European cancer mortality predictions for 2023 suggest death rates will be 6.5% lower in men and 3.7% lower in women than they were in 2018, but the overall number of deaths is expected to increase as a result of increases in population aging.
The researchers led by Carlo La Vecchia, a professor at the University of Milan, predicted 1,261,990 cancer deaths for 2023 in the European Union (EU), with age-standardized rates of 123.8 deaths per 100,000 men and 79.3 deaths per 100,000 women. In the U.K. the predicted ASRs are 106.5 deaths per 100,000 men and 83.5 deaths per 100,000 women, corresponding to 11.4% and 9.8% reductions relative to 2018.
The study findings are published in the Annals of Oncology and are based on World Health Organization and Eurostat databases for 1970–2018. The researchers made their 2023 predictions for all cancers combined and individually for the 10 most common cancer sites (stomach, intestines, pancreas, lung, breast, uterus [including cervix], ovary, prostate, bladder, and leukemia).
They also looked at data for the five most populous EU countries—France, Germany, Italy, Poland, and Spain—as well as the 27 EU member States as a whole, and carried out a separate analysis for the U.K. This is the thirteenth consecutive year the researchers have published these predictions.
They report that, in the EU, death rates are expected to fall for all cancers in men this year. For women, the rates will fall in all but pancreatic and lung cancer where rates are expected to increase by 3.4% and 1.2%, respectively. In the U.K., favorable ASRs are predicted for all cancers in both sexes.
Lung cancer is predicted to be the leading cause of cancer deaths in both men and women in the EU with rates of 29.8 and 13.6 deaths per 100,000, respectively. This is followed by colorectal (14.7 per 100,000) and prostate (9.5 per 100,000) cancers in men and breast (13.6 per 100,000) and colorectal (8.1 per 100,000) cancers in women. A similar pattern was observed in the UK.
The researchers carried out a more in-depth analysis of lung cancer cases and found that although there will be a 13.8% drop in lung cancer death rates among women in the U.K., the death rate of 16.2 per 100,000 is still higher than among EU women. They suggest that this is because more U.K. women started smoking earlier than those in the EU.
The team also noted that although death rates are predicted to fall in men for all six individual countries assessed, for women they will rise by nearly 14% in France, 5.6% in Italy and 5% in Spain.
Age-stratified analyses showed a decrease of up to 36% in predicted lung cancer mortality rates from among those aged 25 to 64 years, but an increase of approximately 10% in those aged 65 years and older, and consequently a small (0.74%) increase overall.
“This is because women now aged 45 to 65, born in the 1960s and 1970s, have smoked less and stopped earlier than those born in the 1950s, who were in their twenties in the 1970s when smoking among young women was most prevalent,” said co-leader of the research, Professor Eva Negri from the University of Bologna.
Steady declines are predicted for colorectal, breast, prostate, leukemia, stomach in both sexes, and male bladder cancers, but the researchers note that the lack of improvement among U.K. women with colorectal cancer is a worry.
“This is concerning as increases in both incidence and mortality from colorectal cancer in young women have been recorded in the U.K. This can be partly explained by the prevalence of overweight and obesity, and alcohol and tobacco consumption,” said Negri.
The researchers calculated that between 1989 and 2023 more than 5.8 million cancer deaths have been avoided in the EU compared with peak rates in 1988.
La Vecchia said: “If the current trajectory of declining cancer death rates continues, then it is possible there could be a further 35% reduction by 2035. More smokers quitting contribute to these favorable trends. In addition, greater efforts need to be made to control the growing epidemic in overweight, obesity and diabetes, alcohol consumption, and infections, together with improvements in screening, early diagnosis, and treatments.”
He added: “The advances in tobacco control are reflected in the favorable lung cancer trends but more could be done in this respect, particularly among women, as lung cancer death rates continue to rise among them. No deaths from lung cancer have been avoided in women, both in the EU-27 and the U.K., during the period between 1989 and 2023.”
“Pancreatic cancer is also a cause for concern,” Vecchia remarked, “as death rates from this disease will not fall among men and will rise by 3.4% in women in the EU and 3.2% in women in the U.K. Smoking can explain between about a quarter to a third of these deaths, and women, particularly in the middle and older age groups, did not give up smoking as early as men.”
The researchers note that their estimates do take into account the possible impact of the COVID-19 pandemic, including delayed visits and procedures, on mortality rates.
They concluded that “to maintain and improve favorable trends in EU cancer mortality, it is important to continue pursuing tobacco control strategies including uniformly rising cigarette pricing across Europe, and defining birth cohorts beyond which tobacco products will no longer be purchasable.
“Further work on the identification of at-risk populations (also among nonsmokers) for lung cancer screening would make the practice more viable on a larger scale.”