Key determinants of the future incidence of cancer across Europe: impact of prevention 2005 - 2009

Objective 1

Estimate the prevalence and quantitative impact on cancer incidence of major lifestyle-related risk factors like smoking, excessive alcohol use, fruit and vegetable consumption, overweight and physical activity and socio-economic determinants like educational level. This concerned cancers of the oral cavity, larynx, lung, oesophagus, stomach, pancreas, colon and rectum, bladder, kidney, breast, endometrium and prostate, together comprising about 60% of the incidence.

Work performed:

  • European cancer incidence data were compared across Europe to sketch the potential for prevention, combining the incidence data with knowledge on risk factors and therefore potential avoidability. The results of this exercise are described in: 
  • The prevalence of risk factors and incidence of cancer incidence were addressed for lifestyle risk factors and socio-economic factors. The responsible institutions (bureaus of statistics, etc) of all European countries were contacted in order to get an overview of available data and methodologies. Based on this information, the most comparable data were identified and extracted for each country for the following variables: smoking, excessive alcohol use, fruit and vegetable consumption, overweight and physical activity and hormone replacement therapy use. A summary of their findings by country is available in this report and described in this publication
  • Incidence data of European national or regional cancer registries is available at Cancer Incidence in 5 Continents, which is also available on the internet: http://ci5.iarc.fr/CI5i-ix/ci5i-ix.htm
  • We also collected additional information from these registries in order to make more detailed projections by country and to obtain historical data in order to be able to calculate historic trends in cancer incidence. Historical trends in cancer incidence for Europe were reported in another publication: 
    • Karim-Kos, H.E., et al., Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990sEur J Cancer, 2008. 44(10): p. 1345-89.
  • Much work was performed in the field of socio-economic differences in risk factor prevalence in and in cancer incidence and mortality in Europe, in close collaboration with other European projects such as Eurothine. 
    • Roskam, A.J., et al., Comparative appraisal of educational inequalities in overweight and obesity among adults in 19 European countriesInt J Epidemiol, 2009.
    • Menvielle, G., et al., Educational differences in cancer mortality among women and men: a gender pattern that differs across EuropeBr J Cancer, 2008. 98(5): p. 1012-9.
    • Ezendam, N.P., et al., Educational inequalities in cancer mortality differ greatly between countries around the Baltic Sea. Eur J Cancer, 2008. 44(3): p. 454-64.
    • Schaap, M.M., et al., Effect of nationwide tobacco control policies on smoking cessation in high and low educated groups in 18 European countriesTob Control, 2008. 17(4): p. 248-55.
    • Schaap, M.M., H.M. van Agt, and A.E. Kunst, Identification of socioeconomic groups at increased risk for smoking in European countries: looking beyond educational levelNicotine Tob Res, 2008. 10(2): p. 359-69.
    • Roskam, A.J. and A.E. Kunst, The predictive value of different socio-economic indicators for overweight in nine European countries. Public Health Nutr, 2008. 11(12): p. 1256-66.
    • Strand, B.H., et al., The reversed social gradient: higher breast cancer mortality in the higher educated compared to lower educated. A comparison of 11 European populations during the 1990sEur J Cancer, 2007. 43(7): p. 1200-7.
    • Menvielle, G., et al., The role of smoking and diet in explaining educational inequalities in lung cancer incidence. J Natl Cancer Inst, 2009. 101(5): p. 321-30.
    • Menvielle, G. and A. Kunst, Social inequalities in cancer incidence and cancer survival: Lessons from Danish studiesEur J Cancer, 2008. 44(14): p. 1933-7.
    • Menvielle, G., et al., Socioeconomic inequalities in alcohol related cancer mortality among men: to what extent do they differ between Western European populations? Int J Cancer, 2007. 121(3): p. 649-55.
    • Menvielle G, Soerjomataram I, de Vries E, Engholm G, Barendregt JJ, Coebergh JW, et al. Scenarios of future lung cancer incidence by educational level: Modelling study in DenmarkEur J Cancer. 2010 Sep;46(14):2625-32.