Cancer statistics


Data extracted in October 2016. Most recent data: Further Eurostat information, Main tables and Database. Planned article update: October 2017.

This article presents an overview of European Union (EU) statistics related to cancer and focuses on three aspects: deaths from cancer, cancer healthcare and the availability of specialist healthcare personnel and equipment. Some of the statistics presented in this article are only available for the broader category of neoplasms, which includes benign and uncertain neoplasms as well as malignant ones (cancer). An accompanying article looks in more detail at statistics for a selection of specific cancers: colorectal cancer, lung cancer, breast cancer and prostate cancer.

This article is one of a set of statistical articles concerning health status in the EU which forms part of an online publication on health statistics.

For provision of care, this article concentrates on in-patient care and day care. Both in-patient care and day care comprise a formal admission into a health care facility such as a hospital for diagnosis, treatment or other types of health care. While in-patient care involves an overnight stay after admission, day care comprises planned medical and paramedical services delivered to patients without an overnight stay: day care patients are formally admitted with the intention of being discharged on the same day. The inclusion of accommodation with medical and ancillary care constitutes the main distinction between in-patient and outpatient care.

Table 1: Causes of death — malignant neoplasms, residents, 2013
Source: Eurostat (hlth_cd_aro) and (hlth_cd_asdr2)
Figure 1: Hospital discharge rates for in-patients with neoplasms, 2014 (1)
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_disch2)
Figure 2: In-patient average length of stay for neoplasms, 2009 and 2014 (1)
(days)
Source: Eurostat (hlth_co_inpst)
Table 2: Surgical operations and procedures performed related to cancer, 2009 and 2014
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_proc2)
Table 3: Cancer related healthcare personnel and equipment, 2009 and 2014
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_spec), (hlth_rs_tech) and (hlth_rs_equip)

Main statistical findings

Deaths from cancer

In 2013, more than one and a quarter million people died from cancer in the EU-28, just over one quarter (26.0 %) of the total number of deaths — see Table 1. Cancer accounted for a somewhat higher share (29.3 %) of deaths among men than among women (22.7 %).

Among the EU Member States, the share of deaths from cancer in the total number of deaths exceeded 30.0 % in Slovenia and the Netherlands: among men this share peaked at 35.7 % in Slovenia, while among women at 28.3 % in Ireland. By contrast, 20.0 % of all deaths or less were from cancer in Bulgaria, Lithuania and Romania.

For the EU-28 the standardised death rate for cancer was 265 per 100 000 inhabitants, lower than the rate for circulatory diseases, but higher than the rate for most other causes of death (at a similar level of the International Statistical Classification of Diseases and Related Health Problems (ICD)). An analysis by gender and by age shows large differences in standardised death rates for cancer: for men the rate (355 per 100 000 male inhabitants) was 75 % higher than for women (203 per 100 000 female inhabitants), while the rate for persons aged 65 and over was almost 13 times as high as it was for younger persons (less than 65 years).

EU-28 standardised death rates for men were higher than those for women for colorectal cancer and cancer of the trachea, bronchus and lung (hereafter referred to as lung cancer); this was particularly the case for lung cancer, where the death rate for men was nearly three times as high as that for women. Equally, the standardised death rates for these two types of cancer were much higher for persons aged 65 and over than for younger persons, particularly for colorectal cancer where it was 18 times as high for older people — see the article on specific cancers for more details.

Among the EU Member States, the highest standardised death rates for cancer were recorded in Hungary and Croatia, both with rates over 330 per 100 000 inhabitants in 2013. Cyprus recorded the lowest standardised death rate for cancer among the Member States, 202 per 100 000 inhabitants and also recorded the lowest standardised death rates for cancer for both men and women. For men, the highest standardised death rates for cancer were reported for Hungary, Croatia, Slovakia, the Baltic Member States, Slovenia and Poland, all with rates over 400 per 100 000 inhabitants. For women, the highest standardised death rates for cancer were recorded for Hungary and Denmark, both with rates over 250 per 100 000 inhabitants.

