BACKGROUND: Examination of trends in cancer mortality in Europe over the past 30 years has shown that, after long-term rises, age-standardised mortality from most common cancer sites has fallen in the EU since the late 1980s. This study aimed to examine trends in the age-specific and age-standardised cancer mortality rates and numbers of cancer deaths up to 2020 for all cancers and various specific sites for all 15 EU countries, the 10 acceding countries, Bulgaria and Romania (currently applicant countries, along with Turkey), and Iceland, Norway and Switzerland of the four EEA countries. PATIENTS AND METHODS: Mortality rates were modelled as a function of age, calendar period and birth cohort. Birth cohort was calculated as age subtracted from calendar period. RESULTS: As a consequence of the generally decreasing trends in the age-standardised rates, the best estimate is that there will be approximately 1.25 million cancer deaths in 2015, which is almost 130,000 (11%) more deaths than in 2000, but 155,000 (11%) fewer deaths than the 1.4 million projected in 2015 on the basis of demographic changes alone. The increases in the forecast numbers of cancer deaths in 2015 are proportionally larger in males than in females (13% and 10%, respectively) and proportionally larger in the acceding countries than in the current EU member countries (14% and 11%, respectively). CONCLUSIONS: Our forecasts are conservative best estimates of future cancer mortality. There is clearly scope for large improvements in survival, and hence reductions in cancer mortality, in some countries, through eliminating these differences using existing knowledge and treatment regimes.
Trends in mortality from Hodgkin's disease between mid 1950s and the late 1980s have been analysed for 16 western European and seven eastern European countries. In all western countries there were substantial falls in mortality from the late 1960s onwards, for an overall mean decline of 50% in both sexes, although these falls were somewhat larger in Nordic countries (approaching 70% in Denmark and Sweden), and more limited (20 to 30%) in Portugal, Spain and Greece. The reductions in Hodgkin's disease mortality were evident both in younger (under 35) and middle age (35 to 64 years), as well as in children under 15 and, in several countries, in the elderly (above 65), too. They were persistent up to the most recent calendar periods, with no evidence of flattening off. The pattern of trends in Hodgkin's disease mortality was largely different in Eastern Europe. Among seven countries examined, some fall was observed only in Bulgaria and Czechoslovakia, but other countries showed no consistent pattern and there was some increase, too. In absolute terms, the reductions in Hodgkin's disease mortality in Western Europe correspond to the avoidance of over 3,000 deaths per year. This stresses the importance and urgency of improving the availability of currently defined knowledge and resources for treatment of Hodgkin's disease in Eastern Europe.
BACKGROUND: AIDS has shown dramatic increases among women in the last decade; this has facilitated the spread of paediatric AIDS. Incidence rates of AIDS in children are essential for international comparisons at a population level. METHODS: Incidence rates of AIDS 1985-96 by 3-year period in children 100 cases, the steepest rises were seen in the UK (whose rates increased from 0.8/1,000,000 children in 1985-87 to 4.1/1,000,000 in 1994-96), and Spain (from 4.4/1,000,000 to 16.5/1,000,000). In 1985-87, rates were substantially higher in USA (8.3/1,000,000) than in any European country but, in recent years, they have become similar to those of Spain. Very elevated rates were observed in Romania, with incidences of 120.4/1,000,000 in the early 1990s, due to nosocomial HIV transmission. In most countries, 1994-96 rates tended to level off, or decrease. In a few countries (Germany, Greece, Denmark, Austria, and the Netherlands) AIDS incidence rates were
Histograms including age-standardised (0-14 years, world standard) incidence and mortality rates from selected childhood cancers are presented for 21 European cancer registration areas and 24 countries. The overall range of variation in all childhood cancer incidence rates across various cancer registration areas in Europe was around a factor 1.5, with highest rates in Spain, Italy, Sweden and France, and lowest rates in Poland, Hungary, UK, Germany and Yugoslavia. For most single cancer sites, however, the observed pattern is essentially attributable to random variation alone. A clearer pattern, however, emerged with reference to mortality. The overall range of variation, in fact, was around a factor two in both sexes, with highest rates in Bulgaria, Portugal, Hungary, Czechoslovakia and Poland, and the lowest rates in Austria, UK, Germany, The Netherlands and Finland. Trends in mortality from childhood cancers between 1950 and 1989 were also presented. Recent declines were observed for total childhood cancer mortality, leukaemias, kidney cancer (Wilms' tumours), Hodgkin's disease and other lymphomas in most European countries. These declines, however, were generally earlier and larger in northern as compared with southern and, mostly, with eastern European countries. This pattern of trends likely reflects the different adoption and impact of newer efficacious therapies of childhood cancer, and hence, confirms that there is ample scope for further reduction in childhood cancer mortality in several eastern and some southern European countries.