Dokumendiregister | Ravimiamet |
Viit | RST-1/3291-2 |
Registreeritud | 02.07.2025 |
Sünkroonitud | 03.07.2025 |
Liik | Väljaminev kiri |
Funktsioon | RST Ravimistatistika tegemine |
Sari | RST-1 Ravimistatistika alane kirjavahetus |
Toimik | RST-1/2025 |
Juurdepääsupiirang | Avalik |
Juurdepääsupiirang | |
Adressaat | SIA Merck Sharp & Dohme Latvija |
Saabumis/saatmisviis | SIA Merck Sharp & Dohme Latvija |
Vastutaja | Janne Sepp (RA, Peadirektori asetäitja valdkond, Ravimiohutuse osakond, Statistikabüroo) |
Originaal | Ava uues aknas |
Dear Arturs,
Thank you for your e-mail.
Please find my answers written in bold text:
1. Is it possible to recieve this data on monthly basis? Quarterly data while great, leaves a large period blank until we recieve the next report, therefore would be greatly appreciated if we recieved this information on monthly basis. – Estonian State Agency has the data on quarterly basis only. The data source is wholesalers’ quarterly reports. So this is the time frame we have.
2. Is it possible to add a column in the reports that discloses to what institution exactly the products have been shipped as currently only totals for hospitals, pharmacies and others are visible. – The wholesalers’ provide their data to us as the total amount sold to the sectors and they do not distinguish institutions separately. Therefore this is the maximum data we have and provide.
3. Could you please provide guidance on the availability of data related to oncology, specifically concerning ICD-10 codes, and the associated costs for each treatment? – Probably you could ask this information from Estonian Health Insurance Fund (https://www.tervisekassa.ee/en). OECD recently shared their newest reports on this topic (attached). See also: https://www.oecd.org/content/oecd/en/search.html?q=cancer+profiles&orderBy=mostRelevant&page=0
General overviews about Estonian medicinal products market can be found on our website publications:
https://ravimiamet.ee/en/statistics/statistics-medicines (2024 overview will be published soon)
https://ravimiamet.ee/en/statistics/statistical-yearbooks
I hope my answers were helpful.
Kind regards,
Janne Sepp
State Agency of Medicines
Department of Post-Authorisation Safety
Bureau of Drug Statistics
Specialist
Phone: +372 737 4140
Nooruse 1, 50411 Tartu, Estonia
This e-mail and any attachments transmitted may contain confidential and privileged information. If you are not the intended recipient, please notify the sender immediately by returning the e-mail and permanently deleting what you have recieved. Any dissemination or use of this information by a third person without permission is prohibited and may be illegaal.
Saatja: Veips, Artūrs <[email protected]>
Saatmisaeg: teisipäev, 18. märts 2025 12:34
Adressaat: Janne Sepp <[email protected]>; Dzirkale, Ieva <[email protected]>
Koopia: Muursepp, Andres <[email protected]>
Teema: MSD data request clarification
Tähelepanu! Tegemist on väljastpoolt asutust saabunud kirjaga. Tundmatu saatja korral palume linke ja faile mitte avada. |
Proprietary
Hello Janne.
I am new Data analyst for MSD Baltics, my colleague Andres Muursepp recommended that I get in touch with you regarding a report we recieve from you on quarterly basis called “EE Medicine Agency statistics”.
Could you please clarify few aspects regarding the data and its availability.
If this should be adressed to someone else, please let me know.
Best regards,
Artūrs Veips
Insight analyst Baltic region
MSD
A. Skanstes str. 50A, Riga, Latvia LV-1013
M. +371 28781254
Today MSD is a global healthcare leader working to help the world be well. MSD is a tradename of Merck & Co., Inc., Rahway, NJ., U.S.A. Through our prescription medicines, vaccines, biologic therapies, and consumer care and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to healthcare through far-reaching policies, programs and partnerships. For more information, visit www.msd.com
European Cancer Inequalities Registry
EU Country Cancer Profiles
Synthesis Report
2025
1
EU Country Cancer Profiles
EU Country Cancer Profiles Synthesis Report 2025
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Please cite this publication as:
OECD/European Commission (2025), EU Country Cancer Profiles Synthesis Report 2025, OECD
Publishing, Paris, https://doi.org/10.1787/20ef03e1-en.
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3
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Foreword
Europe’s Beating Cancer Plan (EBCP) addresses the longstanding threat posed by cancer. One of the
Plan’s ten flagship initiatives, the European Cancer Inequalities Registry assesses inequalities in cancer.
Under this umbrella, the OECD and European Commission present this synthesis report, highlighting
findings from the 2025 Country Cancer Profiles. These country-specific assessments, authored by the
OECD and the European Commission, provide the latest data and developments across the cancer
spectrum, from prevention to survivorship in EU Member States, Iceland and Norway.
The 2025 synthesis report brings to light four main messages. First, cancer is only growing as a public
health concern in the EU, as the share of people under active treatment or living with a history of cancer
expands due to population ageing and notable decreases in cancer mortality. However, even with the
reductions, mortality rates remain much higher among lower income countries in the EU, as well as among
men and those with lower levels of education.
Second, there is evidence of improvement on a number of cancer risk factors in the EU over time, with the
notable exception of overweight and obesity, which are an increasing challenge. Smoking rates have
decreased in the vast majority of EU countries. Trends in alcohol use show more variability by country, but
point to an overall decrease at the EU level. However, even with substantial policy measures addressing
the intersecting risk factors of overweight, low physical activity and poor diet – over half of adults in
EU countries are overweight and rates are rising among adolescents.
Third, early detection efforts via screening programmes show worrying trends. One in two EU countries
saw a decline in breast cancer screening participation, while two out of three saw decreases in cervical
cancer screening. However, many countries have introduced population-based colorectal cancer
screening in the last 15 years, promoting earlier detection and improved outcomes. Other positive efforts
aim at making self-sampling for cancer screening more widely available and closing gaps in screening
participation between population groups.
Finally, improved cancer survival rates and increasing cancer prevalence are propelling efforts to develop
rehabilitation and quality of life programmes for people with cancer. Countries are making wide-ranging
investments in palliative care services and developing new programmes to address the psychological,
social, occupational and economic reintegration of cancer survivors.
This synthesis report provides insight on the performance of countries across the cancer care spectrum,
identifying common challenges and parallel improvements. The second part of the report presents a
Cancer Performance Tracker (CaPTr) for each country across several cancer domains: prevention, early
detection, care capacity, and outcomes. The Country Cancer Profiles and synthesis report reveal that there
is still great need to collect better, more comprehensive, internationally comparable data. Actionable and
comparable information on cancer incidence trends, effectiveness of screening programmes, timeliness
and quality of cancer care, patient-reported outcomes, and cancer survival have the potential to catalyse
improved cancer care monitoring and policy making across the EU, in line with the vision of EBCP.