Cancer healthcare

Three sets of data are available for cancer healthcare. These concern the number of discharges of in-patients, the average length of stay for in-patients and the type of operations and procedures performed.

In 2013, there were more than 7.1 million in-patients who were discharged from hospitals in the EU (2013 data for Belgium, 2012 data for the Netherlands; no data for Greece) having been treated for neoplasms.

Austria recorded the highest discharge rate for in-patients with neoplasms

From Figure 1 it can be seen that, for all neoplasms, the highest discharge rate for in-patients was in Austria, where 2.9 thousand in-patients per 100 000 inhabitants were discharged after diagnosis or treatment for neoplasms. In Germany, Hungary, Bulgaria, Romania and Estonia, this rate also exceeded 2.0 thousand per 100 000 inhabitants. Elsewhere the rate ranged from 808 per 100 000 inhabitants in the United Kingdom to 1 938 per 100 000 inhabitants in Lithuania, with Portugal (745 per 100 000 inhabitants), Cyprus and Ireland (737 per 100 000 inhabitants) below this range.

Neoplasms: falling average length of stay for in-patients

In 2014, the average length of stay for in-patients having been classified for the purpose of their treatment or investigation under neoplasms ranged, among those EU Member States for which data are available (see Figure 2), from 4.9 days in Bulgaria to 10.0 days in Ireland and Portugal. A comparison of the data for 2014 with that for 2009 (see Figure 2 for the precise availability) shows an overall downward pattern in the average length of stays for in-patients, with increases recorded only for Malta and Hungary, as well as for Iceland among the non-member countries. The largest reduction in terms of the average number of days was recorded in Bulgaria (1.4 days fewer in 2014 than in 2009).

Table 2 presents data for the frequency (relative to population size) with which a range of operations and procedures were carried out: the selected operations and procedures are used mainly for the diagnosis or treatment of cancer. The most common of these was a colonoscopy (ICD-9-CM codes 45.22–45.25, 45.42 and 45.43). A colonoscopy is a procedure to examine the inside of the colon, whereas a colectomy (codes 45.7 and 45.8) is an operation to remove all or part of the colon.

In 2014, more than half a million operations were performed in the 22 EU Member States with data available to remove part or all (total mastectomy) of a mammary gland (codes 85.20–85.23, 85.33–85.36 and 85.4) to prevent or treat breast cancer.

The least common of the operations and procedures shown in Table 2 was a pulmectomy, an operation to remove part or all of a lung (codes 32.3–32.5; segmental resection of lung, lobectomy of lung and complete pneumonectomy).

Relative to population size, more than 1.0 thousand colonoscopies per 100 000 inhabitants were performed in 2014 in Sweden, Croatia, Luxembourg, the United Kingdom, Ireland, Malta and Belgium (2013 data), exceeding 2.0 thousand per 100 000 inhabitants in France and peaking at 2.5 thousand per 100 000 inhabitants in Denmark. Fewer than 100 colonoscopies per 100 000 inhabitants were performed in Finland and Hungary. Cyprus recorded the lowest frequency of colectomies (20 per 100 000 inhabitants), while Germany reported 111 colectomies per 100 000 inhabitants, with Denmark, Croatia, Hungary and Austria also reporting relatively high rates. Germany reported also the highest frequency of pulmectomies, with 40 of these operations per 100 000 inhabitants, followed by Hungary with 27 pulmectomies per 100 000 inhabitants. In six EU Member States, this procedure was performed 10 or fewer times per 100 000 inhabitants, with the lowest frequencies reported by Cyprus, Malta and most notably Finland. Partial or total mastectomies were most commonly performed in Belgium (2013 data), while Denmark and Italy recorded also 150 or more of these procedures per 100 000 inhabitants. Cyprus recorded the lowest frequency for this procedure, with 37 partial or total mastectomies per 100 000 inhabitants.

