How Common Is Cancer in Europe? Prevalence and Long-Term Survivor Numbers

Cancer is a major disease of the modern era: complex, disruptive to quality of life and burdensome for health systems. Its statistics and terminology can be confusing. We begin with the key differences between prevalence and incidence, then consider The Lancet Oncology 's recent detailed analysis of European cancer prevalence, published on January 30, 2024, and why it matters.

Prevalence and Incidence: The Main Differences

• Prevalence measures people with a particular disease during a specified period, expressed as the total number . In other words, it shows how widespread a disease is in a population.
• Incidence , by contrast, counts cases newly diagnosed within a particular interval, such as the number of new cancer diagnoses in a country each year.
• "Frequency" may be used for incidence and "widespreadness" for prevalence, although these words may not fully capture the two concepts.
• Incidence reflects how quickly disease occurs, while prevalence reflects its overall burden in the population.

A Detailed Look at Cancer Prevalence in Europe

EUROCARE-6, the most comprehensive European study, provides a detailed analysis of prevalence as of 2020. It describes the total number of people living after a cancer diagnosis and their characteristics in 29 European countries, estimating survivor numbers and proportions by sex, age, disease duration and period for 32 cancer types.

The study does not include cancer data from Türkiye .

European Cancer Prevalence as of 2020

People living after a cancer diagnosis are an understudied population with diverse care needs. These depend on prognosis and treatment phase, whether initial care, follow-up or end-of-life care. Accurate prevalence measurement by changing time since diagnosis is essential for follow-up guidance, late-effect prevention, addressing inequalities and improving quality of life.

Rapidly increasing survivor numbers in aging populations, combined with the high cost of innovative treatments, challenge public healthcare sustainability. Detailed, comparable prevalence indicators are increasingly needed for cancer planning and Health Technology Assessment.

Cancer prevalence is the number or proportion of people alive after a diagnosis at a specified index date. It includes everyone diagnosed, regardless of time since diagnosis, ongoing treatment or recovery. Population-based registries can measure prevalence using incidence and survival data, counting cases alive on the chosen date. Observed prevalence is incomplete because it cannot include people diagnosed before registration began. Registries operating for five decades or more provide nearly complete observed prevalence.

Because registration periods are generally shorter than five decades, the number alive at any time after diagnosis can be estimated only through statistical models.

IARC provides globally comparable estimates for all European countries, limited to the first 5 years after diagnosis, using projected incidence and death rates. Complete prevalence, despite its potential value, is not systematically estimated in every European country with active population-based registries.

Study Design

Using incidence and follow-up data through January 1, 2013, from 61 registries, this population-based study estimated complete and limited-duration prevalence by cancer type, sex and age for 29 European countries and the European Union's 27 countries (EU27, represented by 22 member states providing data). It used a completeness-index method and focused on 32 malignant cancer types defined by the third edition of the International Classification of Diseases for Oncology, considering only the first primary tumor. Measures included absolute cases, crude prevalence (percentage or cases per 100,000 population) and age-standardized prevalence based on the 2013 European Standard Population. Linear regression projected rates to January 1, 2020.

Study Results

1. In 2020, an estimated 23,711,000 people in Europe were alive after a cancer diagnosis, approximately 5% of the population.
2. Within the European Union (EU27), the estimate was 22,347,000.
3. Among women, the most prevalent cancers were breast, colorectal, uterine, skin melanoma and thyroid cancer. Rates per 100,000 ranged from approximately 2,270 for breast cancer to 301 for thyroid cancer.
4. Among men, prostate, colorectal, urinary tract, skin melanoma and kidney cancers were most prevalent. Rates per 100,000 ranged from approximately 1,714 for prostate cancer to 255 for kidney cancer.
5. An estimated 14,850,000 had survived more than 5 years after diagnosis and 9,099,000 more than 10 years.
6. Between 2010 and 2020, prevalent cases increased by an average of 3.5% annually and 41% overall.
7. Prevalence differences between European countries ranged from 2- to 10-fold by cancer type in 2020.
8. Female survivors outnumbered male survivors, particularly for breast, uterine and thyroid cancers.
9. The most common cancers in male survivors included prostate, bladder and kidney cancer.
10. A large proportion of people living after cancer diagnosis have survived beyond 5 years: 65.3% of women and 59.5% of men.
11. The proportion more than 10 years after diagnosis is particularly high in some cancers, such as cervical cancer and Hodgkin lymphoma.
12. Between-country differences may reflect cancer risk, screening coverage and access to healthcare.
13. Population aging, alongside changing incidence and survival, contributes substantially to increasing prevalence.
14. Researchers noted that the findings could help countries develop policies to improve survivors' quality of life, care and rehabilitation.
15. Future work is expected to estimate recovery time among prevalent cases according to stage at diagnosis.

The graph below shows cancer prevalence by sex across European countries on January 1, 2020. Women are shown on the left and men on the right, with the eight most prevalent cancers expressed as cases per 100,000 people. Bars show each country's cancer distribution, with colors indicating types. Breast cancer is most prevalent in women and prostate cancer in men. Countries are ranked by complete all-cancer prevalence in EUROCARE-6, allowing comparisons and providing important information for health policy.

Why Is Lung Cancer Not Among the 5 Most Prevalent Cancers?

Worldwide, 2.5 million new cases each year make lung cancer the cancer with the highest incidence. It is often diagnosed at an advanced stage with a poor prognosis, leading to high mortality. The proportion surviving for a long time after diagnosis may therefore be lower than for other cancers.

Smoking is the main risk factor. European tobacco-control campaigns and public health efforts may have reduced lung cancer incidence, and consequently prevalence, in some countries.

Higher prevalence of cancers such as breast, prostate and colorectal cancer may also push lung cancer lower in the rankings. These cancers generally have a better prognosis and longer survival.

Why Does This Matter?

The study helps explain the complexity and diversity of cancer care needs. Increasing numbers living more than 5 years after diagnosis create new needs for health systems, requiring comprehensive oncology rehabilitation addressing psychological, cognitive, social, sexual and nutritional symptoms.

What the Study Contributes

EUROCARE-6 shows major between-country prevalence differences and cancer-specific time trends influenced by demographic aging. These differences inform intervention priorities and Health Technology Assessment.