1-500 | 501-793
    Part,  Chapter, Paragraph

  1    I,     2. 10.  1|               particular in the field of cancer. As we see a clear need
  2    I,     2. 10.  2|                imaging, in particular in cancer imaging:~- Nanorods: nanoparticles
  3   II,     4.  2    |            mortality by various types of cancer started to contribute to
  4   II,     4.  2    |                  Whereas smoking related cancer had a negative impact on
  5   II,     4.  2    |                  the 1970s, mortality by cancer declined in the 1990s. For
  6   II,     4.  2    |                  decline in mortality by cancer. However, mortality by smoking
  7   II,     4.  2    |             mortality by smoking related cancer continued to increase for
  8   II,     4.  2    |               other main cause of death, cancer (causes 2, 3, 4 and 5 in
  9   II,     4.  2    |           important part of mortality by cancer is caused by smoking. Mortality
 10   II,     4.  2    |               impact on mortality due to cancer, for men more than for women,
 11   II,     4.  2    |            larger than mortality by lung cancer and other smoking related
 12   II,     5.  1.  1|                 cardiovascular diseases; cancer; asthma and other respiratory
 13   II,     5.  1.  1|                  cardiovascular disease, cancer and violence (injury and
 14   II,     5.  1.  1|                  cardiovascular disease, cancer and violence (injury and
 15   II,     5.  1.  1|               different countries.~ ~ ~ ~Cancer ~ ~The majority of cancers
 16   II,     5.  1.  1|            though lifestyles. ~ ~Stomach cancer: It has been estimated that
 17   II,     5.  1.  1|                  that most cases of this cancer are preventable by appropriate
 18   II,     5.  1.  1|                  protect against stomach cancer; salt and also salt-preserved
 19   II,     5.  1.  1|                 foods are causes of this cancer. There is strong evidence
 20   II,     5.  1.  1|                increased risk of stomach cancer (WCRF, 2007).~ ~Colorectal
 21   II,     5.  1.  1|                WCRF, 2007).~ ~Colorectal cancer: the evidence that physical activity
 22   II,     5.  1.  1|              protects against colorectal cancer is convincing, although
 23   II,     5.  1.  1|                 are causes of colorectal cancer is convincing. Substantial
 24   II,     5.  1.  1|                 probably a cause of this cancer in women. Foods containing
 25   II,     5.  1.  1|            probably protect against this cancer (WCRF, 2007). Cancer control
 26   II,     5.  1.  1|                this cancer (WCRF, 2007). Cancer control priority should
 27   II,     5.  1.  1|       determinants related to colorectal cancer aetiology, such as healthy
 28   II,     5.  1.  1|                physical activity.~ ~Lung cancer: smoking is a primary cause
 29   II,     5.  1.  1|                  a primary cause of lung cancer, although pollution and
 30   II,     5.  1.  1|              Geographic patterns of lung cancer incidence and mortality
 31   II,     5.  1.  1|                2005). Although male lung cancer incidence is decreasing
 32   II,     5.  1.  1|               European macro-areas, lung cancer remains the first cancer
 33   II,     5.  1.  1|                 cancer remains the first cancer diagnosed in men in Eastern
 34   II,     5.  1.  1|               risk factor promoting lung cancer is increasing, but the war
 35   II,     5.  1.  1|                  are necessary.~ ~Breast cancer: Breast cancer is hormone
 36   II,     5.  1.  1|                    Breast cancer: Breast cancer is hormone related, and
 37   II,     5.  1.  1|                  modify the risk of this cancer when diagnosed premenopausally
 38   II,     5.  1.  1|                  Risk factors for breast cancer in women include the events
 39   II,     5.  1.  1|                  protects against breast cancer in postmenopause, and there
 40   II,     5.  1.  1|                 it protects against this cancer diagnosed in premenopause.
 41   II,     5.  1.  1|             drinks are a cause of breast cancer at all ages is convincing.
 42   II,     5.  1.  1|                 of postmenopausal breast cancer is convincing, and these
 43   II,     5.  1.  1|          probably also a cause of breast cancer diagnosed in premenopause (
 44   II,     5.  1.  1|                  WCRF, 2007).~ ~Cervical cancer: the main risk factor is
 45   II,     5.  1.  1|                to progress into cervical cancer, and once detected early
 46   II,     5.  1.  1|                not develop into cervical cancer.~ ~Prostate cancer: age
 47   II,     5.  1.  1|              cervical cancer.~ ~Prostate cancer: age is the strongest risk
 48   II,     5.  1.  1|                 risk factor for prostate cancer: development of this malignancy
 49   II,     5.  1.  1|                  2003).~ ~Other types of cancer: Body fatness has been associated
 50   II,     5.  1.  1|                   endometrial and kidney cancer and, through the formation
 51   II,     5.  1.  1|              stones, also to gallbladder cancer.~ ~Other risk factors are:
 52   II,     5.  1.  1|          conditions and diseases such as cancer and cardio-vascular diseases.~ ~·
 53   II,     5.  2.  2|                   stroke and other CVD), cancer and violence were calculated.~
 54   II,     5.  2.  3|                  more deaths than breast cancer.~As explained in chapter
 55   II,     5.  3    |                                     5.3. Cancer~ ~
 56   II,     5.  3.Acr|                            Acronyms~ ~CR~Cancer Registry~ENCR~European Network
 57   II,     5.  3.Acr|                 ENCR~European Network of Cancer Registries~ESMO~European
 58   II,     5.  3.Acr|               Oncology~EUROCHIP~European Cancer Health Indicator Project~
 59   II,     5.  3.Acr|            Project~FACT~Fighting Against Cancer Today~GDP~Gross Domestic
 60   II,     5.  3.Acr|      International Agency of Research on Cancer~ICD~International Classification
 61   II,     5.  3.Acr|         Expenditure on Health~WCRF~World Cancer Research Fund~WHO~World
 62   II,     5.  3.  1|                     5.3.1 Introduction~ ~Cancer is a highly complex disease
