EUROCARE-5: Blood Cancer Survival Rates Vary Greatly Across Europe

Data taken from EUROCARE, a large population-based cancer registry in Europe, showed large variations in the survival from several hematologic malignancies across European countries. Specifically, survival trends showed lower survival in Eastern Europe and higher survival in Northern and Central Europe.

These data (abstract LBA1) were presented by Milena Sant, MD, from the Fondazione IRCCS Istituto Nazionale dei Tumori in Milan, Italy, at the 2015 European Cancer Congress in Vienna.

“In general, 5-year relative survival-survival that is adjusted for causes of death other than cancer-increased steadily over time in Europe, particularly in Eastern Europe, for most cancers. However, the most dramatic geographic variations were observed for cancers of the blood where there have been recent advances in treatment, such as chronic myeloid leukemia (CML) and lymphocytic leukemia, non-Hodgkin lymphoma and two of its subtypes (follicular and diffuse large B-cell lymphoma), and multiple myeloma. Hodgkin lymphoma was the exception, with smaller regional variations and a fairly good prognosis in most countries,” said Sant in a prepared statement.

EUROCARE-5 has records from 22 million patients with cancer diagnosed between 1978 and 2007 in 30 European countries and has been reporting results since the late 1990s. In the study, Sant and colleagues analyzed data from more than 10 million people with cancer diagnosed up to 2007 from 29 European countries. They looked at the 5-year relative survival and trends from 1999 to 2007.

Data showed that the 5-year relative survival increased steadily over the course of the study period, with the largest increases in survival occurring for prostate cancer, rectal cancer, and non-Hodgkin lymphoma.

The mean 5-year relative survival for Hodgkin lymphoma was 81%-the highest for all hematologic malignancies-but varied from 79.4% in Ireland and the United Kingdom, to 85% in Northern European countries and 74.3% in Eastern European countries.

However, the researchers found that CML had the greatest geographic variations for relative survival. The mean 5-year survival for CML was 53%; however, in Eastern Europe it was only 33.4% compared with 51% to 58% in the rest of Europe. Specifically, rates were as high as 71.7% in France and as low as 22.1% in Latvia.

Sant and colleagues found fewer variations in survival in those cancers with poor prognosis, such as lung, stomach, ovarian, pancreatic, esophageal, and brain cancers.

Data from EUROCARE-5 was also published in the European Journal of Cancer. These data reported on the overall survival for several cancers in Europe and showed that Denmark, the United Kingdom, and Eastern European countries had lower survival rates than neighboring countries. Five-year relative survival, standardized for age, was 59.6% in Northern Europe, 58% in Central Europe, 54.3% for Southern Europe, 50.1% for Ireland and the United Kingdom, 45% for Eastern Europe, and 50.9% for Denmark.

According to Sant, the variations in survival seen in EUROCARE could be due to a variety of reasons, including differences in biology and behavior of some cancers, and in the screening and diagnosis available for certain cancers. In addition, socioeconomic status, lifestyle, and health differences could also affect survival, she said.

“Results from EUROCARE can help to identify regions of low survival where action is needed to improve patients’ outcomes,” said Sant in a prepared statement. “Population-based survival information is essential for physicians, policymakers, administrators, researchers, and patient organizations who deal with the needs of cancer patients, as well as with the issue of the growing expenditure on healthcare. It is vital to close the gap between the world of research and that of patient advocacy groups in order to improve cancer care.”