Wednesday , March 3 2021

Investment is needed to reduce pancreatic cancer deaths in Europe



Researchers have called on European policymakers to devote adequate resources to the fight against pancreatic cancer, an almost invariably fatal disease in which little progress has been made over the past 40 years.

The latest cancer death predictions in the EU and the UK for 2021, published in a leading cancer magazine Yearbooks of oncology [1]According to researchers led by Carlo La Vecchia (MD), a professor at the University of Milan (Italy), pancreatic mortality is projected to remain roughly stable in men, but to increase further in women in most EU countries.

Researchers predict that 42,300 and 5,000 men in the EU and the UK will die of pancreatic cancer by the end of this year. After adjusting for age differences in the population, the standard age for men (ASR) for men is eight / 100,000 and 6.5 / 100,000 in the EU and the United Kingdom this year. [2]. This represents a 0.8% decrease in mortality from 2015. Women are projected to die from 100,000 deaths in the EU, an increase of 0.6% from 2015. In the United Kingdom, five women are projected to die per 100,000. which means a 4 percent decrease in mortality.

In contrast, researchers predict that in nine out of ten other major cancers, mortality will fall by 7% in men and 5% in women between 2015 and 2021 in most EU countries and the UK.

Professor La Vecchia said: “Pancreatic cancer is the fourth most common cancer and still the only one that has not reduced deaths in both sexes in Europe over the last three decades. It is important that governments and decision-makers provide adequate resources for pancreatic cancer prevention, early diagnosis and treatment. in the near future.

“If cancer is detected early, it is easier to treat it successfully, but most cases have progressed at the time of diagnosis. Avoiding smoking and excessive alcohol consumption, weight management and thus diabetes are the main means by which we can prevent the disease, but they are only part of the cases. New targeted drugs will improve treatment to some extent, but their potential impact is difficult to assess at this time. “

Researchers analyze cancer deaths in the 27 EU Member States [3] as a whole and added the United Kingdom in order to be able to compare with previous years when the United Kingdom was still a member of the EU. They also looked at the six most populous countries – France, Germany, Italy, Poland, Spain and the United Kingdom – for all cancers and separately for the abdomen, intestine, pancreas, lungs, breast, uterus (including cervix), ovaries. prostate, bladder and leukemias in men and women [4]. This is the eleventh consecutive year that scientists have published these predictions. Prof. La Vecchia and his colleagues collected data on deaths from World Health Organization and Eurostat databases from 1970-2016.

They predict that a total of 1,443,000 people will die from the ten cancers in the EU (1,267,000) and the UK (176,000) by the end of the year. This corresponds to age-standardized deaths of 130 / 100,000 men (7% less than in 2015) and 81 / 100,000 women (down 5%) in the EU. In the UK, the mortality rate is 114 / 100,000 men (down 7.5% from 2015) and 89 / 100,000 women (down 4.5%).

Compared to the peak of cancer deaths in 1988, more than 4.9 million cancer deaths will be avoided in the EU and more than one million deaths will be avoided in the United Kingdom in 33 years until 2021. In 2021 alone, 348,000 and 69,000 cancer deaths will be avoided in the EU and the UK.

Changes in smoking patterns, better food supplies, and better treatments are leading to reduced mortality from many cancers, such as lung, stomach, and breast. Although lung cancer deaths in men are declining, women are still on the rise in many countries, reflecting the fact that women tend to smoke later in the 20th century than men. In the EU, lung cancer deaths are estimated at 32 / 100,000 in men (down 10%), but in women at 15 / 100,000 (up 7%). In the UK, it is different: lung cancer deaths fell by 11.5% in 24 per 100.00 men and a 5% mortality rate by 19 per 100,000 women.

The author, Dr Fabio Levi (MD), professor emeritus from the Faculty of Biology and Medicine at the University of Lausanne (Switzerland), said: In the EU, men quit smoking, albeit later than in the UK, which explains the projected decline in male lung cancer mortality in these countries.

“The lung cancer mortality rate in the UK is higher than in EU countries, and this is reflected in the higher mortality rates for all women with all cancers in the UK. However, our forecasts show a favorable downward trend in lung cancer deaths in women in the UK, in contrast to the continued upward trend in women in the EU, where the percentage could rise to 16 or 18 per 100,000 women over the next decade. “

Author, Professor Paolo Boffetta (MD) Yearbooks of oncology assistant editor in epidemiology. Professor and Deputy Director of Stony Brook University in New York (USA) and Professor at the University of Bologna (Italy) have said: “Cancer remains the second leading cause of death in Europe after cardiovascular disease. Although we predict that many cancer deaths will decrease this year, the absolute number of deaths from the disease will continue to rise due to an aging population. This underlines the growing importance of public health in the issue. Delayed cancer diagnosis and treatment caused by the COVID-19 pandemic may increase the burden of cancer in the coming years.

“The results we report this year are particularly important because they highlight the fact that trends in pancreatic cancer and female lung cancer mortality do not show a positive pattern for other major cancers, which is a need for further research and management of these tumors.

“Measures to improve cancer deaths should include smoking cessation, especially in women, management of overweight and alcohol consumption, screening and breast cancer, and optimization of early diagnosis of cervical cancer in Central and Eastern Europe. Up-to-date information management needs to be introduced across Europe, especially in Central and Eastern Europe. , and vaccinations should be widely available to women with cervical cancer caused by human papillomavirus and hepatitis B, which is linked to liver cancer. Effective treatment of hepatitis C also helps control liver cancer. “

Supplied delivery [5]Professor José Martín-Moreno from the University of Valencia in Spain and Suszy Lessof from the European Observatory on Health Systems and Policies in Brussels, Belgium write that Professor La Vecchia and his colleagues are to be commended for their 11 years. mortality predictions and that “the key to understanding the past and approaching the future is knowledge”. They believe that the analysis gives cause for hope; However, they highlight the potential problems with COVID-19 because cancer is “a serious risk factor for COVID-19-infected patients because of its greater likelihood of ICU access, mechanical ventilation, and mortality.”

“Positive [from Prof La Vecchia’s paper] – the existence of practical evidence for effective action that will lead to positive results over time should not obscure the shadow of the COVID-19 pandemic. Its impact on cancer patients (and the fear of this effect) is coming. In addition to the immediate disadvantage of this new coronavirus, immunocompromised and particularly vulnerable people will have a blow to comprehensive clinical treatment and research discontinuation. Perhaps the most worrying in the long run is paralysis of prevention programs, screening, and early diagnosis. Since March 2020, all progress on progress in recent decades has stalled. Characterizing the effects is, of course, too early, but it seems inevitable that they will have significant, if not dramatic, consequences, ”they write. “

[1] “European Cancer Mortality Predictions for 2021 Focusing on Pancreatic and Female Lung Cancer,” G. Carioli et al. Yearbooks of oncology: https://doi.org/10.1016/j.annonc.2021.01.006

[2] The age-standardized percentages per 100,000 population correspond to the annual probability of death.

[3] At the time of this analysis, the EU had 27 Member States, of which Croatia joined in 2013 and the United Kingdom withdrew in 2020. However, Cyprus was excluded from the analysis due to insufficient data.

[4] The paper includes separate tables on cancer deaths in each of the six countries.

[5] “Forecasts of cancer mortality in Europe in 2021: is there room for hope in the shadow of COVID-19?” by José M. Martín-Moreno and Suszy Lessof. Yearbooks of oncology: https://doi.org/10.1016/j.annonc.2021.02.001


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