 63   II,     5.  3.  1|                  the fact that about 100 cancer sites are considered in
 64   II,     5.  3.  1|                 are considered in ICD-X. Cancer incidence has been increasing
 65   II,     5.  3.  1|               increasing since the first cancer statistics became available,
 66   II,     5.  3.  1|             occurrence and importance of cancer risk factors and also due
 67   II,     5.  3.  1|                  at birth (LE). In fact, cancer is mainly a disease of older
 68   II,     5.  3.  1|                 and in these countries a cancer epidemic is currently ongoing
 69   II,     5.  3.  1|                describe the evolution of cancer in a particular population
 70   II,     5.  3.  1|                 the frequency with which cancer appears in a population
 71   II,     5.  3.  1|                  over a given timeframe. Cancer incidence rate is the number
 72   II,     5.  3.  1|           expressed as the number of new cancer cases per 100,000 population
 73   II,     5.  3.  1|                  at risk;~ ~- Mortality: cancer mortality rates show the
 74   II,     5.  3.  1|               the number of deaths where cancer is the underlying cause
 75   II,     5.  3.  1|                 the number of deaths for cancer per 100,000 population at
 76   II,     5.  3.  1|               the survival experience of cancer patients, after removing
 77   II,     5.  3.  1|                  point subsequent to the cancer diagnosis (i.e. 1-year,
 78   II,     5.  3.  1|           Prevalence: reflects the total cancer burden in a population and
 79   II,     5.  3.  1|                 with a past diagnosis of cancer.~ ~As there are several
 80   II,     5.  3.  1|                 several indications that cancer outcomes are related to
 81   II,     5.  3.  1|                   2003), in this chapter cancer outcome indicators are ordered
 82   II,     5.  3.  1|                  on a selection of major cancer sites: lung cancer, still
 83   II,     5.  3.  1|                 major cancer sites: lung cancer, still being the major cancer
 84   II,     5.  3.  1|            cancer, still being the major cancer killer in Europe; cancers
 85   II,     5.  3.  1|                shows the burden of these cancer sites in EU25 as estimated
 86   II,     5.  3.  1|             cases and deaths by selected cancer sites in EU25 (2006).~ ~
 87   II,     5.  3.  2|                                  5.3.2.1 Cancer Registration~ ~Population-based
 88   II,     5.  3.  2|          Registration~ ~Population-based cancer registries (CR) collect
 89   II,     5.  3.  2|                 data on all new cases of cancer occurring in a well-defined
 90   II,     5.  3.  2|               with the goal of improving cancer control. Today, 15 of the
 91   II,     5.  3.  2|               States (MSs) have national cancer registration coverage, while
 92   II,     5.  3.  2|               yet an European recognised cancer registry (Luxembourg, Greece,
 93   II,     5.  3.  2|              Europe-wide coordination.~ ~Cancer Registry roles and functions (
 94   II,     5.  3.  2|               diseases, registration for cancer is not usually based on
 95   II,     5.  3.  2|                 e.g. district hospitals, cancer centres, hospices, private
 96   II,     5.  3.  2|        institution. The population level cancer patient data are becoming
 97   II,     5.  3.  2|                  public health impact of cancer: the minimal role of any
 98   II,     5.  3.  2|                  the minimal role of any cancer registry is the provision
 99   II,     5.  3.  2|                timely and robust data on cancer incidence, survival (following
100   II,     5.  3.  2|               routinely recorded for all cancer patients. For those countries
101   II,     5.  3.  2|             obtain national estimates of cancer incidence from networks
102   II,     5.  3.  2|               registries. While European cancer survival figures are provided
103   II,     5.  3.  2|               programmes: a number of EU cancer registries already contribute
104   II,     5.  3.  2|      environmental and social factors on cancer risk and outcomes, and supporting
105   II,     5.  3.  2|        investigations into the causes of cancer. For instance, thanks to
106   II,     5.  3.  2|                  For instance, thanks to cancer registration we know that:~-
107   II,     5.  3.  2|            asbestos;~- lymphoma and oral cancer rates are higher in ethnic
108   II,     5.  3.  2|                  in ethnic minorities;~- cancer survival for patients living
109   II,     5.  3.  2|                Evaluating the quality of cancer care by providing comparative
110   II,     5.  3.  2|                information in support of cancer genetic counselling services
111   II,     5.  3.  2|                higher risk of developing cancer. People are often worried
112   II,     5.  3.  2|                 put them at high risk of cancer. The CR is often asked by
113   II,     5.  3.  2|                 confirm the details of a cancer diagnosis in a relative
114   II,     5.  3.  2|               and possible solutions for Cancer Registration in the EU~ ~
115   II,     5.  3.  2|               the EU~ ~About one hundred cancer registries operate in Europe
116   II,     5.  3.  2|              Member States have national cancer registration coverage (see
117   II,     5.  3.  2|                As a consequence, several cancer registries closed down as
118   II,     5.  3.  2|          impacted on the flow of data to cancer registries also in the UK (
119   II,     5.  3.  2|                  death certificates with cancer records. For example in
120   II,     5.  3.  2|              this has created a paradox: cancer registration and death registration
121   II,     5.  3.  2|                  are both statutory, but cancer survival analysis is illegal.~ ~
122   II,     5.  3.  2|                  national investment for cancer registration is relatively
123   II,     5.  3.  2|                  For all of the above, a cancer registry or a registry network
124   II,     5.  3.  2|              every country.~ ~Support to cancer registration in all Member
125   II,     5.  3.  2|                  would create harmonised cancer registry procedures and
