The number of people living with a cancer diagnosis is increasing in Europe, partly due to an ageing population

In 2020, 5% of the European population had been diagnosed with cancer. EUROCARE-6 study results published in the journal Lancet Oncology

It is estimated that at the beginning of 2020, 5% of the population in Europe had been diagnosed with cancer during their lifetime, a total of 23.7 million people. This is according to a study by an international research team coordinated by the Italian National Institute of Health (Istituto Superiore di Sanità) and the Fondazione IRCCS Istituto Nazionale dei Tumori in Milan, which estimated the prevalence in 2020 by analysing data from cancer registries in 29 European countries participating in the EUROCARE-6 research programme. The main results of the study are published today in the Journal Lancet Oncology and are available online at the European Commission's European Cancer Information System (ECIS) website.

About the study

The epidemiological study involved 61 European cancer registries and was based on data from patients diagnosed since 1978 and followed up until 2013, covering more than 19 million cancer cases and 32 types of cancer analysed. The study was funded under the Joint Action IPAAC (Innovative Partnership for Action Against Cancer), co-funded by the European Commission and 24 Member States, to improve the European cancer information system (ECIS).

The results

The study showed that by the beginning of 2020, 5% of the population in Europe had been diagnosed with cancer in their lifetime, either recently or in the distant past, totalling 23.7 million people (12.8 million women and 10.9 million men). Of these, 16% were under the age of 55 (3.74 million, of whom 2.32 were females and 1.42 males). Estimates refer to all prevalent cases, i.e. people who are still being treated, people who are being monitored for possible recurrence, and people who have been cured of cancer and do not require further treatment or monitoring.

Of the female prevalent cases, 43% had a previous diagnosis of breast cancer (5.5 million) and 37% of the male prevalent cases had prostate cancer (4 million). Colorectal cancer was the second most common cause of diagnosis among prevalent cases of both sexes (3 million), with higher proportions in men than in women (691 versus 564 cases per 100,000 population, respectively).

The study showed that between 2010 and 2020 the number of prevalent cancer cases in Europe increased by an average of 3.5% per year and 41% in total (from 16.8 to 23.7 million), partly due to the ageing population. The increase was more marked in men (+46%, from 7.47 million in 2010 to 10.9 million in 2020) than for women (+37%, from 9.34 to 12.8 million) due to the different composition of cancers in the two sexes.

The estimation of long-term and very long-term survivors is a unique feature of the study. In fact, the complete prevalence was reconstructed, including both cases observed by cancer registries and the estimated number of cases diagnosed before the start of the registries. In 2020, the number of prevalent cases diagnosed less than 5 years before (8.86 million) was much lower than the number living longer than 5 years, estimated at 14.85 million in total, respectively 5.75 million between 5 and 10 years, 5.54 million between 10 and 20 years and 3.55 million living more than 20 years after diagnosis. Overall, 38% of all prevalent cases in Europe in 2020 had survived more than 10 years after diagnosis (44% for women and 32% for men).

The study also revealed major differences in prevalence levels between the 29 participating European countries (ranging from 2 to 10 times depending on the type of tumour), much larger than those observed for incidence. For all malignant tumours, the highest values among the 29 countries surveyed were found in Germany, Italy, Belgium and France (crude prevalence proportions between 5.861 and 5.603 per 100,000 inhabitants), and the lowest in Bulgaria, Poland and Slovakia (3.026-3.775 per 100,000). The largest differences concern cancers with high geographical variability in incidence, such as skin melanoma, for which the prevalence proportion was eight times higher in Denmark than in Bulgaria, for both sexes.

“The results of the study” - the authors explain – “indicate that a very significant share of the population is or has been affected by the experience of cancer. This proportion is likely to increase and is even larger when families and caregivers are taken into account. The increasing cancer burden, driven by an ageing population and combined with the high cost of innovative therapies, has serious implications for the sustainability of health and social care systems. These data confirm the urgent need to strengthen primary prevention and early diagnosis. Prevention remains the way forward, not only to reduce the number of patients but also to improve the chances of recovery and a good quality of life after cancer, as clearly stated in the objectives of Europe's Beating Cancer Plan 2021-2027 (EBCP)”.

The authors point out that prevalence estimates “complement studies on cancer survivors and quality of life in cancer patients and are useful for developing guidelines for follow-up, preventing second cancers or late effects, and improving care throughout the disease course”. In addition, “prevalence by disease duration allows quantification of the target population affected by policies aimed at mitigating the socioeconomic consequences of the disease, such as employment or financial discrimination (legislation on the right to be forgotten of cured patients)”.

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De Angelis R, Demuru E, Baili P, Troussard X, Katalinic A, Chirlaque Lopez MD, Innos K, Santaquilani M, Blum M, Ventura L, Paapsi K, Galasso R, Guevara M, Randi G, Bettio M, Botta L, Guzzinati S, Dal Maso L, Rossi S, on behalf of the EUROCARE-6 Working Group. Complete cancer prevalence in Europe in 2020 by disease duration and country (EUROCARE-6): a population-based study. Lancet Oncol 2024. https://doi.org/10.1016/S1470-2045(23)00646-0

Read the article published in Lancet Oncology 

Read the peer-reviewed accepted article 

See study results in the European Cancer Information System website

Read the Europe's Beating Cancer Plan