Cancer statistics

Data extracted in November 2019.

Planned article update: November 2020.

Highlights

In 2016, 1.3 million people died from cancer in the EU, more than one quarter (26.0 %) of the total number of deaths.

In 2016, among the EU Member States, the highest standardised death rates for cancer were recorded in Hungary and Croatia, each with rates of at least 330 per 100 000 inhabitants.

In-patient average length of stay for neoplasms, 2017

This article presents an overview of statistics related to cancer in the European Union (EU) and focuses on three aspects: deaths from cancer, cancer healthcare and the availability of specialist healthcare personnel and equipment for the treatment of cancer. 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, Cancer statistics — specific cancers, 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.

Full article

Deaths from cancer

In 2016, 1.3 million people died from cancer in the EU-28, which equated to more than one quarter (26.0 %) of the total number of deaths — see Table 1. Cancer accounted for a somewhat higher share (29.2 %) of deaths among men than among women (22.9 %).

Table 1: Causes of death — malignant neoplasms, residents, 2016
Source: Eurostat (hlth_cd_aro) and (hlth_cd_asdr2)

Among the EU Member States, the share of deaths from cancer in the total number of deaths in 2016 reached or exceeded 30.0 % in Denmark, the Netherlands and Slovenia: among men this share peaked at 36.7 % in Slovenia and 34.4 % in the Netherlands, while among women it peaked at 29.0 % in Ireland and 28.7 % in Denmark. By contrast, less than one fifth of all deaths in Bulgaria were caused by cancer.

For the EU-28, the standardised death rate for cancer was 259.5 per 100 000 inhabitants in 2016, 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 (343.3 per 100 000 male inhabitants) was 71 % higher than that for women (200.5 per 100 000 female inhabitants), while the rate for persons aged 65 years and over was 13 times as high as it was for younger persons (those aged less than 65 years).

Among the EU Member States, the highest standardised death rates for cancer were recorded in Hungary and Croatia, each with rates of at least 330 per 100 000 inhabitants in 2016. Cyprus recorded the lowest standardised death rate for cancer among the Member States, 193.7 per 100 000 inhabitants and also recorded the lowest standardised death rates for cancer for men (254.7 per 100 000 male inhabitants) and for women (145.6 per 100 000 female inhabitants). For men, the highest standardised death rates for cancer were reported in Hungary, Croatia, Latvia, Slovakia and Estonia, all with rates close to or above 450 per 100 000 male inhabitants. For women, the highest standardised death rates for cancer were recorded in Hungary and Denmark, both with rates over 250 per 100 000 female 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.

Concerning the 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.

In 2017, there were around 7.1 million in-patients who were discharged from hospitals in the EU-28 (2016 data for Denmark, Luxembourg and the United Kingdom; 2015 data for Portugal; no recent 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 in 2017 after diagnosis or treatment for neoplasms. In Germany, Bulgaria, Hungary, Estonia and Croatia, this rate also exceeded 2 000 per 100 000 inhabitants. Elsewhere the rate ranged from 964 per 100 000 inhabitants in Denmark (2016 data) to 1 989 per 100 000 inhabitants in Romania, with the United Kingdom (2016 data), Portugal (2015 data), Cyprus, Ireland and Malta below this range.

Figure 1: Hospital discharge rates for in-patients with neoplasms, 2017
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_disch2)

Neoplasms: falling average length of stay for in-patients

In 2017, the average length of stay for in-patients having been classified for the purpose of their treatment or investigation under neoplasms ranged among the EU Member States from 4.9 days in Bulgaria to 10.1 days in Portugal (2015 data) and 10.2 days in Malta (no recent data for Greece). A comparison of the data for 2017 with that for 2012 (see Figure 2 for the precise availability) shows an overall downward pattern in the average length of stays for in-patients, with increases only being recorded for Malta, Cyprus, Spain and Austria, while there was no change in the average length of stay in Portugal (2012-2015) and the United Kingdom (2012-2016); increases were also recorded for Serbia (2014-2017) and Turkey (2011-2016) among the non-member countries shown in Figure 2. The largest reductions in terms of the average number of days were recorded in Croatia and Slovenia (respectively 1.6 and 1.7 days fewer in 2017 than in 2012).

Figure 2: In-patient average length of stay for neoplasms, 2012 and 2017
(days)
Source: Eurostat (hlth_co_inpst)

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 2017, more than half a million operations were performed in the 24 EU Member States with data available (2016 data for Denmark, 2015 data for Spain and Portugal, 2014 data for the Netherlands, no or incomplete data for Czechia, Greece, Latvia and Slovakia) 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).