126   II,     5.  3.  2|                 procedures and efficient cancer control monitoring across
127   II,     5.  3.  2|                monitoring across Europe. Cancer Registries should be further
128   II,     5.  3.  2|                 the impact evaluation of cancer screening and cancer treatment
129   II,     5.  3.  2|                  of cancer screening and cancer treatment programmes:~·
130   II,     5.  3.  2|              that all Member States make cancer registration a statutory
131   II,     5.  3.  2|            health tool for evaluation of cancer control, including incidence,
132   II,     5.  3.  2|                  design for establishing cancer registration in countries
133   II,     5.  3.  2|      Recommendations highlight that:~ ~· cancer registries are necessary
134   II,     5.  3.  2|             registries are necessary for cancer control and epidemiological
135   II,     5.  3.  2|              patient care improvement;~· cancer registry provide standardized
136   II,     5.  3.  2|              comparable across Europe;~· cancer registries are essential
137   II,     5.  3.  2|               are essential to implement Cancer Health Information System
138   II,     5.  3.  2|                 in the European Union;~· cancer registries are unique providers
139   II,     5.  3.  2|                  are unique providers of cancer data at population level;~·
140   II,     5.  3.  2|              data at population level;~· cancer registries need to be maintained
141   II,     5.  3.  2|              maintained and supported;~· cancer registries need ad-hoc national
142   II,     5.  3.  2|              restricting legislations;~· cancer registries should be recognised
143   II,     5.  3.  2|             European projects connecting cancer registries are the best
144   II,     5.  3.  2|              tools for the comparison of cancer burden in EU.~ ~
145   II,     5.  3.  2|              results coming from various cancer organisations, networks
146   II,     5.  3.  2|      International Agency of Research on Cancer: IARC is part of the World
147   II,     5.  3.  2|          research on the causes of human cancer, the mechanisms of carcinogenesis,
148   II,     5.  3.  2|                scientific strategies for cancer control. The Agency is involved
149   II,     5.  3.  2|                to publish the volume of “Cancer Incidence in V Continents”
150   II,     5.  3.  2|            produce national estimates of cancer incidence. See: http://www.
151   II,     5.  3.  2|               ENCREuropean Network of Cancer Registries: ENCR is concerned
152   II,     5.  3.  2|           concerned with the teaching of cancer registrars, definition of
153   II,     5.  3.  2|                 proper monitoring of the cancer burden and for promote the
154   II,     5.  3.  2|               and for promote the use of cancer registries in cancer control,
155   II,     5.  3.  2|                  of cancer registries in cancer control, health-care planning
156   II,     5.  3.  2|                  address inequalities in cancer information in Europe and
157   II,     5.  3.  2|             information and knowledge on cancer across the EU. The specific
158   II,     5.  3.  2|                  to set up a Europe-wide cancer surveillance system to describe
159   II,     5.  3.  2|                to reduce inequalities in cancer care, by extending collaboration,
160   II,     5.  3.  2|               net/eurochip/~ ~EUROCARECancer survival in Europe: The
161   II,     5.  3.  2|               and explain differences in cancer survival rates across Europe.
162   II,     5.  3.  2|                 these hurdles to improve cancer research in Europe; analysis
163   II,     5.  3.  2|                and synthesis of National Cancer Plans in Europe; evaluation
164   II,     5.  3.  2|                  contribution to EU 2015 Cancer Target; development of a
165   II,     5.  3.  2|                  a common European Union Cancer Plan; evaluation of potential
166   II,     5.  3.  2|                  contribution to EU 2015 Cancer Target. See: http://www.
167   II,     5.  3.  2|         addresses global inequalities in cancer care and practice in Europe.
168   II,     5.  3.  2|             registries and guidelines on cancer. See: http://www.esmo.org/
169   II,     5.  3.  2|              regarding patient access to cancer drugs by Karolinska Institute
170   II,     5.  3.  2|                  access to treatment for cancer patients and availability
171   II,     5.  3.  2|                  and availability of new cancer drugs. See: http://annonc.
172   II,     5.  3.  3|                  3.3 Data presentation~ ~Cancer is a mix of diseases with
173   II,     5.  3.  3|             populations. For this reason cancer outcome indicators (i.e.
174   II,     5.  3.  3|                  subdivided per selected cancer site: stomach (ICD-9 code
175   II,     5.  3.  3|               140-172 and 174-208). Each cancer site is presented according
176   II,     5.  3.  3|             figures (or set of them):~ ~ Cancer incidence estimates in the
177   II,     5.  3.  3|                   Ferlay et al, 2007).~- Cancer incidence estimates trends
178   II,     5.  3.  3|               iss.it) and the IARC World Cancer database (http://www-dep.
179   II,     5.  3.  3|      Classification of Diseases (ICD).~- Cancer mortality trends in men
180   II,     5.  3.  3|                  from the Czech National Cancer Registry were provided (
181   II,     5.  3.  3|                end of 2008.~ ~Figures on cancer incidence, mortality and
182   II,     5.  3.  3|           EUROSTAT for 2006. The risk of cancer increases with age; furthermore,
183   II,     5.  3.  4|               major risk factors for the cancer sites included in the present
184   II,     5.  3.  4|               present chapter.~ ~Stomach cancer: It has been estimated that
185   II,     5.  3.  4|                  that most cases of this cancer are preventable by appropriate
186   II,     5.  3.  4|                  protect against stomach cancer; salt and also salt-preserved
187   II,     5.  3.  4|             foods are the causes of this cancer. There is strong evidence
