Epidemiology of Cancer in Central and Eastern Europe Versus Western Europe and Poland
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The health transformation that took place after the Second World War in Europe was significantly delayed in the Central and Eastern European countries compared to countries of Northern Europe and United Kingdom. However, as death rates from cardiovascular disease have begun to fall since the 1990s, cancer has emerged as the most common cause of death among young and middle-aged adult women (20-64 years old) in the Central and Eastern European countries. In the coming decade it seems likely to be the leading cause of death among young and middle-aged adult men.The aim of the study was to compare the diversity in cancer risk, contrasting the "old" (EU-15) and the "new" Member States of European Union coming from Central and Eastern European (EU-10) and separately Poland.Material and methods. Data on deaths (1959-2002) in each country have been extracted from the World Health Organization database. Population data are from the Population Division of the Department of Economic and Social Affairs of the United Nations. Direct standardization has been undertaken using the World Standard Population.Results. The difference in life expectancy attributable to cancer for group 20-64 years of age is 0.68 of a year (16% of the total gap) among men and 0.35 of a year (24% of the total) among women. Trends in cancer over time differ significantly by gender, age group and time period in Central and Eastern Europe. The predicted mortality rate in Central and Eastern Europe in 2015 equates to 201/105 (95% CI 198.9-204) for men and 105.6/105 (95% CI 104.1-107.0) for women.Conclusions. In the Central and Eastern European countries deficiency of primary prevention is a main reason of poor health consciousness (consequences of smoking, fatty diet, low physical activity) and late introduction of poorly organized secondary prevention is responsible for worse survival of cancer patients, however tertiary prevention (therapy) is implemented in similar way as in Western Europe. Our analysis indicates that the greatest possibilities, but also the greatest unmet need, lie in primary and secondary prevention.
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- Zatoński WA, McMichael AJ, Powles, JW: Ecological study of reasons for sharp decline in mortality from ischaemic heart disease in Poland since 1991. BMJ 1998; 316(7137): 1047-51.
- Zatoński, W, Boyle P: Commentary. Health transformations in Poland after 1988, Journal of Epid and Biostatistics 1996; 1(4): 183-97.
- Zatoński, W, Jha P: The health Transformation in Eastern Europe after 1990: A Second Look.
- Zatoński WA, Willett W: Changes in dietary fat and declining coronary heart disease in Poland: population based study, BMJ 2005; 331(7510): 187-88.
- Boyle P, Autier P, Bartelink H et al.: European Code Against Cancer and scientific justification: third version (2003) Ann Oncol 2003; 14(7): 973-1005.[Crossref][PubMed]
- Boyle P, d'Onofrio A, Maisonneuve P et al.: Measuring progress against cancer in Europe: has the 15% decline targeted for 2000 come about? Ann Oncol 2003a; 14(8): 1312-25.
- United Nations. World Population Prospects: The 2000 Revision Medium variant, 2001-2050 Department of Economic and Social Affairs of United Nations, 1997.
- Parkin DM, Whelan SL, Ferlay J et al.: Cancer Incidence in Five Continents. Vol. VII. No. 143. Lyon: IARC Scientific Publications.
- Peto R: Mortality from smoking in developed countries, 1950-2000: indirect estimates from national vital statistics. Oxford University Press, Oxford 1994.
- Rehm J, Sulkowska U, Manczuk M et al.: Alcohol accounts for a high proportion of premature mortality in central and eastern Europe. Int J Epidemiol 2007; 36(2): 458-67.[Crossref][PubMed][WoS]
- Preston SH, Heuveline P, Guillot M: Demography: measuring and modeling population processes. Blackwell Publishers, Oxford 2001.
- Dyba T, Hakulinen T: Comparison of different approaches to incidence prediction based on simple interpolation techniques. Stat Med 2000; 19(13): 1741-52.[Crossref][PubMed]
- Quinn MJ, d'Onofrio A, Moller B et al.: Cancer mortality trends in the EU and acceding countries up to 2015. Ann Oncol 2003; 14(7): 1148-52
- IARC. Alcohol drinking IARC Monograph 1988; 44.
- Anttila A, Pukkala E, Soderman B et al.: Effect of organized screening on cervical cancer incidence and mortality in Finland, 1963-1995: recent increase in cervical cancer incidence. Int J Cancer 1999; 83(1): 59-65.
- Ferlay J, Bray F, Pisani P et al.: GLOBOCAN 2002: Cancer Incidence, Mortality and Prevalence Worldwide IARC CancerBase No. 5. version 2.0. Lyon: IARC Press 2004.
- Hakama M, Luostarinen T, Hakulinen T: Survival of in situ carcinoma of cervix uteri: a 50-year follow-up in Finland. Int J Cancer 2004; 112(6):1072-74.[PubMed][Crossref]
- American Cancer Society Inc. Cancer Statistics American Cancer Society 2007.