Table 2: Surgical operations and procedures performed related to cancer, 2010, 2012, 2015 and 2017
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_proc2)

Relative to population size, more than 1 000 colonoscopies per 100 000 inhabitants were performed in 2015 in Sweden, Luxembourg, the United Kingdom, Ireland, Malta and Belgium (2014 data), exceeding two thousand per 100 000 inhabitants in Croatia and France (2014 data) and peaking at 2 900 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 (18.6 per 100 000 inhabitants) in 2015, while the highest ratio was recorded in Germany (107.7 colectomies per 100 000 inhabitants), with Denmark, Hungary and Austria also reporting relatively high rates. Germany also reported the highest frequency of pulmectomies, with 39.1 of these operations per 100 000 inhabitants in 2015, followed by Hungary (26.1 pulmectomies per 100 000 inhabitants). In five of the EU Member States for which data are available, this procedure was performed fewer than 10 times per 100 000 inhabitants, with these relatively low frequencies reported in Sweden, Slovenia, Malta, Cyprus and most notably Finland.

In 2017, partial or total mastectomies were most commonly performed in Belgium, the only EU Member State to record in excess of 200 of these procedures per 100 000 inhabitants, while the next highest rates were just under 150 per 100 000 inhabitants in Italy and Denmark (2016 data). Poland, Cyprus and Romania recorded the lowest frequency for these procedures, with less than 60 partial or total mastectomies per 100 000 inhabitants in 2017.

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

Between 2010 and 2015, most EU Member States (subject to data availability) reported increases in the frequency with which colonoscopies, colectomies and pulmectomies were performed (Table 2). The most rapid increases were normally reported for colonoscopies, with increases between 30 % and 110 % in Croatia (2012-2015), Lithuania, Romania, Finland, Denmark, Malta (2012-2015) and the United Kingdom; only Slovenia and Italy reported falls in the frequency (relative to population size) with which colonoscopies were performed.

For colectomies, the largest increase in frequency of operations and procedures was reported by Cyprus (note that there is a break in series) and increases between 10 % and 30 % were observed in Romania, Malta (2012-2015), Finland, Denmark, Lithuania Spain and Ireland, whereas around half of the EU Member States with data available recorded decreases in the frequency of these operations, most notably in Luxembourg (2012-2015).

For pulmectomies, particularly large increases in the rate at which this procedure was performed were reported by Croatia (2012-2015), Spain, Romania, Luxembourg (2012-2015), Ireland, the United Kingdom and Lithuania in contrast to decreases in France (2010-2014, note that there is a change in definition), Slovenia, Finland and Malta (2012-2015).

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 between 2012 and 2017: the largest increases were reported by Belgium (up 43.6 %), Cyprus (up 43.5 % between 2013 and 2017), Croatia (up 40.2 %) and Slovenia (up 38.2 %), while the decreases were all relatively small, the biggest being recorded in Sweden (down 10.8 %).

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 2015, there were around 18 200 oncologists in the EU Member States for which data were available (2014 data for Denmark, Finland and Sweden, 2013 data for Czechia; no recent data for Croatia, Hungary, the Netherlands, Austria and Slovakia).

Table 3: Cancer related healthcare personnel and equipment, 2010, 2012, 2015 and 2017
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_spec), (hlth_rs_tech) and (hlth_rs_equip)

Among the six largest EU Member States (Germany, France, the United Kingdom, Italy, Spain and Poland), the number of oncologists in 2016 ranged from 968 in France to 4 333 in Italy, equivalent to 1.5 oncologists per 100 000 inhabitants in France and 7.1 oncologists per 100 000 inhabitants in Italy (see Table 3). Across those Member States for which data are available (see Table 3), only Italy (2009 to 2015) and Latvia (2010 to 2015) reported a fall in the number of oncologists relative to their number of inhabitants during the period for which data are shown; there was also a fall in Iceland. Relative to the number of inhabitants, the largest increases in the number of oncologists between 2010 and 2015 were recorded in Poland (3.4 additional oncologists per 100 000 inhabitants), followed by Estonia and Bulgaria (1.8 additional oncologists per 100 000 inhabitants in both countries; note that there is a break in series for Estonian 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), the range in availability of day care places in 2017 was large, from no places in Slovakia to 13.3 places per 100 000 inhabitants in Belgium and 18.7 places per 100 000 inhabitants in Spain.

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 for cancer. In 2017, there were more than 3 600 radiation therapy units in the EU Member States for which data are available (no data for the Netherlands; note that data for Belgium, Germany, France, Portugal and Sweden refer only to equipment in hospitals), with the largest numbers in France (721) and the United Kingdom (536). Relative to population size, radiation therapy equipment was most common in Belgium (data for hospitals only), while it was least common in Portugal (data for hospitals only) and Romania.

Source data for tables and graphs

Data sources

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 the background article Causes of death statistics — methodology 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.

Please refer to this background information document for country specific notes on this data collection.

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).

Please refer to this background information document for country specific notes on this data collection.

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 the background article Healthcare non-expenditure statistics — methodology 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).

Please refer to this background information document for country specific notes on this data collection.

Symbols

Note on tables:

  • a colon ‘:’ is used to show where data are not available;
  • a dash ‘–‘ is used to show where data are not applicable/relevant.

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 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 — was a joint action initiative, co-funded by participating organisations, institutes, universities and health care units, and the EU. CanCon developed a European Guide on Quality Improvement in Comprehensive Cancer Control.

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Health care (t_hlth_care)
Causes of death (t_hlth_cdeath)
Health care (hlth_care)
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)
Causes of death (hlth_cdeath)
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)