For colorectal cancer the gap between the higher Nordic survival figures and western Europe is also closing, but again the gap between west and east is widening.
Prostate cancer survival trends vary widely, with survival increasing in most countries. Five-year survival increased in the Nordic countries, except Denmark, and there were sharp improvements in France, Germany, Italy, England, Scotland and Wales. Trends were more diverse in eastern Europe, with a rapid increase in Estonia but a decline in Poland and Slovakia. The trends appear mostly to reflect international differences in the use of Prostate-Specific Antigen (PSA) as a diagnostic test, and the increases cannot all be interpreted as a better outcome for men with this cancer.
Professor Coleman said that although European survival trends for all cancers combined were not adjusted for differences in the case-mix between countries, they were remarkably consistent and appeared to offer an overall indicator of the performance of health care systems in each country.
He sounded a warning note for the future on the east-west divide. "The survival trends reflect a substantial and increasing gap in the overall prognosis of cancer between eastern and western Europe. Since all five eastern European countries participating in EUROCARE will probably join the EU in 2004, this raises a major new problem of inequity in health within the EU.
Professor Coleman added that "The wide differences in survival trends are likely to reflect differences in both stage at diagnosis and the availability of and access to health resources, both of which are amenable to intervention. They represent a benchmark f
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Contact: Mary Rice
mary.rice@blueprintpartners.be
45-3252-4163
Federation of European Cancer Societies
25-Sep-2003