Comparative cancer survival in European countries.

BACKGROUND: Survival for patients with cancer varies widely across Europe. This review is an attempt to explore some of the factors that influence this variation. SOURCES OF DATA: The data on cancer survival come from EUROCARE-5 and a recent OECD report. These figures have been analysed together with data from a variety of other sources: other OECD data sets; EUROSTAT; The World Bank; Gallup and the World Health Organisation. AREAS OF AGREEMENT: This study confirms the importance of national socio-economic factors in influencing the outcomes for patients with cancer. AREAS OF CONTROVERSY: The usual suspects (limited access to expensive new cancer drugs; delayed diagnosis and late presentation) may have less influence on cancer survival than is usually assumed. GROWING POINTS: Disparities in outcomes challenge systems of health care to re-evaluate their strategies. The key point is that these new strategies need to be informed by facts, rather than suppositions. AREAS TIMELY FOR DEVELOPING RESEARCH: The role and scope of national cancer registries should be enhanced. We need to record more detailed information on each patient with cancer and, in an era of linked data, cancer registries are ideally placed to collect and curate such information.