4
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Table of contents
Foreword 3
Acronyms and abbreviations 7
1 Cancer burden 8
In Europe, the ageing population and lower cancer mortality rates are leading to an increase in
the number of people living with cancer 8
In virtually all EU countries, national cancer plans align with Europe’s Beating Cancer Plan 13
2 Risk factors and prevention policies 15
Tobacco smoking has decreased in all but three EU+2 countries between 2012 and 2022 15
Alcohol consumption has decreased in two out of three EU countries between 2010 and 2022 16
Trends in tobacco and alcohol consumption among adolescents reflect those seen in adults 16
More than half of the adult population is overweight in 23 EU+2 countries, while overweight
rates among adolescents have increased in all but three countries 18
Although countries are investing in prevention, additional efforts are needed to reduce the key
cancer risk factors 19
3 Early detection 22
Although cancer screening programmes are expanding and using new outreach methods,
participation rates are stagnating or even declining 22
Countries are working to overcome screening inequalities and are making self-sampling more
accessible 25
Lung, prostate and gastric cancer screening and expanded genetic testing are under
consideration 26
4 Cancer care performance 28
Growing cancer prevalence is driving efforts to improve accessibility and quality of cancer care 28
Improvements in survival estimates and cancer care quality initiatives are evident across
EU countries 32
The increasing cancer burden has wide-ranging impact on the health system and the economy 35
Given increasing cancer prevalence, countries are developing follow-up and rehabilitative care,
and implementing policies to address quality of life 37
5 Spotlight on paediatric cancer care 40
Over 50% of new cancer diagnoses among children stem from three main cancer types:
Leukaemia, brain and non-Hodgkin’s lymphoma 40
In 12 EU+2 countries, paediatric cancer patients had access to less than 5% of oncology clinical
trials running in Europe 41
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
6 Cancer performance trackers 42
Notes 74
References 75
FIGURES
Figure 1.1. Breast cancer is responsible for almost one in three new cancer cases among women in the EU,
while prostate cancer accounts for almost one in four new cases among men 9 Figure 1.2. While decreasing over the last decade, cancer mortality rates are almost 70% higher among men
than women 11 Figure 1.3. Avoidable lung cancer mortality among men decreased in all EU countries, but increased among
women in 16 countries 12 Figure 1.4. Cancer prevalence increased by over 20% in 24 EU+2 countries over the last ten years 13 Figure 2.1. Tobacco smoking rates among adults have decreased across almost all EU countries over the
past decade 16 Figure 2.2. Adolescent smoking is strongly associated with the prevalence of smoking among adults 17 Figure 2.3. Tobacco smoking and drunkenness have decreased among adolescents in the EU 17 Figure 2.4. While about a third of women with high education levels are overweight in the EU, that figure
jumps to over half of women with low education 19 Figure 2.5. Almost 2 million cancer cases could be prevented in the EU between 2023-50 by meeting tobacco
reduction targets 21 Figure 3.1. Breast cancer screening coverage declined in more than half of EU+2 countries over the last
decade 23 Figure 3.2. Cervical cancer screening participation rates decreased in two-thirds of EU+2 countries 24 Figure 3.3. Colorectal cancer screening programmes have recently expanded in EU countries alongside
initiatives to better reach target populations 25 Figure 4.1. The availability of nurses per cancer case varies more than 5-fold across EU+2 countries 29 Figure 4.2. Volume of radiotherapy equipment varies almost threefold across EU countries 31 Figure 4.3. Over the last decade, there has been a reduction in potential years of life lost across all main
cancer sites 34 Figure 4.4. On average in the EU, health expenditure on cancer is projected to increase by more than 50% in
2050 compared to 2023 36 Figure 4.5. Cancer is expected to have a large impact on workforce participation and productivity 37 Figure 4.6. Cancer is projected to reduce life expectancy by between 1.4 and 2.5 years across EU countries 38 Figure 5.1. The paediatric cancer mortality rate in the EU stood at 2.1 per 100 000 children 40 Figure 6.1. Belgium’s Cancer Performance Tracker (CaPTr) 43 Figure 6.2. Bulgaria’s Cancer Performance Tracker (CaPTr) 44 Figure 6.3. Czechia’s Cancer Performance Tracker (CaPTr) 45 Figure 6.4. Denmark’s Cancer Performance Tracker (CaPTr) 46 Figure 6.5. Germany’s Cancer Performance Tracker (CaPTr) 47 Figure 6.6. Estonia’s Cancer Performance Tracker (CaPTr) 48 Figure 6.7. Ireland’s Cancer Performance Tracker (CaPTr) 49 Figure 6.8. Greece’s Cancer Performance Tracker (CaPTr) 50 Figure 6.9. Spain’s Cancer Performance Tracker (CaPTr) 51 Figure 6.10. France’s Cancer Performance Tracker (CaPTr) 52 Figure 6.11. Croatia’s Cancer Performance Tracker (CaPTr) 53 Figure 6.12. Italy’s Cancer Performance Tracker (CaPTr) 54 Figure 6.13. Cyprus’ Cancer Performance Tracker (CaPTr) 55 Figure 6.14. Latvia’s Cancer Performance Tracker (CaPTr) 56 Figure 6.15. Lithuania’s Cancer Performance Tracker (CaPTr) 57 Figure 6.16. Luxembourg’s Cancer Performance Tracker (CaPTr) 58 Figure 6.17. Hungary’s Cancer Performance Tracker (CaPTr) 59 Figure 6.18. Malta’s Cancer Performance Tracker (CaPTr) 60 Figure 6.19. The Netherlands’ Cancer Performance Tracker (CaPTr) 61 Figure 6.20. Austria’s Cancer Performance Tracker (CaPTr) 62
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.21. Poland’s Cancer Performance Tracker (CaPTr) 63 Figure 6.22. Portugal’s Cancer Performance Tracker (CaPTr) 64 Figure 6.23. Romania’s Cancer Performance Tracker (CaPTr) 65 Figure 6.24. Slovenia’s Cancer Performance Tracker (CaPTr) 66 Figure 6.25. Slovak Republic’s Cancer Performance Tracker (CaPTr) 67 Figure 6.26. Finland’s Cancer Performance Tracker (CaPTr) 68 Figure 6.27. Sweden’s Cancer Performance Tracker (CaPTr) 69 Figure 6.28. Iceland’s Cancer Performance Tracker (CaPTr) 70 Figure 6.29. Norway’s Cancer Performance Tracker (CaPTr) 71 Figure 6.30. EU’s Cancer Performance Tracker (CaPTr) 72 Figure 6.31. Cancer Performance Tracker (CaPTr) methods table 73
TABLES
Table 1.1. While EU+2 countries closely align national cancer plans with the four pillars of the Europe’s
Beating Cancer Plan, inequalities and paediatrics are not always fully addressed 14
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Acronyms and abbreviations
ASMR Age standardised mortality rate
BGN Bulgarian lev
CaPTr Cancer Performance Tracker
CT Computed tomography
EBCP Europe’s Beating Cancer Plan
eCAN Joint Action on strengthening eHealth for Cancer Patients
ECIS The European Cancer Information System
EU European Union
EU CraNE Joint Action on network of Comprehensive Cancer Centres
EUNetCCC European Network of Comprehensive Cancer Centres
EUR Euro
FIT Faecal immunochemical testing
FTE Full-time equivalent
GDP Gross domestic product
HPV Human papillomavirus
HTA Health Technology Assessment
ICER Incremental cost-effectiveness ratio
MRI Magnetic resonance imaging
NCP National Cancer Plan
OECD Organisation for Economic Co-operation and Development
PET Positron emission tomography
PM Particulate matter
PRAISE-U Prostate cancer Awareness and Initiative for Screening in the European Union
PROMs Patient Reported Outcome Measures
PPP Purchasing power parities
PSA Prostate-specific antigen
PYLL Potential years of life lost
QALY Quality-adjusted life years
SIOPE European Society for Paediatric Oncology’s
SOLACE Strengthening the screening of Lung Cancer in Europe
SPHeP OECD Strategic Public Health Planning model
TOGAS Towards gastric cancer screening implementation in the European Union
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Large variation across countries is seen in both age-standardised cancer incidence and mortality rates.
Cancer mortality rates remain highest in the lower-income countries in the EU but have decreased across
almost all countries between 2011-21. Cancer mortality rates are also much higher among men than
women and among people with low education levels. The combination of population ageing, which
increases cancer incidence, and declining cancer mortality rates is resulting in higher cancer prevalence.
Recognising the growing burden of cancer, most countries have developed national cancer plans that align
closely with the key elements in Europe’s Beating Cancer Plan.
In Europe, the ageing population and lower cancer mortality rates are leading to
an increase in the number of people living with cancer
Every minute, five people in the EU find out they have cancer
According to the European Cancer Information System (ECIS) of the EC Joint Research Centre based on
incidence trends from pre-pandemic years, a total of 2 742 447 new cancer cases were expected to be
diagnosed in the EU in 2022. Estimated age-standardised cancer incidence in the EU is 572 per
100 000 population. Cancer incidence is higher among men (684 per 100 000) compared to women (488
per 100 000) (Figure 1.1), partly due to higher prevalence of cancer risk factors among men. Countries
with the highest incidence rates include Denmark, Ireland, the Netherlands and Croatia. In addition to
cancer risk factors, estimated cancer incidence is influenced by the quality of national cancer surveillance
and coding systems, by cancer screening programmes that can facilitate earlier detection of asymptomatic
cancer cases and by access to diagnostic capacity.
1 Cancer burden
9
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 1.1. Breast cancer is responsible for almost one in three new cancer cases among women in the EU, while prostate cancer accounts for almost one in four new cases among men
Age-standardised incidence rate per 100 000, EU average, 2022 estimates
Note: 2022 figures are estimates based on incidence trends from previous years, and may differ from observed rates in more recent years.
Includes all cancer sites except non-melanoma skin cancer. Corpus uteri does not include cancer of the cervix.
Source: European Cancer Information System (ECIS). From https://ecis.jrc.ec.europa.eu, accessed on 10 March 2024. © European Union,
2024. The incidence percentage breakdown was re-computed based on age-standardised incidence rates and as such differs from the
percentage breakdown based on absolute numbers shown on the ECIS website.
About half of cancer incidence is driven by four main cancer types: Colorectal, lung,
prostate and breast
In 2022, three cancer sites (prostate, colorectal and lung) accounted for 51% of all age-standardised
cancer cases in men in the EU. A similar share of 51% of cancers among women were caused by breast,
colorectal and lung cancer, with breast cancer accounting for the majority, or 30% of all cancer cases.
Colorectal cancer accounted for a similar proportion of all cancers among men (14%) and women (12%).
In contrast, lung cancer accounted for a greater proportion of cancer cases among men (14%) than women
(9%), related to higher smoking prevalence among men over time.
Prostate cancer incidence varies 2.5-fold and breast cancer incidence 2-fold across
EU countries
Countries with the highest incidence of prostate cancer were Lithuania, Norway and Sweden. Incidence
ranged from 104 per 100 000 in Bulgaria to 265 per 100 000 in Lithuania, 72% higher than the EU average
of 154 per 100 000 population. Prostate cancer incidence is highly influenced by prostate cancer screening
practices, which differ considerably across the EU and may explain the much higher incidence observed
in some EU countries (Vaccarella et al., 2024[1]).