188   II,     5.  3.  4|                increased risk of stomach cancer (WCRF, 2007).~ ~Colorectal
189   II,     5.  3.  4|                WCRF, 2007).~ ~Colorectal cancer: the evidence that physical activity
190   II,     5.  3.  4|              protects against colorectal cancer is convincing, although
191   II,     5.  3.  4|                 are causes of colorectal cancer is convincing. Substantial
192   II,     5.  3.  4|                 probably a cause of this cancer in women. Foods containing
193   II,     5.  3.  4|            probably protect against this cancer (WCRF, 2007). Cancer control
194   II,     5.  3.  4|                this cancer (WCRF, 2007). Cancer control priority should
195   II,     5.  3.  4|       determinants related to colorectal cancer aetiology, such as a healthy
196   II,     5.  3.  4|                physical activity.~ ~Lung cancer: smoking is a primary cause
197   II,     5.  3.  4|                  a primary cause of lung cancer, although pollution and
198   II,     5.  3.  4|              Geographic patterns of lung cancer incidence and mortality
199   II,     5.  3.  4|                2005). Although male lung cancer incidence is decreasing
200   II,     5.  3.  4|               European macro-areas, lung cancer remains the first cancer
201   II,     5.  3.  4|                 cancer remains the first cancer diagnosed in men in Eastern
202   II,     5.  3.  4|               risk factor promoting lung cancer is increasing, but the war
203   II,     5.  3.  4|              people are needed.~ ~Breast cancer: Breast cancer is hormone
204   II,     5.  3.  4|                    Breast cancer: Breast cancer is hormone related, and
205   II,     5.  3.  4|                  modify the risk of this cancer when diagnosed pre-menopausally
206   II,     5.  3.  4|                  Risk factors for breast cancer in women include the events
207   II,     5.  3.  4|                  protects against breast cancer in post-menopause, and there
208   II,     5.  3.  4|                 it protects against this cancer diagnosed in pre-menopause.
209   II,     5.  3.  4|             drinks are a cause of breast cancer at all ages is convincing.
210   II,     5.  3.  4|                 of postmenopausal breast cancer is convincing, and these
211   II,     5.  3.  4|          probably also a cause of breast cancer diagnosed in premenopause (
212   II,     5.  3.  4|                  WCRF, 2007).~ ~Cervical cancer: the main risk factor is
213   II,     5.  3.  4|                to progress into cervical cancer, and once detected early
214   II,     5.  3.  4|                not develop into cervical cancer.~ ~Prostate cancer: age
215   II,     5.  3.  4|              cervical cancer.~ ~Prostate cancer: age is the strongest risk
216   II,     5.  3.  4|                 risk factor for prostate cancer: development of this malignancy
217   II,     5.  3.  5|            mainly a proxy of the overall cancer care performance. In 2006,
218   II,     5.  3.  5|              women.~ ~Figure 5.3.1a. All cancer (ICD9 140-172, 174-208)
219   II,     5.  3.  5|                   Men~Figure 5.3.1b. All cancer (ICD9 140-172, 174-208)
220   II,     5.  3.  5|             Figure 5.3.2a. Trends of all cancer (ICD9 140-172, 174-208)
221   II,     5.  3.  5|             Figure 5.3.2b. Trends of all cancer (ICD9 140-172, 174-208)
222   II,     5.  3.  5|             Women~ ~ ~Figure 5.3.3a. All cancer (ICD9 140-172, 174-208)
223   II,     5.  3.  5|                   Men~Figure 5.3.3b. All cancer (ICD9 140-172, 174-208)
224   II,     5.  3.  5|             Figure 5.3.4a. Trends of all cancer (ICD9 140-172, 174-208)
225   II,     5.  3.  5|             Figure 5.3.4b. Trends of all cancer (ICD9 140-172, 174-208)
226   II,     5.  3.  5|                by sex B) Women~ ~Stomach Cancer (ICD-9 151)~In 2006 Europe
227   II,     5.  3.  5|             deaths estimated for stomach cancer (Ferlay et al, 2007). In
228   II,     5.  3.  5|                  Figures 5.3.7). Stomach cancer incidence (Figures 6) and
229   II,     5.  3.  5|                   Figure 5.3.5a. Stomach cancer (ICD9 151) standardized
230   II,     5.  3.  5|               Men~Figure 5.3.5b. Stomach cancer (ICD9 151) standardized
231   II,     5.  3.  5|                  3.6a. Trends of stomach cancer (ICD9 151) standardized
232   II,     5.  3.  5|                  3.6b. Trends of stomach cancer (ICD9 151) standardized
233   II,     5.  3.  5|                   Figure 5.3.7a. Stomach cancer (ICD9 151) standardized
234   II,     5.  3.  5|               Men~Figure 5.3.7b. Stomach cancer (ICD9 151) standardized
235   II,     5.  3.  5|                  3.8a. Trends of stomach cancer (ICD9 151) standardized
236   II,     5.  3.  5|                  3.8b. Trends of stomach cancer (ICD9 151) standardized
237   II,     5.  3.  5|                sex B) Women~ ~Colorectal Cancer (ICD-9 153, 154)~In 2006,
238   II,     5.  3.  5|                 estimated for colorectal cancer in Europe (Ferlay et al,
239   II,     5.  3.  5|                 per 100,000).~Colorectal cancer incidence rates are increasing
240   II,     5.  3.  5|                Figure 5.3.9a. Colorectal cancer (ICD9 153, 154) standardized
241   II,     5.  3.  5|                Figure 5.3.9b. Colorectal cancer (ICD9 153, 154) standardized
242   II,     5.  3.  5|                10a. Trends of colorectal cancer (ICD9 153, 154) standardized
243   II,     5.  3.  5|                10b. Trends of colorectal cancer (ICD9 153, 154) standardized
244   II,     5.  3.  5|               Figure 5.3.11a. Colorectal cancer (ICD9 153, 154) standardized
245   II,     5.  3.  5|               Figure 5.3.11b. Colorectal cancer (ICD9 153, 154) standardized
246   II,     5.  3.  5|                12a. Trends of colorectal cancer (ICD9 153, 154) standardized
247   II,     5.  3.  5|                12b. Trends of colorectal cancer (ICD9 153, 154) standardized
248   II,     5.  3.  5|                 by sex B) Women~ ~ ~Lung Cancer (ICD-9 162)~In 2006, in
249   II,     5.  3.  5|                is by far the most common cancer of men, while in women incidence
250   II,     5.  3.  5|         experienced the peak of the lung cancer epidemic in men, although
