Articles
27. 10. 2015 Cancer in the older population of the Czech Republic
Population ageing has become a challenge to cancer care in developed countries. Particularities of the older population must be taken into account when considering cancer treatment. However, there is a lack of consensus on guidelines for this population due to the underrepresentation of older patients in clinical trials.
15. 1. 2014 Personalised invitations of Czech citizens to cancer screening programmes
In January 2014, a project of personalised invitations for cancer screening programmes was launched in the Czech Republic. In particular, citizens are invited to participate in colorectal cancer screening (men and women), as well as breast cancer screening and cervical cancer screening (women). Personalised invitations are aimed at citizens who have not participated in cancer screening programmes in the long term, and therefore are at a higher risk of developing cancer. The project is expected to increase participation rates in Czech cancer screening programmes.
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Cancer burden in the Czech Republic: European and worldwide comparison
The global cancer burden is on the rise, warned IARC at the beginning of 2014. The Czech Republic is no exception: cancer incidence rates are growing in our country, too. But where does the Czech Republic rank among other European countries (or even globally) in terms of cancer burden?
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.
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
Diagnosis | Incidence | Mortality | ||||
both sexes |
men | women | both sexes |
men | women | |
Breast cancer (C50) - women | – | – | 30th | – | – | 117th |
Colorectal cancer (C18-C21) | 6th | 4th | 16th | 11th | 6th | 31st |
Lung cancer (C33-34) | 23rd | 24th | 30th | 30th | 28th | 33rd |
Kidney cancer (C64-C66) | 1st | 1st | 1st | 2nd | 4th | 2nd |
Prostate cancer (C61) | – | 34th | – | – | 98th | – |
Bladder cancer (C67) | 19th | 23rd | 11th | 36th | 43rd | 25th |
Testicular cancer (C62) | – | 12th | – | – | 51st | – |
Oesophageal cancer (C15) | 69th | 62nd | 92nd | 83rd | 74th | 106th |
Stomach cancer (C16) | 74th | 68th | 80th | 90th | 82nd | 95th |
Pancreatic cancer (C25) | 1st | 1st-2nd | 1st | 3rd | 5th | 2nd |
Malignant melanoma of skin (C43) | 12th | 11th | 14th | 33rd | 28th | 44th |
Cervical cancer (C53) | – | – | 107th | – | – | 137th |
Uterine cancer (C54) | – | – | 9th | – | – | 44th |
Ovarian cancer (C56) | – | – | 15th | – | – | 16th |
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
Diagnosis | Incidence | Mortality | ||||
both sexes |
men | women | both sexes |
men | women | |
Breast cancer (C50) - women | – | – | 18th | – | – | 36th |
Colorectal cancer (C18-C21) | 5th | 3rd | 10th | 9th | 6th | 20th |
Lung cancer (C33-34) | 13th | 17th | 18th | 17th | 19th | 20th |
Kidney cancer (C64-C66) | 1st | 1st | 1st | 2nd | 3rd | 1st |
Prostate cancer (C61) | – | 18th | – | – | 23th | – |
Bladder cancer (C67) | 12th | 16th | 7th | 19th | 25th | 9th |
Testicular cancer (C62) | – | 12th | – | – | 16th | – |
Oesophageal cancer (C15) | 15th | 17th | 15th | 19th | 21st | 21st |
Stomach cancer (C16) | 26th | 26th | 23rd | 22nd | 23rd | 22nd |
Pancreatic cancer (C25) | 1st | 1st | 1st | 2nd | 4th | 2nd |
Malignant melanoma of skin (C43) | 9th | 8th | 11th | 23th | 21st | 24th |
Cervical cancer (C53) | – | – | 13th | – | – | 18th |
Uterine cancer (C54) | – | – | 4th | – | – | 16th |
Ovarian cancer (C56) | – | – | 14th | – | – | 10th |
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
- 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.
- 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.
- Institute of Health Information and Statistics of the Czech Republic: Czech National Cancer Registry [9. 9. 2014]. http://www.uzis.cz/registry-nzis/nor
- 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.
- 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.
- 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