Breast cancer incidence ranged from 88 per 100 000 in Bulgaria to 190 per 100 000 in Luxembourg, 28%
higher than the EU average of 148 per 100 000 population. Other countries with breast cancer incidence
above 170 per 100 000 women were Belgium, Cyprus, France, the Netherlands, Denmark, Finland and
Norway.1 Differences in breast cancer incidence are largely accounted for by differences in prevalence of
obesity and alcohol consumption, as well as genetic factors and cancer screening participation. Some
national data reported in the Country Cancer Profiles indicate concerning trends in incidence, such as an
Breast 30%
Prostate 23%
Colorectum 12%
Lung 14%
Lung 9%
Colorectum 14%
Corpus uteri 5%
Bladder 9%
All other cancer sites 43%
All other cancer sites 41%
0 100 200 300 400 500 600 700 800
Women
Men
488
684
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
increased risk of breast cancer each year from 2012 to 2021 (Finland) or a faster increase in breast cancer
incidence among younger ages (the Slovak Republic), mirroring trends observed in France (Hassaine
et al., 2022[2]) and the United States (Sung et al., 2024[3]).
Men have more than double the lung cancer incidence and 60% higher colorectal cancer
incidence rates than women
Lung cancer incidence in men ranged from 39 per 100 000 in Sweden to 139 per 100 000 in Hungary, 46%
higher than the EU average of 95 per 100 000. Lung cancer rates among women in the EU (at 44 per
100 000) are about half those of men, but there are also large differences among countries, with incidence
ranging from 19 per 100 000 women in Latvia to 79 per 100 000 women in Denmark. While Hungary,
Poland and Croatia have the highest lung cancer incidence among men, it is the Western European
countries of Denmark, the Netherlands and Ireland that have some of the highest rates among women.
Differences in lung cancer incidence are mainly driven by differences in historical rates of smoking
prevalence.
Gender gaps in colorectal cancer are also notable, with men in the EU having average incidence rates at
93 per 100 000, 60% higher than rates among women (58 per 100 000). Similarly, there are large
differences across countries. Hungary had the highest estimated incidence among men (at 138 per
100 000), double the rate of Austria, with the lowest incidence (63 per 100 000). Among women, estimated
colorectal cancer incidence varied even more – from 104 per 100 000 in Norway2 to 38 per 100 000 in
Austria. Differences in colorectal cancer incidence are largely accounted for by differences in prevalence
of obesity, consumption of alcohol and processed foods and cancer screening participation. Similar to
breast cancer, there are concerning trends indicating an increasing incidence of colorectal cancer among
younger birth cohorts in Europe and North America (Vuik et al., 2019[4]; Sung et al., 2025[5]).
According to ECIS, the number of new cancer cases in the EU is projected to grow by 18% from 2022 to
2040. Increases are expected to be greatest for Luxembourg (57%), Ireland (47%) and Malta (44%) and
smallest for Latvia (2%), Bulgaria (3%) and Croatia (4%).
Every minute, cancer kills more than two people in the EU
In EU countries in 2021, 1.15 million people died from cancer, which was the second-leading cause of
mortality on average after cardiovascular disease. The average age-standardised cancer mortality rate in
the EU was 235 per 100 000 population (Figure 1.2), with rates ranging from about 200 per 100 000 in
Malta and Luxembourg to about 310 per 100 000 in Hungary and Croatia. Mortality rates were generally
lower in wealthier countries: 235 per 100 000 in the top tercile compared to 257 in the bottom tercile.3
Age-standardised cancer mortality rates in the EU decreased by 12% on average from 2011 to 2021. All
countries saw decreased cancer mortality for both men and women, except Bulgaria and Cyprus, which
experienced increases for both genders. The largest decreases for men were in Luxembourg (25%),
Norway (23%) and Iceland (22%), while the largest decreases for women were in Luxembourg (24%),
Malta (23%) and Ireland (16%). Higher reductions were seen among the top and middle income terciles of
countries (13% each), as compared to a reduction of 10% in the bottom tercile.
In 2021, the cancer mortality rate was 67% higher among men (308 per 100 000) than women (184 per
100 000). From 2011 to 2021, the cancer mortality rate in men decreased by 16% on average in the EU
compared to an 8% decrease among women. The faster decline in cancer mortality rates among men
partly reflects the large decrease in lung cancer mortality rates among men, who have historically had
much higher smoking rates and lung cancer mortality than women.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 1.2. While decreasing over the last decade, cancer mortality rates are almost 70% higher among men than women
Age-standardised mortality rate per 100 000 population, 2021
Source: Eurostat Database.
From 2011 to 2021, avoidable mortality fell 16% for breast cancer and 17% for colorectal
cancer
Avoidable mortality refers to deaths among people aged under 75 and includes both preventable deaths
(such as lung cancer) that can be avoided through effective public health and prevention interventions,
and treatable deaths (such as colorectal and breast cancer) that can be avoided through timely and
effective healthcare interventions. On average in the EU from 2011 to 2021, avoidable mortality rates
decreased for breast cancer by 16% among women and for colorectal cancer by 17%, for both men and
women. These decreases suggest improvements in diagnosis and treatment for both cancers.
In contrast, while avoidable lung cancer mortality decreased by 27% among men, it increased by 4%
among females. Decreases among men were seen in all EU countries, ranging from 42% in Sweden to
2% in Cyprus. Among women however, avoidable lung cancer mortality increased in 16 EU countries, and
varied from a 45% increase in Malta to a 29% decrease in Iceland (Figure 1.3). These diverging trends
reflect the fact that although men have historically had higher smoking prevalence, increases in smoking
rates (followed by their subsequent decline) occurred in more recent birth cohorts of women as compared
to men. In addition to a reduction in smoking, improvements in diagnosis and treatment of lung cancer
(See Cancer care performance section) have contributed to improved outcomes in lung cancer for both
genders.
0
50
100
150
200
250
300
350
400
450
500
Total Men Women
-16%
-8%
Men Women
2011-21 change, EU average
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Figure 1.3. Avoidable lung cancer mortality among men decreased in all EU countries, but increased among women in 16 countries
Percentage change in avoidable lung cancer mortality, from 2011 to 2021
Note: Avoidable mortality is based on causes of deaths for those aged under 75. *In Iceland, the relative decline in mortality rates was greater
among women than among men.
Source: Eurostat Database.
Educational inequalities in cancer mortality are much larger among men than women,
and gaps vary greatly across EU countries
Large differences exist in overall cancer mortality by socio-economic status in EU countries, with higher
mortality rates reported among more vulnerable populations. Across 15 EU+2 countries4 with available
data, cancer mortality among men with low education levels was 84% higher (583 age-standardised cancer
mortality rates per 100 000), compared to men with high education levels (318 per 100 000) (European
Commission/IARC/Erasmus MC, 2024[6]). Mortality rates among lower-educated men were over twice
those of higher educated men in Czechia, Estonia, France, Hungary, Lithuania and Poland – while the
smallest gaps (below 45%) were in Sweden and Spain.
Socio-economic gaps in cancer mortality, albeit smaller, also appear among women. Cancer mortality
among women with low education levels was 37% higher (333 per 100 000), than among women with high
education levels (243 per 100 000). The largest gaps in cancer mortality in women were reported in Norway
(82%), Denmark (78%), Czechia (66%) and Estonia (59%), and the smallest gaps, at 10% or lower, were
in Spain, Italy and France. Slovenia was the notable exception that did not report any difference in cancer
mortality in women by education level.
Overall, the social gradient holds true when looking at other cancer outcomes such as cancer incidence
and cancer survival, as well as other markers of vulnerability such as income, geographical location,
migration status or ethnicity. In Ireland for instance, individuals in the most deprived areas faced, on
average, a 43% higher risk of mortality within five years following cancer diagnosis compared to their
counterparts in the least deprived regions. A 2024 study in the Netherlands found that 5-year cancer
survival rates were 10% lower among those from lower income groups compared to those from higher
income groups (Aarts et al., 2024[7]).
Educational inequalities in cancer mortality reflect higher prevalence of modifiable cancer risk factors
among lower socio-economic groups, along with differences in health literacy and knowledge of cancer
risk factors and symptoms. In addition, they reflect lower participation in screening programmes that
-50
-40
-30
-20
-10
0
10
20
30
40
50 %
Men Women
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
support earlier detection and may also reflect differences in access to and quality of cancer diagnosis and
treatment (OECD, 2024[8]).
Cancer prevalence in the EU increased by a quarter in the last 10 years, as
improvements in early detection and treatment have increased cancer survival
In 2022, five-year cancer prevalence5 was estimated at 1 876 cases per 100 000 population in the EU
(Figure 1.4), or about two people out of every 100. This ranged from 1 268 cases per 100 000 population
in Bulgaria, which has relatively low incidence and lower survival rates among EU countries to 2 424 cases
per 100 000 in Denmark, which has high incidence but also higher survival.
From 2010 to 2020 the average age-standardised lifetime cancer prevalence in the EU increased by 24%.
The relative increase in cancer prevalence was highest in Latvia (45%), Lithuania (41%) and Estonia
(39%). Conversely, prevalence increases were lowest in Austria (13%), Iceland (16%) and France (17%).
