks at the five-year survival data for 2.7 million adult cancer patients for eight cancer types. Those diagnosed in 1995-1999 were compared to those diagnosed in 1990-1994. The main findings were:
- survival for the four most common cancers (colorectal, lung, breast, and prostate), and for ovarian cancer were highest in Nordic countries (except Denmark) and central Europe, intermediate in southern Europe, lower in the UK and Ireland, and lowest in Eastern Europe.
- countries with high expenditure on health generally had better survival rates (except the UK and Denmark who both had lower survival than countries with similar expenditure). Finland by contrast had high survival but only moderate health expenditure.
A second article estimates survival of patients diagnosed more recently in 2000-02 by country and cancer site. It concludes:
- overall survival has improved for all cancers and for the major cancer sites.
- survival for patients diagnosed in 2000-2 was generally highest in northern Europe, and lowest in eastern Europe. Although patients in eastern Europe had the largest improvement in survival and the gap between East and West is decreasing.
- For all cancers, 5-year survival improved for patients diagnosed in 2000-2. Survival for patients diagnosed with solid tumors was lower in Europe than that reported for patients from the US.
EMHF members can download both articles and the Mike Richards editorial in the Members News section. Log on here.