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BMJ. 2007 April 14; 334(7597): 764.
PMCID: PMC1852000

UK ranks among lowest in Europe on cervical cancer survival

Rates of survival for cervical cancer in the United Kingdom are among the lowest in Europe, a new study shows.

The study, which was published online in Gynecologic Oncology on 30 March (www.sciencedirect.com, doi: 10.1016/j.ygyno.2007.01.048) and was based on data from more than 70 000 women in 18 countries, shows that survival in Europe overall has improved slowly but steadily but that the trend is not geographically uniform, with central European countries and the UK seeing little or no improvement.

Some of the biggest differences between countries were among women aged over 75. The five year survival rate in this group was below 30% in Scotland, Denmark, and four eastern European countries—Estonia, Slovakia, Slovenia, and Poland—whereas in the Netherlands the rate was 56%.

“This finding is distressing, because it suggests different standards of treatments for elderly women in different countries,” write the authors, from the Eurocare Working Group. The Eurocare project is an international collaborative study on the survival of cancer patients in Europe.

The study looked at relative survival and the relative excess risk of death within five years of diagnosis among 73 022 women in the 18 European countries in the Eurocare study aged 15-99 years whose cancer was diagnosed during 1983 to 1994 and who were followed up to 1999. Data came from 34 population based cancer registries.

The results show that relative survival at five years dropped markedly with age at diagnosis in most countries—overall from 78% in women aged 15-44 to 33% in women aged 75-99.

Age standardised relative survival at five years ranged from around 70% in several northern and western European countries (Iceland, Norway, Sweden, France, and the Netherlands) to 50-60% in eastern European countries (Estonia, Poland, Slovakia, and Slovenia). Survival in England, Scotland, and Wales was around 60%.

The results also show that the five year survival rate for localised disease was in the range of 78-88% in most countries, with relatively little variability. The report says that survival was markedly below the European average only in the Thames region in England and Basel in Switzerland, at around 72%, and that it was also below average in Krakow, Poland.

Among women whose cancer was diagnosed at the regional stage (stages IIa to IIIb), geographical variability in survival was more marked, ranging from 58% to 59% in Norway, Geneva (Switzerland), and Tuscany (Italy) down to about 30% in Basel (Switzerland) and the West Midlands (UK) and 19% in Slovakia.

The report says that variation in survival between registries did not decrease when stage distribution was taken into account: “This suggests that other factors influencing the treatment offered to women with cervical cancer may also affect prognosis.”

It adds, “This large population-based study confirms a slow but steady improvement of about 2% in five-year survival over the 12 years up to 1994. Improvement was not uniform across countries, and little improvement occurred in Central European countries, which remain, with the UK, at the lowest levels in Europe.

“Prognosis is better for younger women, particularly those diagnosed at an early stage. International variation in survival for women aged 75 and over was particularly marked, with the highest survival in the Netherlands.”

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Articles from The BMJ are provided here courtesy of BMJ Publishing Group