Trends in prevalence are influenced by increased cancer incidence and survival, in addition to
demographic changes (De Angelis et al., 2024[9]). Looking forward, increased population ageing and
further improvements in cancer survival will lead to higher cancer prevalence and more people living with
a history of cancer, calling for investment in quality of life and survivorship programmes.
Figure 1.4. Cancer prevalence increased by over 20% in 24 EU+2 countries over the last ten years
Source: IARC Globocan Database 2024; De Angelis, R. et al. (2024), “Complete cancer prevalence in Europe in 2020 by disease duration and
country (EUROCARE 6): a population-based study”, https://doi.org/10.1016/s1470-2045(23)00646-0.
In virtually all EU countries, national cancer plans align with Europe’s Beating
Cancer Plan
Overall, national cancer plans in EU+2 countries are aligned with the four pillars of Europe’s Beating
Cancer Plan (EBCP): Prevention, Early detection, Diagnosis and treatment, and Quality of life (Table 1.1).
All countries reported having a section of their national cancer plan that is focused on the Prevention pillar,
with the exception of Cyprus, and all have a section dedicated to Diagnosis and treatment.
There is more variability with regards to alignment of national cancer plans with the transversal themes
established by the EBCP (Paediatrics, Inequalities and Research and innovation). France, Poland, Spain
and Sweden had a section specifically focused on each transversal theme of the EBCP in their national
cancer plans and the majority of countries had a national cancer plan with a section focused on Research
0
10
20
30
40
50
0
500
1 000
1 500
2 000
2 500 %Rate
Five-year crude prevalence rates per 100 000 population, 2022 (Globocan), left axis Change in age-standardised lifetime prevalence rates, 2010-20 (EUROCARE-6), right axis
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
and innovation. However, only about half of countries had sections specifically focused on Paediatric
cancer and two countries did not address this topic in their plans. Furthermore, most countries lacked a
specific section in their national plans around cancer inequalities, with two countries not covering the topic
at all.
Table 1.1. While EU+2 countries closely align national cancer plans with the four pillars of the Europe’s Beating Cancer Plan, inequalities and paediatrics are not always fully addressed
Adoption of the topic in the National Cancer Plan (NCP), marked by blue (a dedicated section exists), orange (a
section partially covering the topic exists), or pink (not covered)
Pillars of Europe’s Beating Cancer Plan (EBCP) Transversal themes of EBCP Number of full
alignments Prevention Early
detection Diagnosis & treatment
Quality of life
Inequalities Paediatrics Research & innovation
France ● ● ● ● ● ● ● 7
Poland ● ● ● ● ● ● ● 7
Spain ● ● ● ● ● ● ● 7
Sweden ● ● ● ● ● ● ● 7
Croatia ● ● ● ● ● ● ● 6
Czechia ● ● ● ● ● ● ● 6
Germany ● ● ● ● ● ● ● 6
Ireland ● ● ● ● ● ● ● 6
Italy ● ● ● ● ● ● ● 6
Lithuania ● ● ● ● ● ● ● 6
Netherlands ● ● ● ● ● ● ● 6
Bulgaria ● ● ● ● ● ● ● 6
Estonia ● ● ● ● ● ● ● 5
Finland ● ● ● ● ● ● ● 5
Malta ● ● ● ● ● ● ● 5
Norway ● ● ● ● ● ● ● 5
Portugal ● ● ● ● ● ● ● 5
Romania ● ● ● ● ● ● ● 5
Slovenia ● ● ● ● ● ● ● 5
Iceland ● ● ● ● ● ● ● 5
Hungary ● ● ● ● ● ● ● 5
Cyprus ● ● ● ● ● ● ● 4
Latvia ● ● ● ● ● ● ● 4
Luxembourg ● ● ● ● ● ● ● 4
Slovak Republic ● ● ● ● ● ● ● 4
Austria ● ● ● ● ● ● ● 3
Denmark ● ● ● ● ● ● ● 3
Note: Countries are ordered first by the number of alignments and then alphabetical by name. Greece does not have a cancer-specific national
plan, although the National Action Plan for Public Health 2021-25 touches on cancer screening and palliative care for cancer patients. In Belgium,
the Cancer Centre of Sciensano is currently developing the Belgium Cancer Inventory in line with Europe’s Beating Cancer Plan.
Source: Adapted from “Study on mapping and evaluating the implementation of Europe’s Beating Cancer Plan” (forthcoming).
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
The EU could prevent millions of new cancer cases in the coming decades through concerted efforts to
meet policy targets on cancer risk factors. In 2021, about 40% of cancer deaths in the EU were attributable
to known behavioural, metabolic and environmental risk factors (Global Burden of Disease Collaborative
Network, 2021[10]). This figure has remained relatively constant over the last decade (at 43% in 2011 and
42% in 2021), although there has been some improvement in the performance of EU countries on various
cancer risk factors. Tobacco use has fallen in almost all countries (although there is concern about a shift
towards e-cigarettes and other new tobacco and nicotine products), and on average, there has been a
small reduction in alcohol consumption. Similarly, progress has been made on reducing air pollution and
in expanding human papillomavirus (HPV) vaccination coverage. However, overweight and obesity and
the accompanying issues of poor diet and low physical activity are growing challenges. Over half of adults
are overweight in the EU and overweight rates among adolescents are increasing, while socio-economic
gaps in overweight rates remain substantial.
Tobacco smoking has decreased in all but three EU+2 countries between 2012
and 2022
Tobacco continues to be the leading driver of cancer cases in Europe, accounting for nearly 20% of all
cancer deaths in the EU in 2021 according to the Global Burden of Disease data tool. The share of daily
smokers among those aged 15+ varies widely across EU+2 countries, with Iceland having the lowest rate
(6%) and Bulgaria the highest rate (29%) (Figure 2.1). Countries in Central and Eastern Europe, along with
France, tend to have the highest smoking rates, while the Nordic countries (Iceland, Norway, Sweden,
Finland and Denmark), along with the Netherlands, have the lowest. Among adults, smoking rates are
higher among men in all EU+2 countries, with an EU average of 23% for men compared to 14% for women.
Intensified efforts to reduce tobacco consumption in recent years, including increases in taxation,
enactment of smoking bans in public places, restrictions on tobacco advertisement, use of visual health
warnings on tobacco products, and treatment to help people quit are paying off. Across the EU the share
of smokers has decreased from 22% in 2012 to 18% in 2022 on average, with all but three EU+2 countries
(Bulgaria, Luxembourg, Malta) seeing reductions. Decreases of more than 5 percentage points were seen
in Czechia, Denmark, Estonia, Finland, Germany, Iceland, the Netherlands, Norway and Poland. In
Czechia and Denmark, reductions in smoking rates reflect policies implemented over the last 5-8 years as
reported in the Country Cancer Profiles, including comprehensive tobacco control legislation, restrictions
on smoking in public places and increases in tobacco excise taxes. In 2024, both Slovenia and Spain
enacted tougher anti-smoking legislation, including further regulation of e-cigarettes (as well as heated
tobacco products in Slovenia), expansion of smoke-free areas, and new warning labels on nicotine
products (Slovenia) or standardised packaging (Spain).
2 Risk factors and prevention policies
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 2.1. Tobacco smoking rates among adults have decreased across almost all EU countries over the past decade
Share of adults (aged 15 and over) reporting smoking on a daily basis
Note: The EU average is unweighted.
Source: OECD Health Statistics 2024.
Alcohol consumption has decreased in two out of three EU countries between
2010 and 2022
Alcohol consumption averaged 10.0 litres per person aged 15 and over in the EU in 2022. Consumption is
highest in Austria, Czechia, Latvia, Romania and Spain (at 11.6 litres or above) and lowest in Finland,
Greece, Iceland, Italy, Norway and Sweden (at less than 7.7 litres). Between 2010 and 2022 there was a
small decrease of 0.3 litres in average alcohol consumption in the EU. Underlying this figure, however, are
major differences, with nine EU+2 countries reporting decreases of 10% or more (Belgium, Croatia,
Cyprus, Denmark, Finland, France, Greece, Ireland and Lithuania), while seven EU+2 countries showed
increases of 10% or more (Bulgaria, Italy, Latvia, Malta, Poland, Romania and Spain).
Trends in tobacco and alcohol consumption among adolescents reflect those
seen in adults
Behavioural patterns often emerge during childhood and become engrained over the life course; thus,
examining risk factors among adolescents provides insight into future cancer risk factors and calls for
greater investments in prevention. For example, adolescent smoking rates tend to be higher in countries
with higher rates of adult smoking, with a correlation coefficient of 0.61 reported among EU+2 countries
(Figure 2.2).
29
25 25 25 23 23 22
21 21
21 20
20 20 19 19 19 17 17 16 16 15 15 14 14
13 12 11
9 8 6
22
0
5
10
15
20
25
30
35
%
2022 (or nearest year) 2012 (or nearest year)
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 2.2. Adolescent smoking is strongly associated with the prevalence of smoking among adults
Note: The EU averages are unweighted. Adults are those aged 15 and over, while adolescents are those aged 15. Data refer to 2022 or nearest year.