251   II,     5.  3.  5|                     Figure 5.3.13a. Lung cancer (ICD9 162) standardized
252   II,     5.  3.  5|                 Men~Figure 5.3.13b. Lung cancer (ICD9 162) standardized
253   II,     5.  3.  5|                  5.3.14a. Trends of lung cancer (ICD9 162) standardized
254   II,     5.  3.  5|                  5.3.14b. Trends of lung cancer (ICD9 162) standardized
255   II,     5.  3.  5|             Women~ ~Figure 5.3.15a. Lung cancer (ICD9 162) standardized
256   II,     5.  3.  5|                 Men~Figure 5.3.15b. Lung cancer (ICD9 162) standardized
257   II,     5.  3.  5|                  5.3.16a. Trends of lung cancer (ICD9 162) standardized
258   II,     5.  3.  5|                  5.3.16b. Trends of lung cancer (ICD9 162) standardized
259   II,     5.  3.  5|                 B) Women~ ~Female Breast Cancer (ICD-9 174)~Breast cancer
260   II,     5.  3.  5|                Cancer (ICD-9 174)~Breast cancer is by far the most frequent
261   II,     5.  3.  5|                the most frequent type of cancer in women with an estimated
262   II,     5.  3.  5|               cases per 100,000). Breast cancer incidence seems to be associated
263   II,     5.  3.  5|             Figure 5.3.17. Female breast cancer (ICD9 174) standardized
264   II,     5.  3.  5|                  Trends of female breast cancer (ICD9 174) standardized
265   II,     5.  3.  5|             Figure 5.3.19. Female breast cancer (ICD9 174) standardized
266   II,     5.  3.  5|                  Trends of female breast cancer (ICD9 174) standardized
267   II,     5.  3.  5|            European standard)~ ~Cervical Cancer (ICD-9 180)~Cervical cancer
268   II,     5.  3.  5|              Cancer (ICD-9 180)~Cervical cancer estimates were about 60,
269   II,     5.  3.  5|              risk of developing cervical cancer is mainly related to the
270   II,     5.  3.  5|                Kleihues, 2003). Cervical cancer incidence rates can be influenced
271   II,     5.  3.  5|                 before becoming cervical cancer. If two countries have similar
272   II,     5.  3.  5|                 the second, the cervical cancer incidence rate in the latter
273   II,     5.  3.  5|                 the former one.~Cervical cancer incidence seems to be negatively
274   II,     5.  3.  5|         substantial declines in cervical cancer incidence and mortality,
275   II,     5.  3.  5|                  Figure 5.3.21. Cervical cancer (ICD9 180) standardized
276   II,     5.  3.  5|                 3.22. Trends of cervical cancer (ICD9 180) standardized
277   II,     5.  3.  5|          standard)~Figure 5.3.23. Uterus cancer standardized mortality rates (
278   II,     5.  3.  5|                 5.3.24. Trends of uterus cancer standardized mortality rates (
279   II,     5.  3.  5|               age class 20-44~ ~Prostate Cancer (ICD-9 185)~In 2006, 346,
280   II,     5.  3.  5|              were estimated for prostate cancer in Europe (Ferlay et al,
281   II,     5.  3.  5|                   Comparison of prostate cancer rates in European populations
282   II,     5.  3.  5|              cancers prognosis.~Prostate cancer incidence seems to be positively
283   II,     5.  3.  5|                  Figure 5.3.25. Prostate cancer (ICD9 185) standardized
284   II,     5.  3.  5|                 3.26. Trends of prostate cancer (ICD9 185) standardized
285   II,     5.  3.  5|                  Figure 5.3.27. Prostate cancer (ICD9 185) standardized
286   II,     5.  3.  5|                 3.28. Trends of prostate cancer (ICD9 185) standardized
287   II,     5.  3.  6|                study of population-based cancer registries on patients survival
288   II,     5.  3.  6|                 only on regional (local) cancer registries. These can be
289   II,     5.  3.  6|                        5.3.5.1 Childhood cancer survival~ ~In EUROCARE,
290   II,     5.  3.  6|              with a history of childhood cancer will inevitably increase.~ ~
291   II,     5.  3.  6|                            5.3.5.2 Adult cancer survival~ ~Patients diagnosed
292   II,     5.  3.  6|                 reflects the case mix by cancer site. For this reason Figures
293   II,     5.  3.  6|              adjusted by age but also by cancer site. Women generally had
294   II,     5.  3.  6|          Countries fell into two stomach cancer survival groups both for
295   II,     5.  3.  6|                  Figure 5.3.30a. Stomach cancer (ICD9 151) age-standardized
296   II,     5.  3.  6|                  Figure 5.3.30b. Stomach cancer (ICD9 151) age-standardized
297   II,     5.  3.  6|                Women~ ~5-year colorectal cancer relative survival (Figures
298   II,     5.  3.  6|                  survival for colorectal cancer increased from 44% in the
299   II,     5.  3.  6|           patients, and rectal and colon cancer sites (Sant et al, 2003).~ ~
300   II,     5.  3.  6|               Figure 5.3.31a. Colorectal cancer (ICD9 153,154) age-standardized
301   II,     5.  3.  6|               Figure 5.3.31b. Colorectal cancer (ICD9 153,154) age-standardized
302   II,     5.  3.  6|                Women~ ~Survival for lung cancer patients remains poor, with
303   II,     5.  3.  6|                  modest tendency of lung cancer survival improvement in
304   II,     5.  3.  6|                     Figure 5.3.32a. Lung cancer (ICD9 162) age-standardized
305   II,     5.  3.  6|                 Men~Figure 5.3.32b. Lung cancer (ICD9 162) age-standardized
306   II,     5.  3.  6|                 The prognosis for breast cancer is relatively good, with
307   II,     5.  3.  6|                  Particularly low breast cancer survival was seen in Eastern
308   II,     5.  3.  6|             Relative survival for breast cancer improved steadily in all
309   II,     5.  3.  6|              result, the range of breast cancer survival rates between the
310   II,     5.  3.  6|             Figure 5.3.33. Female breast cancer (ICD9 174) age-standardized
311   II,     5.  3.  6|           relative survival for cervical cancer was lower in Poland (48%)
312   II,     5.  3.  6|          survival of women with cervical cancer in Northern and Western
313   II,     5.  3.  6|                  Figure 5.3.34. Cervical cancer (ICD9 180) age-standardized