- Zatoński W, Jeziorski K, Tyczynski J: Testicular cancer in Poland. Lancet 1990; 336(8708): 183.
- Zatoński W: The East-West Health Gap in Europe - what are the causes? The Europ J Public Heath 2007; 17(2): 121.
- Zatoński W: Tobacco smoking in central European countries: Poland, in P. Boyle, N. Gray, J. Henningfield, J. Sefrin and Z. W (eds) Tobacco and Public Health: Science and Policy pp 235 - 252 Oxford: Oxford University Press 2004.
- Didkowska J, Manczuk M, McNeill A et al.: Lung cancer mortality at ages 35-54 in the European Union: ecological study of evolving tobacco epidemics. BMJ 2005; 331(7510): 189-91.
- Zatoński WA, Manczuk M, Powles J et al.: Convergence of male and female lung cancer mortality at younger ages in the European Union and Russia. Eur J Public Health 2007.[PubMed]
- Zatoński W: Leczenie zespołu uzależnienia od tytoniu jest obowiązkiem lekarza. Medipress 2000; Supp. 7: 3-5.
- Zatoński W: Lung Cancer Trends in selected European Countries: What we can learn from the Swedish Experience with oral tobacco (snus). European Status Report 2003 on Oral Tobacco: 2003; 37-54.
- Joossens L, Raw M: The Tobacco Control Scale: a new scale to measure country activity. Tob Control 2006; 15(3): 247-53.[Crossref][PubMed]
- Popova S, Rehm J, Patra J et al.: Comparing alcohol consumption in central and eastern Europe to other European countries. Alcohol and Alcoholism 2007.[WoS]
- La Vecchia C: Alcohol in the Mediterranean diet: benefits and risks. Int J Vitam Nutr Res 2001; 71(3): 210-13.[PubMed][Crossref]
- Plant M, Plant M: Binge Britain: Alcohol and the National Response. Oxford University Press, Oxford, UK. 2006.
- Lang K, Vali M, Szucs S et al.: The composition of surrogate and illegal alcohol products in Estonia. Alcohol 2006; 41(4): 446-50.
- Szucs S, Sarvary A, McKee M et al.: Could the high level of cirrhosis in central and eastern Europe be due partly to the quality of alcohol consumed? An exploratory investigation. Addiction 2005; 100(4): 536-42.[PubMed][Crossref]
- McKee M: A European alcohol strategy. BMJ 2006; 333(7574): 871-72.[WoS]
- National Statistics Office. GUS National Statistics Office 2006.
- Zatoński W, Smans M, Tyczyński J et al.: Atlas of Cancer Mortality in Central Europe. IARC Scientific Publications No. 134 Lyon: International Agency for Research on Cancer 1996.
- Didkowska J, Wojciechowska U, Zatoński W: Nowotwory szyjki macicy w Polsce - epidemiologiczny bilans otwarcia i perspektywy. Gin Pol 2006; 77 (9): 660-66.
- Mandelblatt JS, Lawrence WF, Gaffikin L et al.: Costs and benefits of different strategies to screen for cervical cancer in less-developed countries. J Natl Cancer Inst 2002; 94(19): 1469-83.
- van Ballegooijen M, van den Akker-van Marle E, Patnick J et al.: Overview of important cervical cancer screening process values in European Union (EU) countries, and tentative predictions of the corresponding effectiveness and cost - effectiveness. Eur J Cancer 2000; 36(17): 2177-88.
- Miller AB: The brave new world - what can we realistically expect to achieve through cancer control early in the new millennium? Chronic Dis Can 1999; 20(4): 139-50.[PubMed]
- Cancer Society of Finland. Cancer in Finland 2002 and 2005. Helsinki: Cancer Society of Finland.
- Chosia M, Bedner E, Domagala W: Czy cytologiczne badania przesiewowe mogą obniżyć w Polsce współczynnik umieralności z powodu raka szyjki macicy? Nowotwory 2001; 51: 523-29.
- Smallwood S, Chamberlain J: Replacement fertility, what has it been and what does it means. Population trends 2005; 119(Spring): 16-27.
- Wojciechowska U, Didkowska J, Tarkowski W et al.: Nowotwory złośliwe w Polsce w 2004 roku (Cancer in Poland in 2004). Centrum Onkologii - Instytut. Warsaw 2006.
- Regula J, Rupinski M, Kraszewska E et al.: Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med 2006; 355(18): 1863-72.
- Suhrcke M, Rocco L, McKee M: Health: a vital investment for economic development in eastern Europe and central Asia. Copenhagen: European Observatory on Health Systems and Policies 2007.
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