Source: OECD Health Statistics; Health Behaviour in School-Aged Children Survey.
Like the trend seen among adults, Figure 2.3 shows that the smoking rate among 15-year-olds in the EU
dropped from 22% in 2014 to 17% in 2022. This trend was seen in all countries except Bulgaria, Romania
and Spain. Among adolescents, girls have slightly higher rates of smoking (18%) compared to boys (16%).
In addition, there is concern that reductions in smoking are partly due to a shift towards e-cigarettes and
other new tobacco and nicotine products. In the EU on average, more than one in five 15-year-olds (21%)
reported using e-cigarettes at least once in the last 30 days in 2022, with rates above 30% in Bulgaria,
Hungary, Lithuania and Poland.
Figure 2.3. Tobacco smoking and drunkenness have decreased among adolescents in the EU
Percentage of 15-year-olds reporting various cancer risk factors
Note: The EU average is unweighted with 26 EU countries for smoking and drunkenness (excluding Cyprus) and 25 countries for overweight
and obesity (excluding Cyprus and Ireland).
Source: Health Behaviour in School-Aged Children Survey.
AT
BE
BG
HR
CY
CZ DK
EE
EU27 FI
FR
DE EL
HU
IS
IE
IT
LVLT
LU
MT
NL
NO
PL
PT
RO
SK
SI ES
SE
R² = 0.38
0
5
10
15
20
25
30
35
5 10 15 20 25 30 Adults - Population prevalence of daily smoking (%)
Adolescents - Self-reported smoking at least once over the last 30 days (%)
22
17
25
23
17
21
10
15
20
25
30
2014 2018 2022
%
Smoking at least once in the last 30 days Drunkenness more than once in a lifetime Overweight or obese
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Alcohol use among adolescents similarly reflects the mixed trend seen among adults. Overall, the rates of
15-year-olds reporting being drunk more than once in their life decreased slightly by 2 percentage points
between 2014-22. The largest decreases, of eight or more percentage points, were seen in Estonia,
Lithuania, Malta, Portugal and the Slovak Republic. In ten of the EU+2 countries, increased rates of
repeated drunkenness were reported between 2014-22 among adolescents. Increases by six or more
percentage points were seen in Austria, Denmark, Germany and Italy. Decreases were driven by boys,
among whom rates decreased from 27% in 2014 to 23% in 2022, while rates remained steady at 23%
among girls.
Countries showing large reductions in alcohol use among adults or adolescents have prioritised alcohol
control initiatives over the past years. In 2011, the Slovak Republic became the first EU country to introduce
minimum unit pricing, followed by Ireland in 2022. Lithuania implemented a 2018 ban on alcohol
advertising, including on social media.
More than half of the adult population is overweight in 23 EU+2 countries, while
overweight rates among adolescents have increased in all but three countries
Despite a slew of polices to address the high rates of overweight and associated issues of poor diet and
low physical activity, the share of overweight adults in the EU remained persistently high (at 51%) in 2022,
close to the 52% figure in 2017. In 2022, there were only six countries that had a self-reported overweight
prevalence of less than 50% of the adult population (Belgium, Cyprus, France, Italy, Luxembourg and the
Netherlands). In Iceland, Latvia and Malta, overweight rates were 60% or above. Men are more likely to
be overweight than women in all EU+2 countries, with overweight rates standing at 60% for men in the EU
compared to 44% of women.
High rates of overweight are driven by poor diets and lack of physical activity. In 2022, about four in ten
adults (40%) in the EU consumed vegetables less than once daily and a similar share (39%) consumed
fruit less than once a day. For both fruits and vegetables, men reported lower consumption than women,
and consumption was slightly lower in 2022 than in 2017. A total of 69% of adults reported engaging in
physical activity less than three times per week in 2022, with rates being fairly similar among men and
women.
Efforts to battle overweight and obesity among adolescents in the EU appear insufficient, with rates
increasing to 21% in 2022, up from 17% in 2014. During this period, overweight and obesity rates increased
in all but three (the Netherlands, Spain and Sweden) of the 25 EU+2 countries with available data. In 2022,
overweight rates among boys were much higher (26%) than among girls (16%). Only three in ten
adolescents reported daily fruit consumption in 2022 (similar to the rate in 2014) and slightly more than a
third (34%) reported daily vegetable consumption, an increase from the 30% rate in 2014. Few adolescents
reported engaging in daily physical activity of at least 60 minutes in 2022 – 15% – a rate similar to that in
2014.
Given the increasing challenge of overweight in EU countries, it is concerning to see the large socio-
economic gaps in overweight rates among women (Figure 2.4). In 2022, 53% of women with low education
reported being overweight, which is 20 percentage points higher than the 33% rate of overweight among
those with high education levels. Gaps of over 25 percentage points between low and high educated
groups were reported in Austria, Croatia, Cyprus, Portugal, the Slovak Republic and Spain. Socio-
economic gaps are large among children as well. In each of the 25 EU+2 countries with available data,
children aged 11-15 in the bottom quintile based on family affluence had higher rates of overweight than
those in the top quintile in 2022, with gaps of over 15 percentage points in Belgium, Bulgaria and
Luxembourg.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 2.4. While about a third of women with high education levels are overweight in the EU, that figure jumps to over half of women with low education
Percentage of women aged 18 and over with overweight (including obesity), 2022
Notes: Overweight (including obesity) includes those with a body mass index above 25. Low education refers to lower secondary education or
less (ISCED 0-2); high education refers to tertiary education (ISCED 5-8).
Source: Eurostat Database.
To address the overweight challenge, the German federal government’s food and nutrition strategy
introduced in 2024 aims to make healthy and sustainable diets more easily accessible, thereby also
supporting health and contributing to the prevention of obesity. Under this strategy, specific initiatives
supporting healthy diets in daycare centres and schools are being undertaken, among others.
Similarly, recent efforts in Malta and Italy aim to promote physical activity and reduce overweight and
obesity among school-age children, with Italy relying on educational campaigns and collaboration with
industry on food reformulation. Greece launched a National Action Plan for Childhood Obesity in 2023,
while Belgium also has new programmes that provide coverage to dieticians for overweight children and a
three-tier system including multidisciplinary care in recognised paediatric centres for obese children.
Finland, which has the third highest rate of overweight in the EU, is taking a comprehensive approach to
the issue – entailing excise taxes on sugar-sweetened beverages, front-of-package food labelling, school
food regulation and the Fit for Life cross-sectoral project to encourage physical activity among those ages
40+.
Although countries are investing in prevention, additional efforts are needed to
reduce the key cancer risk factors
In 2021, EU countries spent an average of 6.1% of their health spending on prevention policies, such as
informational and educational campaigns, healthy condition monitoring, and disease surveillance (4.6% in
2022). This reflects a substantial increase from spending levels of about 3% between 2014-19, prior to the
onset of the COVID-19 pandemic. However, much of the increase in recent years is attributed to spending
on vaccination and personal protective equipment, rather than wide-ranging public health initiatives aimed
at improving underlying population health.
0
10
20
30
40
50
60
70 %
Total women High education Low education
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HPV vaccination programmes have become gender-neutral in virtually all EU+2 countries
One of the areas that countries have invested in is vaccination against HPV to eliminate six types of HPV-
related cancers including cervical cancer. While many EU countries have been vaccinating girls for HPV
for over a decade, vaccination of boys is more recent. The addition of Estonia in 2024 to this list means
that all but one of the EU+2 countries already have gender-neutral vaccination programmes in place, with
Bulgaria’s updated national programme planning for inclusion of boys in 2025.
HPV vaccination uptake among 15-year-old girls averaged 64% in 2023 in the EU. Figures vary widely
across the 22 EU countries with available data, with rates below 50% in five countries and above 90% in
Iceland, Norway and Portugal. With its relatively low vaccination rate, France rolled out its first school-
based HPV vaccination campaign in 2023, seeing an increase in vaccination rates from 31% to 48% among
12-year-olds between the end of 2022 and the end of 2023. Via the RIVER-EU Project targeting
underserved groups, the Netherlands is developing interventions to increase HPV vaccine uptake among
adolescent girls of Turkish and Moroccan descent while the Slovak Republic is aiming to increase
vaccination among the Roma population. In Romania, which has cervical cancer incidence rates three
times the EU average, efforts include vaccination campaigns around January’s cervical cancer awareness
month and March’s HPV awareness day. A number of countries have implemented catch-up programmes
for those who were not adequately vaccinated at younger ages; for example, in Poland the vaccine is
reimbursed 50% for those older than 18 when purchased at pharmacies and in Sweden, a newer version
of the vaccine is temporarily being offered free of charge to women born 1994-99 in an effort to eliminate
HPV-related cancer by 2027.