314   II,     5.  3.  6|           relative survival for prostate cancer 5 years after diagnosis
315   II,     5.  3.  6|              survival rates for prostate cancer differed greatly from one
316   II,     5.  3.  6|           relative survival for prostate cancer were seen in Estonia (from
317   II,     5.  3.  6|                  Figure 5.3.35. Prostate cancer (ICD9 185) age-standardized
318   II,     5.  3.  6|              2007) analysed data from 83 cancer registries in 23 European
319   II,     5.  3.  6|             countries on 2 699 086 adult cancer cases that were diagnosed
320   II,     5.  3.  6|            prostate (European mean: 76%) cancer was higher in Nordic countries (
321   II,     5.  3.  6|          survival, might indicate better cancer care. Wealthy countries
322   II,     5.  3.  6|                  TNEH generally had good cancer outcomes, but those with
323   II,     5.  3.  6|                  patients diagnosed with cancer in 200002, collected from
324   II,     5.  3.  6|                  from 47 of the European cancer registries participating
325   II,     5.  3.  6|                was 79% for female breast cancer, 25% for stomach cancer
326   II,     5.  3.  6|                  cancer, 25% for stomach cancer and 11% for lung cancer.
327   II,     5.  3.  6|                  cancer and 11% for lung cancer. Survival for patients diagnosed
328   II,     5.  3.  6|        improvement in survival for major cancer sites during 19912002 (
329   II,     5.  3.  6|             during 19912002 (colorectal cancer passed from 30% to 45%;
330   II,     5.  3.  6|                  from 30% to 45%; breast cancer from 60% to 74%; prostate
331   II,     5.  3.  6|                from 60% to 74%; prostate cancer from 40% to 68%).~Cancer-service
332   II,     5.  3.  7|             Control tools and policies~ ~Cancer control means cancer prevention,
333   II,     5.  3.  7|          policies~ ~Cancer control means cancer prevention, diagnosis and
334   II,     5.  3.  7|                  and quality of life for cancer patients. This is achieved
335   II,     5.  3.  7|                  phase to plan effective cancer control programmes is finalized
336   II,     5.  3.  7|                prevent people dying from cancer are in the first instance
337   II,     5.  3.  7|                  development of clinical cancer and in the second instance
338   II,     5.  3.  7|                 result in a reduction in cancer risk. Although all of these
339   II,     5.  3.  7|             prevention in the context of cancer is an important area of
340   II,     5.  3.  7|              sunlight, and screening for cancer are all recommended by the
341   II,     5.  3.  7|               2003 European Code Against Cancer as ways to avoid the disease (
342   II,     5.  3.  7|                 prevention approaches of cancer risk factors related to
343   II,     5.  3.  7|                  successful treatment of cancer patients due to detection
344   II,     5.  3.  7|                effectiveness in reducing cancer mortality. Attention should
345   II,     5.  3.  7|                  The ultimate purpose of cancer screening is to reduce cancer
346   II,     5.  3.  7|            cancer screening is to reduce cancer mortality, and reduce the
347   II,     5.  3.  7|                 has been shown to reduce cancer mortality in regional comparisons
348   II,     5.  3.  7|                 comparisons for cervical cancer (with the cervical smear
349   II,     5.  3.  7|             controlled trials for breast cancer (mammography) and colorectal
350   II,     5.  3.  7|              mammography) and colorectal cancer (faecal occult blood or
351   II,     5.  3.  7|             amongst women and colorectal cancer is one of the most frequent
352   II,     5.  3.  7|                for breast and colorectal cancer, and up to 75% for cervical
353   II,     5.  3.  7|               and up to 75% for cervical cancer. The situation of cervical
354   II,     5.  3.  7|               Europe is one of the major cancer control priorities to be
355   II,     5.  3.  7|                anomalies before becoming cancer: this means that effective
356   II,     5.  3.  7|              drastically reduce cervical cancer.~ ~The international scientific
357   II,     5.  3.  7|            mammography for female breast cancer, pap smear for cervical
358   II,     5.  3.  7|                   pap smear for cervical cancer and faecal occult blood
359   II,     5.  3.  7|              occult blood for colorectal cancer. In 2003 the European Council
360   II,     5.  3.  7|                 aged 50 to 69 for breast cancer screening (with 2 or 3 years
361   II,     5.  3.  7|                  screening of colorectal cancer (with 1 or 2 years of interval).~ ~
362   II,     5.  3.  7|           whether screening for prostate cancer or lung cancer in high-risk
363   II,     5.  3.  7|                  prostate cancer or lung cancer in high-risk subjects may
364   II,     5.  3.  7|            implementing lung or prostate cancer screening.~ ~
365   II,     5.  3.  7|                differences and trends in cancer survival within Europe are
366   II,     5.  3.  7|                 or trends in the type of cancer, diagnostic investigations
367   II,     5.  3.  7|              regarding patient access to cancer drugs” (Jonsson et al, 2007)
368   II,     5.  3.  7|                 to access new innovative cancer drug treatments and the
369   II,     5.  3.  7|          authorization of new innovative cancer drugs through the competent
370   II,     5.  3.  7|         Assessment (HTA) regarding a new cancer drug is done quickly to
371   II,     5.  3.  7|               funding for new innovative cancer drugs is available for the
372   II,     5.  3.  7|                  treatment of metastatic cancer and thus the cost of treatment
373   II,     5.  3.  7|                  the most cost-effective cancer treatment.~ ~
374   II,     5.  3.  7|                                  5.3.6.4 Cancer Plans~ ~Definition of cancer
375   II,     5.  3.  7|             Cancer Plans~ ~Definition of cancer control plan~ ~The cancer