Broad increase in the frequency (relative to population) in operations and procedures

Between 2009 and 2014 most EU Member States (subject to data availability) reported increases in the frequency with which the operations and procedures shown in Table 2 were performed. The most rapid increases were normally reported for colonoscopies, with increases of 25 % or more in Lithuania (between 2010 and 2014), Romania, Finland, Denmark, Sweden and the United Kingdom; only Slovenia reported fall in frequency (relative to population size).

For pulmectomies, particularly large increases were reported by Cyprus (note that there is a break in series in Cypriot data for all types of operations and procedures shown in Table 2), Spain, the United Kingdom, Romania and Ireland in contrast to decreases in France, Slovenia and Hungary. For colectomies, the largest increase in frequency of operations and procedures was reported by Cyprus and increases between 10 and 25 % were observed in Spain, Denmark, Finland, Lithuania (between 2010 and 2014) and Romania, whereas around half of the EU Member States with data available recorded decreases in the frequency of these operations.

For partial or total mastectomies, more than half of the EU Member States for which data are available reported increases in the frequency of these operations while around one third reported decreases: the largest increases were reported by Cyprus and Slovenia and the largest decreases by Luxembourg, Denmark, Germany, Austria and Romania.

Healthcare personnel and equipment

Oncologists are doctors specialising in the diagnosis or treatment of cancer, for example through medical practices such as radiation therapy or through surgery. In 2014, there were around 18 000 oncologists in the Member States for which data were available (2013 data for the Czech Republic and Denmark, 2012 data for Sweden; no data for Croatia, Hungary, the Netherlands and Slovakia).

Among the six largest EU Member States (Germany, France, the United Kingdom, Italy, Spain and Poland) the number of oncologists ranged from 896 in France to 4 447 in Italy, equivalent to 1 oncologist per 100 000 inhabitants in France and to 7 oncologists per 100 000 inhabitants in Italy (see Table 3). Among the Member States for which data are available (see Table 3), only Italy reported a fall in the number of oncologists relative to its number of inhabitants between 2009 and 2014. An increase of 2 oncologists per 100 000 inhabitants was recorded for Bulgaria, Estonia, Ireland and Poland, and 4 oncologists per 100 000 inhabitants in Belgium (note that there was a break in series in Estonian and Irish data).

Oncological day care involves treatments that do not require an overnight stay, for example day case chemotherapy, blood and platelet transfusions, tests, removal of sutures (stitches), injections and dressings. Although only a limited amount of data are available (see Table 3 for data availability; note that data are not available for the majority of the EU Member States), the range in availability of day care places in 2014 was large, from 0.4 places per 100 000 inhabitants in Slovakia to more than 10 places per 100 000 inhabitants in Spain and Belgium.

Radiation therapy equipment covers machines used for treatment with x-rays or radionuclides. These include linear accelerators, Cobalt-60 units, Caesium-137 therapy units, low to orthovoltage x-ray units, high dose and low dose rate brachytherapy units and conventional brachytherapy units: note that some of these machines may also be used for treatments other than cancer. In 2014, there were almost 3 100 radiation therapy units in the EU Member States for which data are available (2013 data for Belgium, Greece, Italy and Hungary; 2015 data for Sweden; no data for the Netherlands; note that data for Belgium, Germany, France, Portugal and Sweden refers only to equipment in hospitals), with the largest number in France (679). Relative to population size, radiation therapy equipment was most common in Belgium, Denmark and Slovakia, while it was least common in Poland, Romania, Estonia, Latvia, and Portugal.

Data sources and availability

Key concepts

An in-patient or day care patient is discharged from hospital when formally released after a procedure or course of treatment (episode of care). A discharge may occur because of the finalisation of treatment, signing out against medical advice, transfer to another healthcare institution, or because of death.

The number of deaths from a particular cause of death can be expressed relative to the size of the population. A standardised (rather than crude) death rate can be compiled which is independent of the age and sex structure of a population: this is done as most causes of death vary significantly by age and according to sex and the standardisation facilitates comparisons of rates over time and between countries.