Air pollution has decreased substantially over the decade between 2010-20
EU countries have similarly invested in reducing air pollution, with average particulate matter (PM)2.5 levels
decreasing to 11.7 µg/m³ in 2020, down over 30% from the 2010 figure of 16.9 µg/m³. Decreases were
seen in all countries. In Europe in particular, occupational exposure is a large driver of mortality, accounting
for 6% of cancer deaths in the EU in 2021. Reported rates of occupational exposure to chemical products
or substances among those aged 15+ ranged from 17% in the Netherlands to 37% in Poland. Rates were
higher among men than women in about two-thirds of EU countries. Regions in Belgium have different
policies against asbestos in both occupational and residential settings, with Flanders requiring an asbestos
inspection prior to building sales, which can only be undertaken by certified experts. In Poland, the National
Fund for Environmental Protection and Water Management carried out a national programme for safe
removal of asbestos and hosted an asbestos database for 2019-24.
Millions of cancer cases could be prevented in the EU over the coming decades via
concerted action on the key cancer risk factors
Much opportunity remains to reduce risk factors in EU countries in order to lower the cancer burden.
According to the OECD’s Strategic Public Health Planning (SPHeP) modelling work, the biggest potential
lies in meeting tobacco targets. Almost 1.9 million new cancer cases could be prevented in the EU between
2023 and 2050 if tobacco reduction targets were met (Figure 2.5), with over a million cases prevented in
Germany, France, Italy and Poland alone. If alcohol consumption targets were met, an additional 1 million
cancer cases could be prevented during this period. In Sweden and Norway, which already have relatively
low smoking rates, meeting alcohol targets holds the biggest potential for a reduction in cancer cases.
Meeting other risk factor targets would also reduce the number of new cancer cases substantially in the
EU: air pollution by about 430 000 cases and obesity by about 310 000 cases.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 2.5. Almost 2 million cancer cases could be prevented in the EU between 2023-50 by meeting tobacco reduction targets
Total number of cancer cases prevented between 2023-50 by meeting risk factor targets, by risk factor and country
Note: The target for tobacco is a 30% reduction in tobacco use between 2010 and 2025, and less than 5% of the population using tobacco by
2040. For alcohol, the target is a reduction of at least 20% in overall alcohol consumption and a 20% reduction in heavy drinking (six or more
alcoholic drinks on a single occasion for adults) between 2010 and 2030. For air pollution, it is an annual average PM2.5 level capped at 10 μg/m3
by 2030 and at 5 μg/m3 by 2050. For obesity, the target is a reduction to the 2010 obesity level by 2025.
Source: OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, https://doi.org/10.1787/85e7c3ba-en.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Screening and early diagnosis increases the proportion of cancers detected at an early stage, improving
the likelihood of a successful response to treatment and contributing to better patient outcomes and more
sustainable health expenditures. Approximately 90% of EU+2 countries introduced population-based
breast cancer screening programmes as of 2022, and three-quarters of them have implemented cervical
and colorectal cancer screening programmes. While an increasing number of countries adopted a
population-based approach to boost participation and to systematically invite the relevant target
populations, uptake has recently stalled or even declined for breast and cervical cancer screening. As the
2022 Council Recommendation was adopted, countries are making efforts to reach out to
socio-economically disadvantaged communities and using outreach activities, self-sampling and digital
solutions to improve accessibility and participation. Moreover, additional cancer screening initiatives for
lung, prostate and gastric cancers are on the horizon, with pilot projects to establish the scientific rationale
for potential screening programmes implemented under the EU4Health Programme 2021-27.
Although cancer screening programmes are expanding and using new outreach
methods, participation rates are stagnating or even declining
Breast cancer screening participation rates have dropped in more than half of
EU+2 countries
The breast cancer screening participation rate reached 56% on average across 24 EU countries with
programme data available in 2022 (Figure 3.1). Participation rates were notably high (above 75% of eligible
women) in the Nordic countries (Denmark, Finland, Sweden and Norway) as well as in Slovenia. In
contrast, fewer than 40% of the target population underwent mammograms in Poland, Latvia, Hungary,
Cyprus and the Slovak Republic, according to programme data.6 Low participation was also observed in
Bulgaria (36%) and Romania (9%) according to 2019 survey data.
Uptake has been declining over the last decade, even prior to the additional challenges posed by the
COVID-19 pandemic. More than half of countries with programme data reported a drop in participation
from 2014 to 2022. During this period, the downward trend was most pronounced in Hungary
(-12 percentage points), Luxembourg (-10 percentage points), the Netherlands (-9 percentage points) and
Ireland (-6 percentage points). In these countries, participation rates were already lower in 2019 compared
to 2014.
3 Early detection
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 3.1. Breast cancer screening coverage declined in more than half of EU+2 countries over the last decade
Breast cancer screening participation rates among the eligible population, by year and data source
Note: The EU average is based on the unweighted average among the 24 EU countries with programme data for 2022 and the 22 EU countries
with programme data for 2014. For the 2014 programme data, different years are referenced for Austria (2015), Poland (2017), Portugal (2017)
and Sweden (2017).
Source: OECD Health Statistics; Programa Nacional para as Doenças Oncológicas (Directorate General of Health, Portugal); Institute of
Oncology Ljubljana, National Institute of Public Health (Slovenia).
Cervical cancer screening rates declined in two-thirds of countries over the last decade
For cervical cancer screening programmes, cross-country variation in participation rates is substantial. In
the EU, based on programme or administrative data, 55% of eligible women were screened for cervical
cancer within the past 3 years in 2022 (Figure 3.2). However, while some Nordic countries (Sweden,
Finland and Norway), as well as Slovenia, Czechia and Ireland recorded high participation rates exceeding
70%, the uptake was poor in Poland (11%), Malta (16%) and Hungary (26%). A similar pattern can be
observed among countries with survey data, as the 2019 uptake ranged widely from a high of 85% in
Austria to a low of 39% in Romania. In Malta, the proportion of women aged 20-69 who were screened for
cervical cancer is much higher based on survey data (at 64%) than programme data (16%), reflecting the
important role of opportunistic screening for cervical cancer in the country.
Similar to breast cancer, falling participation is also evident in cervical cancer screening programmes, with
two-thirds of countries with programme or administrative data registering a decline in uptake during the
period of 2014 to 2022. The size of the decrease is particularly noticeable in the Netherlands
(-19 percentage points), Iceland (-11 percentage points), Hungary (-10 percentage points) and
Luxembourg (-7 percentage points), and these four countries all experienced a falling trend even in the
pre-pandemic years from 2014 to 2019. By contrast, Portugal and Latvia observed substantial
improvement: Portugal saw participation rates rapidly rising from 29% to 60% due to the programme’s
geographic expansion, whereas Latvia’s participation rates nearly doubled to 55%, a possible contributing
factor being that invitation letters became available electronically and eligible women were allowed to
participate without presenting a letter.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
D en
m ar
k
F in
la nd
S w
ed en
S lo
ve ni
a
N or
w ay
S pa
in
N et
he rla
nd s
Ir el
an d
E st
on ia
C ro
at ia
C ze
ch ia
Li th
ua ni
a
Ic el
an d
B el
gi um
E U
a ve
ra ge
Ita ly
Lu xe
m bo
ur g
G er
m an
y
P or
tu ga
l
F ra
nc e
M al
ta
A us
tr ia
P ol
an d
La tv
ia
H un
ga ry
C yp
ru s
S lo
va k
R ep
ub lic
C yp
ru s
G re
ec e
M al
ta
B ul
ga ria
R om
an ia
Programme data Survey data
2022 or nearest year 2019 Survey2014 2014 Survey
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 3.2. Cervical cancer screening participation rates decreased in two-thirds of EU+2 countries
Cervical cancer screening participation rates among the eligible population, by year and data source
Note: The EU average is based on the unweighted average among the 20 EU countries with programme/administrative data for 2022 and the
18 EU countries with programme/administrative data for 2014. For the 2014 programme data, different years are referenced for Poland (2017)
and Portugal (2017).
Source: OECD Health Statistics; Programa Nacional para as Doenças Oncológicas (Directorate General of Health, Portugal); Institute of
Oncology Ljubljana, National Institute of Public Health (Slovenia).
Most EU+2 countries have introduced colorectal cancer screening programmes
A total of 22 EU+2 countries have implemented population-based colorectal screening programmes
(Figure 3.3). Finland, Norway and Sweden joined this list as recently as 2022, whereas Cyprus, Iceland
and Romania are in the process of launching population-based programmes. The 2022 Council
recommendation on screening noted that the faecal immunochemical test (FIT) is considered the preferred
colorectal cancer screening method, although colonoscopy may be used as well for a combined strategy.
In recent years, countries have intensified their efforts to improve accessibility by making self-sampling FIT
test kits more accessible, adopting new technologies and targeting socio-economically disadvantaged
groups.
Based on programme data, the share of the target population participating in colorectal cancer screening
programmes stood at 42% on average across EU countries in 2022. The uptake was highest in Finland
(77%), the Netherlands (68%) and Slovenia (65%). On the other hand, participation rates were less than
a third of the EU average in Portugal (14%) and Hungary (8%). Additionally, 2019 survey data shows a
high participation of 64% in Austria, but limited participation in Cyprus (22%) and Romania (3%).
