Kielce, Polish conference on cancer, 13/15 June 2011
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Transcript of Kielce, Polish conference on cancer, 13/15 June 2011
Cancer inequalities Cancer inequalities in Europein Europe
Kielce, Polish conference on cancer, 13/15 June 2011Kielce, Polish conference on cancer, 13/15 June 2011
Dr. Andrea MicheliDirector
Descriptive Study and Health Planning UnitFondazione IRCCS “Istituto Nazionale dei Tumori”
Milan
EUROCHIP-1..3EUROCHIP-1..3Cancer is an element of our societies Cancer is an element of our societies
Why?Why? ToTo fight inequalities fight inequalities What?What? Translational research projectTranslational research project
How?How? Economy of scale: EUEconomy of scale: EU
From actions to common actionsFrom actions to common actionsTanks to Magdalena Tanks to Magdalena
Macro-economic approach - background
European vision
Cancer - inequalities - EuropeCancer - inequalities - Europe
LIFE EXPECTANCY IN EU-27, ICE, N, and CHLIFE EXPECTANCY IN EU-27, ICE, N, and CH2005-20092005-2009
Source: United Nations Population Division
LIFE LIFE EXPECTANCY EXPECTANCY
TRENDS IN TRENDS IN EUROPEEUROPE
InequalitiesInequalitiesin healthin health
increasedincreased
Source: United Nations Population Division
Life expectancy at birthLife expectancy at birth $PPP$PPP yrs
I) GDPI) GDP << = 20,000 = 20,000 73.373.3 II) II) 20,000 20,000 << GDPGDP << = 30,000 = 30,000 79.179.1III) III) 30,000 30,000 << GDPGDP << = 336,0006,000 79.679.6IV) GDPIV) GDP >> 336,0006,000 8080.0.0
GDP AND LIFE EXPECTANCY AT BIRTHGDP AND LIFE EXPECTANCY AT BIRTH
I, Bulgaria, Romania, Latvia, I, Bulgaria, Romania, Latvia, POLANDPOLAND, Lithuania, Hungary, Estonia, Slovakia, Lithuania, Hungary, Estonia, SlovakiaII, Portugal, Malta, Czech Republic, Slovenia, Cyprus, Greece, Spain, ItalyII, Portugal, Malta, Czech Republic, Slovenia, Cyprus, Greece, Spain, ItalyIII, France, Germany, Finland, United Kingdom, Belgium, Sweden, DenmarkIII, France, Germany, Finland, United Kingdom, Belgium, Sweden, DenmarkIV, Austria, Iceland, The Netherlands, Switzerland, Ireland, Norway, LuxembourgIV, Austria, Iceland, The Netherlands, Switzerland, Ireland, Norway, Luxembourg
Sources: United Nations Population Division. For GDP International Monetary Fund Sources: United Nations Population Division. For GDP International Monetary Fund
GROSS DOMESTIC PRODUCT (GDP) ANDGROSS DOMESTIC PRODUCT (GDP) ANDCANCER INCIDENCECANCER INCIDENCE
Source: GLOBOCAN 2002, IARC & United Nations (UN)
Age-standardized incidence rates, World Standard Population per 100,000, GDP: at current prices US $, 2006.
GROSS DOMESTIC PRODUCT (GDP) ANDGROSS DOMESTIC PRODUCT (GDP) ANDCANCER MORTALITYCANCER MORTALITY
Age-Standardized incidence rates, World Standard Population per 100,000, GDP: at current prices US $, 2006.
Source: GLOBOCAN 2002, IARC & United Nations (UN)
GDP and age-standardized incidence rates for all cancers. Men
Sources: Human Development Report 2009; Ferlay et al. 2008
GDP and age-standardized mortality rates for all cancers. Men
Disks are proportional to the public health expenditure ($ PPP) Sources: Human Development Report 2009; Ferlay et al. 2008
Source: Verdecchia A. et al.
EUROPE
Gross Domestic Product (GDP), Total National Health Expenditure (TNHE) and Public Health Expenditure (PHE)
GDP ($PPP)
0 10000 20000 30000
EstoniaPoland
SlovakiaCzech Rep
SloveniaScotland
SpainWales
FinlandEngland
ItalyFrance
SwedenGermany
NetherlandsDenmark
AustriaNorway
Switzerland
TNEH ($PPP)
0 1000 2000 3000
EstoniaPoland
SlovakiaCzech Rep
SloveniaScotland
SpainWales
FinlandEngland
ItalyFrance
SwedenGermany
NetherlandsDenmark
AustriaNorway
Switzerland
PHE ($PPP)
0 500 1000 1500 2000
EstoniaPoland
SlovakiaCzech Rep
SloveniaScotland
SpainWales
FinlandEngland
ItalyFrance
SwedenGermany
NetherlandsDenmark
AustriaNorway
Switzerland
Countries are ranked by GDP in 1995
EUROCARE-45-year relative survival, all cancers
countries are ordered by Total Health Expenditure
PolandEurope
Berrino F. et al, The Lancet Oncology, 2007
5 YEARS RELATIVE SURVIVAL FOR ALL CANCERS5 YEARS RELATIVE SURVIVAL FOR ALL CANCERSEUROCARE 3 EUROCARE 3
Ranked by 1995 TNEHRanked by 1995 TNEH
Source: Verdecchia A. et al. European Journal of Public Health, 2008
GDP AND EPIDEMIOLOGICAL CANCER DATA GDP AND EPIDEMIOLOGICAL CANCER DATA
All cancers M & FAll cancers M & FCOUNTRIES BY QUARTILE of GDP per capita ($PPP)
Incidenceper 100,000
Mortalityper 100,000
Survival%
LOWEST GDP < 20,000(BG, RO, LV, PL, LT, HU, EE, SK)
336 209 -
20,000 < GDP < = 30,000(PT, MT, CZ, SI, CY, EL, ES, IT) 363 172 5030,000 < GDP < = 36,000(FR, DE, FI, UK, BE, SE, DK)
411 171 49
HIGHEST GDP > 36,000(AT, IS, NL, CH, IE, NO, LU)
405 176 53
Sources: Ferlay et al. EJC, 2010. EUROCARE-4. For GDP International Monetary Fund Sources: Ferlay et al. EJC, 2010. EUROCARE-4. For GDP International Monetary Fund
• Produce cancer plans (and follow them)• Promote cancer information, i.e. cancer
registration • Organize screening programs for cancer
of cervix, breast and colorectum
• And invest in primary prevention actions
Against cancer inequalities: Against cancer inequalities: indications from Europeindications from Europe
Health Strategies in Europe. Lisbon, 12-13 July 2006. Coleman M., modified
Health Strategies in Europe. Lisbon, 12-13 July 2006. Coleman M. Health Strategies in Europe. Lisbon, 12-13 July 2006. Coleman M.
L. von Karsa et al. Cancer Screening in the European Union. First Report.
L. von Karsa et al. Cancer Screening in the European Union. First Report.
L. von Karsa et al. Cancer Screening in the European Union. First Report.
Lung cancer in Poland and EU-27, malesLung cancer in Poland and EU-27, males
Source: GLOBOCAN 2008, WHO. For Survival: EUROCARE-4. Sant et al. EJC 2009. WORLD Standard Population, per 100.000
Rate per 100,000Rate per 100,000
per 100
Smoking trends in European countries Smoking trends in European countries (M+F)(M+F)
Source: WHO, Health For All Europe, 2011
NO smokingEat better, five portion per dayReduce alcohol consumptionIncrease physical activity, 30’ of walking per day
Cancer inequalities: Cancer inequalities: promote healthpromote health