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Cited by 161Global Cancer Incidence and ScreeningEconomic and Financial Impacts of CancerCutaneous Melanoma Detection and Management

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What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable?

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Abdel-Rahman, M, Stockton, D, Rachet, B, Hakulinen, T, Coleman, M P·2009·British Journal of Cancer
DOI 10.1038/sj.bjc.6605401PMC PMC2790713
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Abstract

OBJECTIVE: To estimate the number of deaths among cancer patients diagnosed in Great Britain that would be avoidable within 5 years of diagnosis if the mean (or highest) survival in Europe for patients diagnosed during 1985-1989, 1990-1994 and 1995-1999 were achieved. DESIGN: Five-year relative survival for cancers in Great Britain compared with that from other countries in the EUROCARE-2, -3 and -4 studies. Calculation of excess deaths (those more than expected from mortality in the general population) that would be avoidable among cancer patients in Britain if relative survival were the same as in Europe. SETTING: Great Britain (England, Wales, Scotland) and 13 other European countries. SUBJECTS: 2.8 million adults diagnosed in Britain with 1 of 39 cancers during 1985-1989 (followed up to 1994), 1990-1994 (followed up to 1999) and 1995-1999 (followed up to 2003). MAIN OUTCOME MEASURE: Annual number of avoidable deaths within 5 years of diagnosis. Percentage of the excess (cancer-related) deaths among cancer patients that would be avoidable. RESULTS: Compared with the mean European 5-year relative survival, the largest numbers of avoidable deaths for patients diagnosed during 1985-1989 were for cancers of the breast (about 18% of the excess mortality from this cancer, 7541 deaths), prostate (14%, 4285), colon (9%, 4090), stomach (8%, 3483) and lung (2%, 3548). For 1990-1994, the largest numbers of avoidable deaths were for cancers of the prostate (20%, 7335), breast (15%, 6165), colon (9%, 4376), stomach (9%, 3672), lung (2%, 3735) and kidney (22%, 2644). For 1995-1999, most of the avoidable deaths were for cancers of the prostate (17%, 5758), breast (15%, 5475), lung (3%, 4923), colon (10%, 4295), stomach (9%, 3137) and kidney (21%, 2686).Overall, some 6600-7500 premature deaths would have been avoided each year among cancer patients diagnosed in Britain during 1985-1999 if the mean survival in Europe had been achieved. This represents 6-7% of cancer-related mortality. Compared with the highest European survival, avoidable premature mortality among cancer patients fell from about 12 800 deaths a year (12.2% of cancer-related mortality) to about 11 400 deaths a year (10.6%) over the same period.A large component of the avoidable mortality is due to prostate cancer: excluding this cancer from comparison with the European mean survival reduces the annual number of avoidable deaths by 1000-1500, and the percentage of excess mortality by up to 1%. Compared with the highest survival, the annual number of avoidable deaths would be 1500-2000 fewer, and 1-2% lower as a percentage of excess mortality, but the overall trend in avoidable premature mortality among cancer patients would be similar, falling from 11.4% (1985-1989) to 10.3% (1990-1994) and 9.7% for those diagnosed during 1995-1999.For several cancers, survival in Britain was slightly higher than the mean survival in Europe; this represented some 110-180 premature deaths avoided each year during the period 1985-2003. CONCLUSIONS: Avoidable premature mortality among cancer patients diagnosed in Britain during 1985-1999 has represented 6-7% of cancer-related mortality compared with the mean survival in Europe. Compared with the highest levels of survival in Europe, the reduction from 12.2% to 10.6% of cancer-related mortality reflects small but steady progress over the period 1985-2003.

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Figure 1 Partition of the annual number of deaths in cancer patients within 5 years of diagnosis into the number expected from background mortality and the excess deaths (attributable to cancer), showing the proportion of the excess deaths that would be avoidable (27%) if relative survival had reached the higher level seen in a comparator population. Note: numbers are of deaths occurring in cancer patients, not deaths certified as due to the cancer in question (see text).
Figure 1 Partition of the annual number of deaths in cancer patients within 5 years of diagnosis into the number expected from background mortality and the excess deaths (attributable to cancer), showing the proportion of the excess deaths that would be avoidable (27%) if relative survival had reached the higher level seen in a comparator population. Note: numbers are of deaths occurring in cancer patients, not deaths certified as due to the cancer in question (see text).CC BY · PubMed Central
Figure 2 Annual number of deaths within 5 years of diagnosis that would be avoidable among cancer patients in Britain if relative survival were equal to the mean European survival: 22 common cancers, patients diagnosed 1985–1989, 1990–1994, 1995–1999,
Figure 2 Annual number of deaths within 5 years of diagnosis that would be avoidable among cancer patients in Britain if relative survival were equal to the mean European survival: 22 common cancers, patients diagnosed 1985–1989, 1990–1994, 1995–1999,CC BY · PubMed Central
Figure 3 Annual number of deaths within 5 years of diagnosis that would be avoidable among cancer patients in Britain if relative survival were equal to the highest European survival: 22 common cancers, patients diagnosed 1985–1989, 1990–1994, 1995–1999.
Figure 3 Annual number of deaths within 5 years of diagnosis that would be avoidable among cancer patients in Britain if relative survival were equal to the highest European survival: 22 common cancers, patients diagnosed 1985–1989, 1990–1994, 1995–1999.CC BY · PubMed Central