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Programme data Survey data
2022 or nearest year 2019 Survey2014 2014 Survey
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Figure 3.3. Colorectal cancer screening programmes have recently expanded in EU countries alongside initiatives to better reach target populations
Colorectal cancer screening programme, launch years and participation rates (colouring) in 2022 or the nearest year
Note: Only participation rates based on programme data are shown in figure. Twenty-two EU+2 countries implemented population-based
colorectal screening programmes as of 2022. Colorectal cancer screening programmes are not population-based in Austria, Iceland, Latvia,
Lithuania and Romania. Bulgaria and Greece do not have a national colorectal cancer screening programme.
Source: OECD Health Statistics; Programa Nacional para as Doenças Oncológicas (Directorate General of Health, Portugal); National Oncology
Institute (Slovak Republic); Institute of Oncology Ljubljana, National Institute of Public Health (Slovenia).
Countries are working to overcome screening inequalities and are making self-
sampling more accessible
Growing evidence reveals that screening participation is significantly lower among socio-economically
disadvantaged groups, including low-income earners, individuals with lower education, rural populations
and people with a migration background. In Iceland, for example, the 2023 uptake of cervical cancer
screening was 72% among Icelandic citizens and 27% among the foreign population. In Sweden in
2019-20, only 64% of women with lower education levels participated in the breast cancer screening
programme in contrast to 82% among women with higher education levels. National data from Germany,
Hungary, Ireland and Sweden also demonstrate that people with low income and people with a low level
of education have a lower likelihood to participate in cancer screening programmes. These countries have
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implemented targeted awareness campaigns to encourage their participation. In addition, the Country
Cancer Profiles note that countries such as Finland, Germany, Ireland, the Netherlands and Norway have
identified low uptake among migrant communities and made screening invitations and guidelines available
in different languages. Slovenia, which has among the highest screening participation rates in the EU, uses
a targeted approach to reach vulnerable populations for each screening programme as well as a general
public communications strategy.
To overcome socio-economic disparities, community outreach and mobile screening solutions are
increasingly adopted by EU+2 countries. France has hired 100 telephone operators to specifically connect
vulnerable groups with the colorectal cancer screening programme since 2024 (see also Figure 3.3). In
Estonia, Germany, Iceland, Ireland, Poland, Romania and Slovenia, mobile breast cancer screening
vehicles are authorised to perform mammography on the spot, often in remote areas. Hungary’s Mobile
Health Screening Programme mainly targets socio-economically disadvantaged communities including the
Roma population, for melanoma, cervical and oral cavity cancers, with records obtained during visits
feeding into the Hungarian e-Health Infrastructure platform.
Moreover, self-sampling kits are increasingly made available to address barriers to screening for
vulnerable populations and to improve the effective inclusiveness of programmes. For colorectal cancer
screening, the FIT kits have become a feasible self-sampling tool. Practical steps differ by country and
region. In France, Luxembourg and the Flemish, Walloon and Brussels regions of Belgium, self-sampling
is available, but individuals can get a test kit from general practitioners (Wallonia), order online (France,
Luxembourg, Wallonia, Flanders), or go to physical pick-up spots such as pharmacies (France,
Luxembourg, Brussels and Wallonia). On the other hand, countries such as Finland, the Netherlands and
Norway, as well as Brussels and the Flanders regions of Belgium, send an invitation with a FIT kit and a
paid return envelope included at the same time (see also Figure 3.3).
When it comes to cervical cancer screening, HPV self-sampling is already used in Denmark, Norway and
the Netherlands: it is optional in the Netherlands, while it is primarily limited to non-responders in the other
countries. In Norway, it is provided through general practitioners to women who face barriers to traditional
screening. Meanwhile, several EU+2 countries are in a pilot phase on HPV self-sampling and the
development has been promising. The Czech pilot has found that this approach supports better
participation from women at risk of poverty and social exclusion. In a Spanish study, HPV self-sampling
turned out to be more used among populations with migrant backgrounds. Belgium is exploring how to
scale up screening via a pilot comparing various HPV self-sampling kit delivery methods such as mail and
GPs.
Digital solutions are also being used to enhance screening awareness and support screening
implementation. Estonia’s digitalised health information system contributes to identifying the target
population, sending screening invitations and reminders, and reaching out to non-participants during their
interaction with healthcare workers. In Poland, the Ministry of Health launched a mobile phone application
in 2021 to inform the target population of screening opportunities. In the Netherlands, cancer screening
data are linked to other information systems to identify the socio-economic and migration status of
individuals in the target population, which then produce performance indicators to ensure quality and
coverage.
Lung, prostate and gastric cancer screening and expanded genetic testing are
under consideration
Consistent with the 2022 update of the Council Recommendation, which proposes to examine
evidence-based feasibility studies to introduce gastric, lung and prostate cancer screening programmes,
a number of EU+2 countries are already operating or about to launch additional screening programmes
for these three cancers. As part of the EU4Health Programme 2021-27, moreover, the TOGAS project (for
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gastric cancer), SOLACE project (for lung cancer) and PRAISE-U project (for prostate cancer) have been
launched to support these screening efforts.
Regarding lung cancer, the cost-effectiveness of the low-dose computed tomography (CT) screening is
recognised in Belgium under specific considerations for a high-risk population of current and recent ex-
smokers aged 50-75 years old (Desimpel F, 2024[11]), and in Sweden, while it is still under examination in
several EU countries. Although not population-based, in October 2020, Croatia became the first country in
Europe to introduce a lung cancer screening programme. It invites active smokers aged 50-70 and former
smokers who quit within the last 15 years to undergo a CT scan every year. Similar targeting is piloted in
Estonia, Germany, Hungary, Italy and Poland, for example.
For prostate cancer, Czechia transitioned to a population-based organised programme in January 2024.
The programme invites men aged 50 to 70 through their registered family doctors or urologists, who are
offered financial incentives to screen this target group. A prostate-specific antigen (PSA) test and a
urological test are performed and, if necessary, a magnetic resonance imaging (MRI) scan will also be
included. Similarly, Latvia and Lithuania introduced national, opportunistic prostate cancer screening in
May 2021 and January 2006, respectively. In Lithuania, guidelines call for men aged 50-69 as well as
those aged 45 and over with a family history of prostate cancer to be tested every 2 years. However, the
screening interval may be stretched to 5 years depending on the individual’s PSA level and age.
Meanwhile, in Latvia, men aged 50-75 as well as those aged 45 and over with a family history of prostate
cancer can be referred for screening every 2 years.
Furthermore, genetic counselling and testing are recommended and offered in a few countries to improve
early detection for individuals with a family history of cancer. Recent evidence suggests that targeted BRCA
genetic testing could be cost-effective for breast and ovarian cancers with an incremental cost-
effectiveness ratio (ICER) of USD 21 700 per quality-adjusted life years (QALYs) compared to no genetic
testing (Koldehoff et al., 2021[12]). Similarly, a meta-analysis of targeted genetic testing for colorectal cancer
finds that the estimated ICERs range from USD 32 322 to USD 76 750 per QALYs (Teppala et al.,
2023[13]). In Italy, all regions are expected to make genetic risk assessment available by the end of 2025.
In Austria, genetic testing is offered in six medical centres for individuals and recommended to those who
have a family history of cancer, have multiple tumours, or cancer occurring at a young age. Predictive
testing is free for patients suspected of hereditary breast and ovarian cancer syndromes.
In addition to screening, early diagnosis to enable the prompt detection of symptomatic people is key to
improving survival rates, patient quality of life and sustainability of health spending. Improving early
detection via fast-track pathways (See Cancer care performance section), raising awareness of cancer
symptoms among the general population, and engaging primary care physicians in early detection efforts
are vital to improving cancer outcomes (OECD, 2024[8]).
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Countries are undertaking different policies, ranging from increasing health professional training capacities,
using online tumour boards, investing in diagnostic and radiotherapy equipment, and implementing
managed entry agreements to improve access to the cancer care system. In parallel, improvements in
cancer survival have occurred in breast, prostate, colorectal and lung cancer, although cervical cancer
survival estimates are stagnant. To improve quality of cancer care, countries are centralising cancer care
at specialised centres supported by larger oncology networks, as well as incorporating use of patient-
reported outcomes and regular quality monitoring. Given that cancer is anticipated to take a large toll on
society in the coming decades, notably through a reduction of the workforce and its productivity and an
increase in mental health disorders, a number of countries are also investing in psychological, social and
occupational rehabilitation to improve the quality of life of people with cancer.
Growing cancer prevalence is driving efforts to improve accessibility and quality
of cancer care
There are shortages in the healthcare workforce involved in primary prevention, early
detection, and management of cancer care
Cancer care has increasingly become more specialised, requiring the collaboration of multidisciplinary
teams across all levels of care. With the growing number of cancer diagnoses, rising cancer prevalence
and efforts to shift health systems towards primary care, general practitioners and nurses play a vital and
expanding role in cancer-related prevention, early detection, rehabilitation, and follow-up. Consequently,
shortages in any links in the care process can create bottlenecks and affect patient outcomes, highlighting
the importance of an adequately staffed and skilled workforce.
