Cancer burden in the Czech Republic: European and worldwide comparison

Earlier this year, the International Agency for Research on Cancer (IARC) warned in its World Cancer Report 2014 [1] that in 2012, the worldwide burden of cancer had risen to an estimated 14 million new cases per year. Future prospects are not optimistic at all: this figure is expected to rise to 22 million annually within the next two decades. Over the same period, cancer deaths are predicted to rise from an estimated 8.2 million annually to 13 million per year.

In the Czech Republic, incidence rates for many types of cancer have been growing in the long term. Detailed information about individual diagnoses is available on the website www.svod.cz [2], which enables users to set numerous parameters according to their individual needs. The Czech National Cancer Registry (CNCR) [3] is the source of data describing cancer epidemiology in the Czech Republic. Figures 1–6 show several examples of analyses that demonstrate growing incidence rates for some cancer types in the Czech Republic. Over the last decade, the epidemiological situation has slightly improved for some types of malignant tumours: mortality rates have stabilised or even slightly decreased (Figs. 1, 4, 5 and 6). Continuously growing incidence rates, however, have inevitably led to an increase in prevalence rates, i.e. the number of cancer survivors.

Fig. 1: Bowel cancer incidence and mortality in the Czech Republic (both sexes), per 100,000 persons. Data source: CNCR	Fig. 2: Pancreatic cancer incidence and mortality in the Czech Republic (both sexes), per 100,000 persons. Data source: CNCR	Fig. 3: Lung cancer incidence and mortality in the Czech Republic (both sexes), per 100,000 persons. Data source: CNCR
Fig. 4: Breast cancer incidence and mortality in the Czech Republic (women), per 100,000 persons. Data source: CNCR	Fig. 5: Prostate cancer incidence and mortality in the Czech Republic (men), per 100,000 persons. Data source: CNCR	Fig. 6: Kidney cancer incidence and mortality in the Czech Republic, per 100,000 persons. Data source: CNCR

Tables 1 and 2 show where the Czech Republic ranks in terms of incidence and mortality rates for selected cancer types when compared to other European countries and globally. According to international data from the GLOBOCAN 2012 study [4], the Czech Republic occupies the unenviable 1st position in both incidence and mortality rates for kidney cancer, both on the European and global level. On top of that, the incidence rate for pancreatic cancer is alarming: the burden among the Czech population belongs to the highest globally. Unfortunately, pancreatic cancer usually has a poor prognosis: long-term statistics show that the 5-year relative survival is only about 5 % [5].

Table 1: Ranking of the Czech Republic in terms of incidence rates of selected cancers - worldwide comparison, age-standardized (world) rate (ASR-W). Data source: GLOBOCAN 2012

Table 2: Ranking of the Czech Republic in terms of incidence rates of selected cancers - European comparison, age-standardized (world) rate (ASR-W). Data source: GLOBOCAN 2012

According to the latest available data [3], the crude incidence rate for all cancer types in the Czech Republic reached almost 802 new cases of cancer per 100,000 men, and 681 new cases of cancer per 100,000 women in 2011. The crude mortality rate for all cancer types in the Czech Republic exceeded 258 deaths per 100,000 persons in 2011; in other words, there were more than 27,000 deaths from cancer in the Czech Republic in 2011, and epidemiologists do not expect any significant improvement of this situation in the years to come. In the last decade (2001–2011), there was an increase in cancer incidence rates (growth index: +27.6%), while cancer mortality rates have stabilised (growth index: –5.0%). This has led to a significant increase in cancer prevalence rates: in the same period, the prevalence exceeded 475,000 cases.

These above-mentioned statistics demonstrate the heavy burden of cancer among the Czech population. There are also some good news, such as the stabilised or even slightly decreasing mortality rates [4] and improvements in Czech cancer care in terms of treatment and survival of Czech cancer patients, as mentioned in the EUROCARE-5 study [6]. However, one must bear in mind that these positive results have been achieved thanks to modern cancer treatments, which have been increasingly more expensive. Taking into account the significant burden of cancer in the Czech Republic, it is necessary to make every effort to diagnose cancer patients at the earliest stages possible, which would not only lead to a much better prognosis for the patient, but also to considerable savings of treatment costs.

References

1. Stewart, B. W., Wild, C. P. (Eds.): World Cancer Report 2014. International Agency for Research on Cancer (IARC), February 2014, 630 pp., ISBN 978-92-832-0429-9.
2. Dušek L., Mužík J., Kubásek M., Koptíková J., Žaloudík J., Vyzula R. Epidemiology of malignant tumours in the Czech Republic [online]. Masaryk University, [2005], [cited on 2014-09-09]. Available from WWW: http://www.svod.cz. Version 7.0 [2007], ISSN 1802-8861.
3. Institute of Health Information and Statistics of the Czech Republic: Czech National Cancer Registry [9. 9. 2014]. http://www.uzis.cz/registry-nzis/nor
4. Ferlay, J., Soerjomataram, I., Ervik, M., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D.M., Forman, D., Bray, F.: GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [online]. International Agency for Research on Cancer, Lyon (France) 2013. Available from WWW: http://globocan.iarc.fr.
5. Pavlík, T., Májek, O., Büchler, T., Vyzula, R., Petera, J., Ryška, M., Ryška, A., Cibula, D., Babjuk, M., Abrahámová, J., Vorlíček, J., Mužík, J., Dušek, L. Trends in stage-specific population-based survival of cancer patients in the Czech Republic in the period 2000-2008. Cancer Epidemiology 2014; 38(1): 28-34. doi: 10.1016/j.canep.2013.11.002.
6. De Angelis, R,, Sant, M., Coleman, M. P., et al. Cancer survival in Europe 1999-2007 by country and age: results of EUROCARE-5 – a population-based study. The Lancet Oncology 2014; 15(1): 23-34. doi: 10.1016/S1470-2045(13)70546-1.

10. 9. 2014 IBA MU

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