Causes of death

Statistics on causes of death provide information on mortality patterns, supplying information on developments over time in the underlying causes of death. This source is documented in more detail in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.

Causes of death are classified according to the European shortlist (86 causes), which is based on the International Statistical Classification of Diseases and Related Health Problems (ICD). Chapter II of the ICD covers neoplasms:

  • C00–C97 Malignant neoplasms;
  • D00–D09 In situ neoplasms;
  • D10–D36 Benign neoplasms;
  • D37–D48 Neoplasms of uncertain or unknown behaviour.

For country specific notes on this data collection, please refer to this background information document.

Healthcare resources and activities

For hospital discharges and the length of stay in hospitals, the International Shortlist for Hospital Morbidity Tabulation (ISHMT) is used to classify data from 2000 onwards; Chapter II covers neoplasms:

  • Malignant neoplasm of colon, rectum and anus (0201);
  • Malignant neoplasms of trachea, bronchus and lung (0202);
  • Malignant neoplasms of skin (0203);
  • Malignant neoplasm of breast (0204);
  • Malignant neoplasm of uterus (0205);
  • Malignant neoplasm of ovary (0206);
  • Malignant neoplasm of prostate (0207);
  • Malignant neoplasm of bladder (0208);
  • Other malignant neoplasms (0209);
  • Carcinoma in situ (0210);
  • Benign neoplasm of colon, rectum and anus (0211);
  • Leiomyoma of uterus (0212);
  • Other benign neoplasms and neoplasms of uncertain or unknown behaviour (0213).

For country specific notes on this data collection, please refer to this background information document.

Statistics on healthcare resources (such as personnel and medical equipment) and healthcare activities (such as information on surgical operations and procedures and hospital discharges) are documented in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.

For surgical operations and procedures the International Classification of Diseases — clinical modification (ICD-9-CM) is used:

  • Pulmectomy (32.3–32.5);
  • Colonoscopy (45.22–45.25, 45.42 and 45.43);
  • Colectomy (45.7 and 45.8);
  • Partial excision of a mammary gland (85.20–85.23);
  • Total mastectomy (85.33–85.36 and 85.4).

For country specific notes on this data collection, please refer to this background information document.

Context

Although significant advances have been made in the fight against this group of diseases, cancer remains a key public health concern and a tremendous burden on EU societies — it is the second largest cause of death in the EU-28. The ambitious goal set by the European Commission Communication on Action Against Cancer: European Partnership (adopted in June 2009) is to reduce cancer incidence by 15 % by 2020.

By way of Decision 2014/C 167/05, the European Commission established an expert group on Cancer Control with the following aims to: assist the European Commission in the drawing up of legal instruments and policy documents, guidelines and recommendations on cancer control; advise in the implementation, monitoring, evaluation and dissemination of the results of EU and national measures and on international cooperation; facilitate coordination and exchange of information between EU Member States; provide an overview of EU and national policies; gather information about relevant experience, policies and practices of the Member States and other parties.

CanCon — short for cancer control — is a joint action initiative, co-funded by participating organisations, institutes, universities and health care units, and the EU. CanCon aims to develop a European Guide on Quality Improvement in Comprehensive Cancer Control.

See also

Online publications

Health status — selected diseases and related health problems

Causes of death

Healthcare activities

Methodology

General health statistics articles

Further Eurostat information

Publications

Main tables

Database

Health care resources (hlth_res)
Health care staff (hlth_staff)
Health care facilities (hlth_facil)
Health care activities (hlth_act)
Hospital discharges and length of stay for inpatient and curative care (hlth_co_dischls)
Hospital discharges - National data (hlth_hosd)
Length of stay in hospital (hlth_hostay)
Operations, procedures and treatment (hlth_oper)
General mortality (hlth_cd_gmor)
Causes of death - Deaths by country of residence and occurrence (hlth_cd_aro)
Causes of death — Standardised death rate by residence (hlth_cd_asdr2)

Dedicated section

Methodology / Metadata

Source data for tables and figures (MS Excel)

External links