376   II,     5.  3.  7|                cancer control plan~ ~The cancer burden of a given population
377   II,     5.  3.  7|               both to reduce and monitor cancer incidence with preventive
378   II,     5.  3.  7|     epidemiological services and improve cancer outcomes with clinical services
379   II,     5.  3.  7|                within the health system.~Cancer control plans (NCPs) are
380   II,     5.  3.  7|        priorities and main objectives of cancer control for a given timeframe.
381   II,     5.  3.  7|                 an effective, integrated cancer plan for primary prevention,
382   II,     5.  3.  7|                  long-term reductions in cancer morbidity and mortality;~·
383   II,     5.  3.  7|               suspect to be affected) by cancer need prompt access to appropriate
384   II,     5.  3.  7|            multidisciplinary approach to cancer care is required to make
385   II,     5.  3.  7|           consistently monitored;~· Most cancer patients need care for diagnosis
386   II,     5.  3.  7|             European Union activities on cancer control plans~ ~A number
387   II,     5.  3.  7|                 5.3.2) consider national cancer plan as a strategy to manage
388   II,     5.  3.  7|         effectively the steps to improve cancer control.~ ~Table 5.3.2.
389   II,     5.  3.  7|                  control.~ ~Table 5.3.2. Cancer national control plans in
390   II,     5.  3.  7|           practice components for global cancer control and areas which
391   II,     5.  3.  7|             during a Parallel Session on Cancer as part of its Health Strategies
392   II,     5.  3.  7|              develop or improve national cancer plans, comprehensive cancer
393   II,     5.  3.  7|              cancer plans, comprehensive cancer control programmes and population-based
394   II,     5.  3.  7|          programmes and population-based cancer registries, all of which
395   II,     5.  3.  7|               play a fundamental role in cancer control. Slovenia, who took
396   II,     5.  3.  7|                  January 2008, has named cancer as one of its top priorities
397   II,     5.  3.  7|                   Reducing the Burden of Cancer” that provides clear indications
398   II,     5.  3.  7|                  beneficial for fighting cancer. The book entitledResponding
399   II,     5.  3.  7|           Responding to the Challenge of Cancer in Europe”, has been produced
400   II,     5.  3.  7|               under the Fighting Against Cancer Today (FACT) umbrella.~ ~
401   II,     5.  3.  7|           strategy addressing four basic cancer control factors: prevention,
402   II,     5.  3.  7|                Commission to set up a EU Cancer Task Force to provide leadership
403   II,     5.  3.  7|                to provide leadership for cancer control activities in Europe.~ ~
404   II,     5.  3.  7|                 Research collaboration~ ~Cancer research in Europe is of
405   II,     5.  3.  7|             implementing innovation into cancer care.~ ~Eurocan+Plus involves
406   II,     5.  3.  7|             light but permanent European Cancer Initiative, which will mainly
407   II,     5.  3.  7|              proactive leadership in the cancer research community;~· Be
408   II,     5.  3.  7|                Manage networks active in cancer research;~· Give guidance
409   II,     5.  3.  8|                 incidence rates for most cancer types are increasing. The
410   II,     5.  3.  8|                 of life expectancy makes cancer a disease of the elderly,
411   II,     5.  3.  8|              people are still exposed to cancer risk factors. Moreover,
412   II,     5.  3.  8|                  risk factors. Moreover, cancer patients survival in Europe
413   II,     5.  3.  8|             years (Coleman et al, 2003). Cancer prevalence, the measure
414   II,     5.  3.  8|                living people with a past cancer diagnosis, grows with incidence
415   II,     5.  3.  8|                 nearly 14 million of all cancer prevalent cases in 2002.
416   II,     5.  3.  8|            prevalent cases in 2002. With cancer prevalence, the demand for
417   II,     5.  3.  8|               for resources to follow-up cancer patients and identify and
418   II,     5.  3.  8|          patients and identify and treat cancer recurrences increases. At
419   II,     5.  3.  8|                  changing the reality of cancer.~The implication is that
420   II,     5.  3.  8|               for resources to follow-up cancer patients and identify and
421   II,     5.  3.  8|          patients and identify and treat cancer recurrences is increasing.
422   II,     5.  3.  8|            changing the understanding of cancer: from a limited number of
423   II,     5.  3.  8|                 integrated and effective cancer control policy for Europe
424   II,     5.  3.  8|                 problems in the field of cancer are:~ ~· Take into consideration
425   II,     5.  3.  8|              Take into consideration the cancer patient needs: achieve full
426   II,     5.  3.  8|                services as a function of cancer type, patient age and rehabilitation
427   II,     5.  3.  8|                the increase in prevalent cancer cases (i.e. increased needs
428   II,     5.  3.  8|                   implementing organized cancer screening programmes and
429   II,     5.  3.  8|            inequalities in the access to cancer diagnosis and treatment
430   II,     5.  3.  8|                 substantial reduction in cancer incidence over the next
431   II,     5.  3.  8|           possible treatment and care to cancer patients, exchange information
432   II,     5.  3.  8|                  European guidelines for cancer research: research on the
433   II,     5.  3.  8|                on the molecular bases of cancer offer new therapeutic possibilities
434   II,     5.  3.  8|                 day and have transformed cancer from being one disease into
435   II,     5.  3.  8|               the escalation of costs of cancer control, that even rich
436   II,     5.  3.  8|                in Europe while improving cancer services.~ ~
437   II,     5.  3.  9|                    European Code Against Cancer and scientific justification:
438   II,     5.  3.  9|               2003): EUROCARE-3 summary. Cancer survival in Europe at the