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Research works printed but not linked: 10

  1. Berrino F, Capocaccia R, Coleman MP, Estève J, Gatta G, Hakulinen T, Micheli A, Sant M, Verdecchia A (eds) (2003) EUROCARE-3: the survival of cancer patients diagnosed in Europe during 1990–1994. Ann Oncol 14 (Suppl 5): 1–155
  2. Berrino F, Capocaccia R, Estève J, Gatta G, Hakulinen T, Micheli A, Sant M, Verdecchia A, EUROCARE Working Group (1999a) Survival of Cancer Patients in Europe: the EUROCARE-2 Study (CDROM). International Agency for Research on Cancer (WHO): Lyon
  3. Berrino F, Capocaccia R, Estève J, Gatta G, Hakulinen T, Micheli M, Sant M, Verdecchia A (eds) (1999b) Survival of Cancer Patients in Europe: the EUROCARE-2 Study (IARC Scientific Publications No. 151). International Agency for Research on Cancer: Lyon
  4. Berrino F, Estève J, Coleman MP (1995a) Basic issues in the estimation and comparison of cancer patient survival. In Survival of Cancer Patients in Europe: the EUROCARE Study (IARC Scientific Publications No. 132), Berrino F, Sant M, Verdecchia A, Capocaccia R, Hakulinen T, Estève J (eds), pp 1–14. International Agency for Research on Cancer (WHO): Lyon
  5. Berrino F, Sant M, Verdecchia A, Capocaccia R, Hakulinen T, Estève J (eds) (1995b) Survival of Cancer Patients in Europe: the EUROCARE Study (IARC Scientific Publications No. 132). International Agency for Research on Cancer: Lyon
  6. Carrani E, Roazzi P, Capocaccia R (1999) Organization and use of the EUROCARE-2 compact disk. In Survival of Cancer Patients in Europe: the EUROCARE-2 Study (IARC Scientific Publications No. 151), Berrino F, Capocaccia R, Estève J, Gatta G, Hakulinen T, Micheli M, Sant M, Verdecchia A (eds), pp 569–572. International Agency for Research on Cancer: Lyon
  7. Coleman MP, Babb P, Damiecki P, Grosclaude PC, Honjo S, Jones J, Knerer G, Pitard A, Quinn MJ, Sloggett A, De Stavola BL (1999) Cancer Survival Trends in England and Wales 1971–1995: Deprivation and NHS Region (Studies on Medical and Population Subjects No. 61). The Stationery Office: London
  8. Curado MP, Edwards BK, Shin HR, Storm HH, Ferlay J, Heanue M, Boyle P (eds) (2007) Cancer Incidence in Five Continents. Vol. IX. IARC Scientific Publications No. 160. IARC: Lyon
  9. Micheli A, De Angelis G, Giorgi Rossi A, Capocaccia R (1999) General mortality and the survival of cancer patients in Europe. In Survival of Cancer Patients in Europe: the EUROCARE-2 Study (IARC Scientific Publications No. 151), Berrino F, Capocaccia R, Estève J, Gatta G, Hakulinen T, Micheli A, Sant M, Verdecchia A (eds), pp 63–71. International Agency for Research on Cancer: Lyon
  10. Threlfall AG, Collins S, Woodman CBJ (2001) ‘Avoided deaths’ may not be useful for predicting mortality reductions from cancer. Br Med J 321: 1470

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Metadata

Authors
Abdel-Rahman, M., Stockton, D., Rachet, B., Hakulinen, T., & Coleman, M. P.
Affiliations
  • Cancer Research UK (GB)
  • Finnish Cancer Registry (FI)
Corresponding author
Coleman, M P
ORCID
Venue
British Journal of Cancer
Publisher
Springer Science and Business Media LLC
Published
2009-12
Volume
101
Issue
S2
Pages
S115-S124
ISSN
  • 0007-0920 (ISSN-L)
  • 1532-1827
DOI
10.1038/sj.bjc.6605401
PMC
PMC2790713
OpenAlex
W2153360645
Cited by
160
References
30
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 6 · 2020: 7 · 2019: 4 · 2018: 5 · 2017: 10 · 2016: 13 · 2015: 23 · 2014: 17 · 2013: 21 · 2012: 18
FWCI
7.16
Type
journal article
Language
en
Open access
Licence
Locations
  • British Journal of Cancer (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
Funders
  • London School of Hygiene and Tropical Medicine
  • Cancer Research UK (11700)
Topics
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
  • Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
Keywords
cancer survival, excess mortality, 5-year relative survival, EUROCARE, breast cancer, prostate cancer, colon cancer, gastric cancer, lung cancer, kidney cancer, Great Britain, European comparison, quality of cancer care, cancer treatment costs
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Europe, Female, United Kingdom, Humans, Male, Middle Aged, Neoplasms, Time Factors

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