Abstract 3710: The gap in cancer mortality between Western and Eastern Europe
Authors: Manczuk Marta , Sulkowska Urszula , Hashim Dana , Boffetta Paolo 
Published: August 2015

Abstract
Introduction
Health disparities between Eastern and Western part of Europe have been the subject of many studies. Eastern Europe experienced delay in health improvement compared to Western Europe. Life expectancy differences between East and West average 7 years in men and 5 years in women, in favor of the West. Cancer contributes to 12% and 9% of this difference in men and women, respectively. For those 20-64 years, contribution of cancer to this difference is higher at 16% and 24%, respectively.
Methods
Cancer mortality data and population data (1959-2010) for each country separately were derived from the WHO Mortality Database. Standardized mortality rates were calculated using the world standard population.
Results
In young men (20-44 years) cancer mortality was equal in Eastern and Western Europe in late 1960s. Since then, a decline in cancer mortality occurred in Western countries while Eastern countries experienced a cancer mortality increase trend. This increase began to decline in Eastern Europe in the early 1990s, decreasing the cancer mortality gap between the two European regions for this sex and age group. Similar trend disparities were observed in middle-aged men (45-64 years). However, the decline since 1990 was much slower in Eastern Europe than Western Europe, resulting in a residual gap between the two regions. The oldest men (65+ years) in Western Europe had a higher cancer mortality rate than Eastern Europe for many decades. In early 1990s cancer mortality in Western Europe declined whilst rising in the East. The trends intersected a decade later and despite the plateau observed in recent years in Eastern Europe, the gap remains persistent.
In young women (20-44 years), cancer mortality diverted in the early 1970s as cancer mortality declined steadily in Western Europe while rising in the east, similarly in trend to cancer mortality among young men. By the 1990s, rates declined and the gap between the two regions trended towards closure. In middle-aged women (45-64 years) cancer mortality rates in Eastern Europe plateaued for the whole observation period, while western rates fell steadily since the 1970s, resulting in a residual gap between the two regions. For several decades, cancer mortality rates in the oldest women (65+ years) in Western Europe were higher than in the east and both regions experienced plateaus. By the 1990s western cancer mortality rates declined with little change in eastern trends. A small gap persists between the two regions.
Conclusions
Despite health improvement, a cancer mortality rate gap between Eastern and Western Europe persists across all sex and age strata. In particular, men at age of 45 years and more, and women at age of 45-64 years, experience the greatest disparities between the two regions. Deficiency of primary prevention and poor health awareness remain biggest challenge in Eastern part of Europe.
Citation Format: Marta Manczuk, Urszula Sulkowska, Dana Hashim, Paolo Boffetta. The gap in cancer mortality between Western and Eastern Europe. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3710. doi:10.1158/1538-7445.AM2015-3710