439   II,     5.  3.  9|     recommendation of 2 December 2003 on cancer screening. htt f (document
440   II,     5.  3.  9|                  2007): Estimates of the cancer incidence and mortality
441   II,     5.  3.  9|                  Group (2005): Childhood Cancer Survival Trends in Europe:
442   II,     5.  3.  9|           Endogenous Hormones and Breast Cancer Collaborative Group (2002):
443   II,     5.  3.  9|                  sex hormones and breast cancer in postmenopausal women.
444   II,     5.  3.  9|              prospective studies. J Natl Cancer Inst 94:606-616.~ ~Jonsson
445   II,     5.  3.  9|               2003): Life expectancy and cancer survival in the EUROCARE-3
446   II,     5.  3.  9|               survival in the EUROCARE-3 cancer registry areas. Ann Oncol
447   II,     5.  3.  9|                MA (2007): Strategies for cancer control in Italy. Tumori
448   II,     5.  3.  9|             Berrino F, Coleman M (2003): Cancer control in Europe: a proposed
449   II,     5.  3.  9|                 proposed set of European cancer health indicators. Eur J
450   II,     5.  3.  9|                  Pisani P (2005): Global cancer statistics, 2002. CA Cancer
451   II,     5.  3.  9|              cancer statistics, 2002. CA Cancer J Clin 55(2):74-108.~ ~Sant
452   II,     5.  3.  9|                  EUROCARE-3: survival of cancer patients diagnosed 1990-
453   II,     5.  3.  9|                 Kleihues P (2003): World Cancer Report. WHO document~ ~Tsubono
454   II,     5.  3.  9|         EUROCARE-4 Working Group. Recent cancer survival in Europe: a 2000–
455   II,     5.  3.  9| Physical activity, and the Prevention of Cancer: a Global Perspective. Washington
456   II,     5.  3.  9|                to improve and strengthen cancer control programmes in Europe. htt f (
457   II,     5.  5.  2|          conditions and diseases such as cancer and cardio-vascular diseases (
458   II,     5.  5.  2|                 of a report by the World Cancer Research fund and the American
459   II,     5.  5.  2|               the American Institute for Cancer Research on the EPHA website,
460   II,     5.  5.  3|   cardio-vascular diseases, diabetes and cancer.~In ASD, several conditions
461   II,     5.  5.  3|            coronary thrombosis. National Cancer Institute Monographs 19:
462   II,     5.  8.  3|             cardiovascular disease, lung cancer, asthma was found in a French
463   II,     5.  8.  3|             ischemic heart disease, lung cancer and asthma were more likely
464   II,     5.  8.  6|                  symptom burden for lung cancer and chronic obstructive
465   II,     5.  8.  6|                05) than people with lung cancer. Patients with COPD generally
466   II,     5.  8.  7|               pulmonary disease and lung cancer in the last 12 months of
467   II,     5. 11.Acr|         arthritis~NMSC~Non-Melanoma skin cancer~SCC~Squamous cell carcinoma~ ~
468   II,     5. 11.  1|               exception of melanoma skin cancer, most skin diseases are
469   II,     5. 11.  3|               sensitive enteropathy) and cancer of internal organs which
470   II,     5. 11.  3|            squamous cell carcinoma) skin cancer (NMSC) are now the most
471   II,     5. 11.  3|                  the most common type of cancer in fair skinned populations.
472   II,     5. 11.  3|       populations. The incidence of skin cancer has reached epidemic proportions (
473   II,     5. 11.  3|               2004).~ ~Non-Melanoma skin cancer~According to recent population-based
474   II,     5. 11.  3|               melanoma per 100,000. Many cancer registries probably underestimate
475   II,     5. 11.  3|               rates of non melanoma skin cancer in European fair skinned
476   II,     5. 11.  3|                Trentino, Italy, the Skin Cancer Registry calculated (for
477   II,     5. 11.  3|                 most common form of skin cancer reported in both men and
478   II,     5. 11.  3|                  and 1995, the Slovakian Cancer Registry registered 38 629
479   II,     5. 11.  3|               always from SCC, a form of cancer whose risk is strongly linked
480   II,     5. 11.  3|              carcinoma and squamous cell cancer are cured by adequate surgical
481   II,     5. 11.  3|                most serious form of skin cancer, and its incidence has been
482   II,     5. 11.  3|                  the development of skin cancer in the first place) and
483   II,     5. 11.  5|                  general message of skin cancer prevention.~Moreover, the
484   II,     5. 11.  5|             preventing sun-burn and skin cancer. Consumers should, therefore,
485   II,     5. 11.  6|               skin diseases such as skin cancer are becoming more common;
486   II,     5. 11.  7|             Autier P, Ringborg U (2004): Cancer of the skin: a forgotten
487   II,     5. 11.  7|                 Boyle P, Smans M (2003): Cancer Mortality Atlas of European
488   II,     5. 11.  7|                  Hillen HF et al (2000): Cancer in the very elderly Dutch
489   II,     5. 11.  7|                elderly Dutch population. Cancer 2000;89:1121–1133.~ ~De
490   II,     5. 11.  7|          decreases in Scandinavia. Int J Cancer 2003;107:119126.~ ~Diepgen
491   II,     5. 11.  7|                 The epidemiology of skin cancer. Br J Dermatol 2002;146(
492   II,     5. 11.  7|                DM (2001): GLOBOCAN 2000: Cancer Incidence, Mortality and
493   II,     5. 11.  7|                al (2001): Trends in Skin Cancer Incidence in Vaud: an update,
494   II,     5. 11.  7|                 update, 19761998. Eur J Cancer Prev 2001;10:371373.~ ~
495   II,     5. 11.  7|           incidence of non-melanoma skin cancer in Slovakia, (19781995).
496   II,     5. 12.  2|               Program of the US National Cancer Institute (National Cancer
497   II,     5. 12.  2|               Cancer Institute (National Cancer Institute, 2005).~Alcohol
498   II,     5. 12.  6|    identification and diagnosis of liver cancer foci. Thus, at least part
499   II,     5. 12.  6|             would be attributed to liver cancer following cirrhosis, rather
500   II,     5. 12.  7|       identifying abrupt changes in U.S. cancer mortality trends. Cancer