Mortality is declining throughout Europe

Until the late 1980s few countries in Europe had reliable population-based cancer registries. Consequently mortality was the only available indicator of the cancer burden until recently. From 1950 to the late 1980s breast cancer mortality was constantly on the increase everywhere in Europe, with a few exceptions (Sweden, Norway). This unfavourable trend was reverted in the 1990s, with downturns or at least levelling off of the rates being observed in most European countries by 2004. Since the incidence rates do not generally mirror this downward trend, this decreasing mortality can be attributed to improved access of the population to early diagnosis and optimal treatment.

In 2004, mortality was still on the increase in Latvia, Lithuania, Romania and Greece; and a clear decrease was not yet visible in Poland, Bulgaria and Estonia.

Also see Trends in mortality from breast cancer. ASR (SDR) per 100.000 of the population in selected countries, 1970-2005.

In Eastern Europe cancer (all sites) has become the most common cause of death in women aged 20-64 years, since death rates from cardiovascular diseases began to fall in the 1990s (Zatonski & Didkowska, 2008); in 2002-2003 22% of all female cancer deaths in this region were due to breast cancer (IARC).

Survival depends on the quality of the health system

Most breast cancers detected early can be cured if properly managed. By 2004 the geographic distribution of mortality from breast cancer across Europe appears to be more influenced by differences in the efficacy of the health systems than by differences in the background risk of the disease. In 2004 for example, Austria and Lithuania had the same age-adjusted mortality rates, despite the incidence of breast cancer being 50% greater in Austria. Also see Interventions.

Despite its relatively good prognosis, breast cancer is still the leading cause of cancer death in women in all but three EU-27 countries. In women lung cancer causes more deaths than breast cancer in Denmark, Hungary and the United Kingdom. See the EUphact Lung cancer.

The status of cancer control in Europe has been reviewed under the Slovenian Presidency (Coleman et al., 2008). The report highlights the gap between the EU-15 and the countries of Eastern Europe that joined the EU at a later stage (Zatonski & Didkowska, 2008), showing how disproportionately high cancer mortality is in the new member states.

Also see Estimated incidences, survival rates and trend in mortality of breast cancer throughout Europe (interactive - click on Indicators to select desired topic).