1) To describe and to compare survival of cancer patients in the European countries, using data recorded by population-based cancer registries.
2) To describe and to compare care processes for cancer patients in Europe through the collection of extra information besides data that are usually recorded by cancer registries.
EUROCARE is a Concerted Action on survival and care of cancer patients in Europe, based on data of population cancer registries. The project describes and compares survival of cancer patients in Europe and care processes for cancer patients in Europe through the collection of extra information besides data that are usually recorded by cancer registries.
The study is carried out on cases of invasive cancer diagnosed in the period 1978 to 1985 and follow up of at least 5 years. All major cancer sites are included, 28 registries participate in the study from 12 countries, and a database of over a million patients has been constituted. Data are collected according to a standardized protocol, the variables studied are those usually recorded by cancer registries. A systematic check has been performed on the whole database and errors and incongruences have been corrected through direct contact with local registries. An 'Atlas of cancer survival in Europe' will be published as an International Agency for Research on Cancer scientific monograph. This book will contain basic survival analysis for each cancer site, with comparisons among countries. Besides this, a detailed study on colon cancer, carried out on 74 325 patients evidenced a high variability in survival among European countries, which cannot be explained by sociodemographic factors such as age distribution, sex, criteria of inclusion of cases, general mortality levels. In 1981, 5-years survival of patients aged 60 to 69 ranged from a maximum of 52% to a minimum of 20%.
A further study was carried out on breast and lung cancer cases diagnosed in 1987, using the existing information on therapy. Data of 17 registries were processed; the proportion of patients not treated varied from 2% to over 30%. Besides, this survey, a detailed collection of information on diagnostic and therapeutic procedures has been carried out for breast and colorectal cancers diagnosed in 1990; 'ad hoc' forms have been adopted for this part of the study.
In most European countries population based cancer registries are active, providing incidence and mortality; some cancer registries currently analyze survival and are developing studies on care of cancer patients. However, survival data recorded by cancer registries are often not sufficiently standardized to allow reliable comparisons, as some practices of registration, criteria of inclusion of cases and age distribution may vary from country to country.
The EUROCARE project was proposed in order to gather standardize and analyse survival and care data collected at population level. It is well known that biological and clinical variables recorded by cancer registries are by far less detailed than the corresponding data derived from clinical studies. On the other hand, population-based data are in principle not affected by selection bias, therefore are representative of the entire population; also, these studies are indirect indicators of the effectiveness of health measures and of their impact on the general population. Population-based survival data are therefore best suited for temporal and/or geographical comparisons. Studies describing the diagnostic and therapeutic procedures can help in interpretation of the observed intercountry and over time survival differences.