Figure 4.1 illustrates the relationship between the number of physicians and nurses per 1 000 cancer cases
across EU+2 countries in 2022. In the EU on average, there are about twice as many nurses (1 376) per
1 000 new cancer cases as there are doctors (679). The Nordic countries (Iceland, Norway and Sweden),
along with Austria, Czechia, Germany, Ireland, Malta and Romania are characterised as having a higher-
than-average number of both doctors and nurses per cancer case. In contrast, many countries in Central
and Eastern Europe, as well as Southern Europe (Croatia, Estonia, Hungary, Italy, Latvia and Poland) are
characterised as having a lower-than-average number of doctors and nurses.
4 Cancer care performance
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Figure 4.1. The availability of nurses per cancer case varies more than 5-fold across EU+2 countries
Note: The data on nurses include all categories of nurses (not only those meeting the EU Directive on the Recognition of Professional
Qualifications). Data refer to practising nurses except in Portugal and the Slovak Republic, where they refer to professionally active nurses. In
Greece, the number of nurses is underestimated as it only includes those working in hospitals. In Portugal and Greece, data refer to all doctors
licensed to practise, resulting in a large overestimation of the number of practising doctors. The EU average is unweighted.
Source: OECD Health Statistics 2024. Data refer to 2022 (or latest available year) for all countries except Luxembourg (2017).
The shortage of general practitioners is particularly pronounced and was identified as an issue in
16 Country Cancer Profiles. Moreover, shortages of medical specialists essential to cancer care, such as
medical and radiation oncologists, radiologists, pathologists, and surgeons, are reported across the
Profiles. Among the 15 countries with available data, the density of medical, radiation or clinical oncologist
was the highest in Italy and Czechia (with more than 6 physicians per 100 000 population) and lowest in
Malta and Bulgaria (with 2 or fewer oncologists per 100 000 population).
In addition, there are significant geographical disparities in the distribution of oncologists within countries,
particularly between urban and rural areas. This is reported in countries such as Austria, Belgium, Czechia,
Greece and Latvia. In Greece, for example, the density of clinical oncologists ranges almost 10-fold from
53 per 1 000 000 population in urban Attica to 5.6 in remote Peloponnese. With nearly two-thirds of
oncology hospitals and clinics concentrated in Athens and Thessaloniki, rural patients face significant
challenges accessing diagnosis, treatment, and follow-up services.
Increasing training capacity, introducing digital solutions and re-envisioning the role of
oncology nurses can help address workforce shortages
Several countries have increased training capacity in cancer care to address shortages and uneven
distribution of the workforce, such as France, Ireland, Italy, Latvia and Norway. France implemented a
significant reform of its medical education programmes in 2017, particularly focusing on cancer specialists,
which led to a doubling of trained medical oncologists and a one-third increase in radiation oncologists by
AT
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EU average: 1 376
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2023. Increasing training capacity and recruitment efforts in Norway has led to a rise in the annual number
of newly recognised medical oncologists by almost 50% between 2013 and 2023.
To bridge gaps in underserved regions, some countries have also implemented innovative solutions such
as regional or online tumour boards and multidisciplinary meetings. Iceland extensively uses online tumour
boards to link its limited and geographically dispersed cancer specialists both among themselves and with
international experts. In Austria, the use of teleconsultations by oncologists and other specialists allows for
virtual consultations to discuss symptoms, treatment plans, and therapy progress, reducing travel
requirements and waiting times. Estonia also offers e-consultations with oncologists while Croatia is
expanding teleconsultation to promote multidisciplinary collaboration and enhance access to care in
isolated areas. The EU Joint Action “eCAN” is exploring the impact of teleconsultation and telemonitoring
on cancer care to reduce inequalities across the EU.
To better address the increasing health needs of people with cancer and tackle oncologist shortages,
several countries have started to implement more advanced roles for nurses in cancer care, such as
“oncology nurses” and “nurse co-ordinators”. Denmark and Sweden have well-developed advanced
practice nursing roles in cancer care that help mitigate physician shortages through task-sharing
opportunities. In 2018, France introduced a new two-year master’s degree for nurses, creating the role of
infirmiers en pratiques avancées [advanced practice nurses], with four specialisations: chronic pathologies
(primary care), oncology, kidney diseases and mental health. Specialisation for oncology nursing in Croatia
was initiated and a curriculum proposal submitted to the legislature. Slovenia has introduced nurse
co-ordinators to encourage substitution among healthcare workers at hospitals, while hospitals in
Luxembourg offer a continuous training programme for oncology nurses.
Addressing shortages of different categories of health workers requires a multi-pronged strategy targeting
both supply-side (e.g. expanding education, increasing retention) and demand-side policies (e.g. making
more effective use of the health workforce by changing skill-mix and supporting effective use of
technologies), with the optimal policy mix dependent on each country’s specific circumstances and guided
by a comprehensive workforce strategy (OECD/European Commission, 2024[14]).
Workforce shortages lead to increased waiting times for patients seeking diagnosis, treatment, and follow-
up care for cancer. Despite several countries reporting challenges in maintaining acceptable waiting times,
most struggle with effectively tracking and monitoring them. To address this issue, some countries have
set specific targets and actively monitor waiting times for various aspects of cancer care (Denmark,
Estonia, Finland, Ireland, Lithuania, Latvia, Luxembourg, the Netherlands, Norway, Poland, Portugal and
Slovenia). Additionally, fast-track pathways and referral mechanisms have also been introduced in
countries such as Croatia, Ireland, Lithuania, Latvia, Luxembourg, the Netherlands, Poland and Slovenia
to streamline the patient journey and reduce delays in accessing care. Lithuania, for instance introduced
the “Green Corridor” in 2023, connecting newly diagnosed patients with a dedicated care manager who
provides logistical and emotional support, as well as co-ordinates medical care.
Despite investments in diagnostic and treatment capacity, uneven geographical
distribution and skill gaps hinder access
Access to cancer diagnostic and treatment equipment is crucial for cancer care across EU+2 health
systems. Over 2012-22, EU countries registered substantial increases in the number of CT scans (28%),
MRIs (58%), and positron emission tomography (PET) scans (53%) per million inhabitants. Some of these
developments have been supported through joint efforts between countries and the EU. Portugal, for
example, is leveraging Recovery and Resilience Plan funds to increase and renew dated therapy and
imaging equipment and introduce new capabilities like robotic surgery across its national health service.
The density of radiotherapy equipment varies almost 3-fold among the 22 EU+2 countries with available
data, ranging from slightly less than 5 per million people in Portugal to 12 per million people in the
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Slovak Republic (Figure 4.2). Countries in the top economic tercile had an average radiotherapy
equipment supply of 8.8 per million people compared to 7.3 per million among countries in the bottom
economic tercile. Over the decade between 2013-23, most countries have also prioritised increasing
radiotherapy equipment. Bulgaria and Poland reported the highest increases (by 60% or more), while
Sweden, Iceland and Denmark experienced a decrease in the volume of radiotherapy equipment over the
same period.
Figure 4.2. Volume of radiotherapy equipment varies almost threefold across EU countries
Volume of equipment per 1 000 000 population
Note: The vast majority of radiotherapy equipment in EU countries is found in hospitals. Data for Portugal and France include equipment in
hospitals only while data for other countries refer to all equipment.
Source: OECD Health Statistics 2024.
Effective access to radiotherapy treatment can be restricted due to poor geographical distribution of
equipment, health workforce shortages and cost-sharing arrangements. Uneven geographic distribution of
diagnostic and treatment capacity is evident in countries such as Belgium, Cyprus, Czechia, Estonia,
Finland and Italy. To address this issue, several countries have pursued policies such as providing financial
support for travel or hotel costs (Ireland, Finland and Romania).
In addition, the low supply of a specialised health workforce and gaps in skills necessary to operate
equipment and provide treatment hinder effective access to medical equipment. Shortages of radiation
therapists and radiologists have, for example, been reported in Bulgaria, Czechia and the Slovak Republic.
In the Netherlands, a shortage of personnel in 2021 led to an increase from two to three years in the
invitation cycle for mammography screening, alongside campaigns and investments to boost the supply of
technicians. In Sweden, the decrease in available radiation therapy equipment over the last decade has
been attributed to the lack of specialised health personnel.
There is a three-fold difference in the reimbursement of cancer medicines with a high
clinical benefit across EU+2 countries
Alongside radiotherapy, traditional chemotherapy and novel medications are a mainstay of cancer
treatment. However, national coverage of cancer medications and the timelines for making coverage
decisions vary widely among EU countries. The proportion of indications among a sample of new cancer
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medicines for breast and lung cancers with high clinical benefit that are reimbursed stood at 100% in
Germany, 92% in the Netherlands, and 85% for both Bulgaria and Sweden (Hofmarcher, Berchet and
Dedet, 2024[15]). In contrast, Malta did not reimburse any indications, while Cyprus and Latvia reported that
only about a third of indications were covered (both 31%). Both Malta and Cyprus however had some
indications available through named-patient early access programmes. Time from European-wide
marketing authorisation of an indication until national reimbursement approval also ranged widely – from
around 100 days or less in Germany and Sweden to more than three years in Cyprus, Latvia and Lithuania.
Similarly, among 19 biosimilars of three cancer medicines, the share reimbursed also exhibits substantial
differences across countries. In Malta, only three biosimilars (16%) are available on the Government
Formulary while in Estonia, that figure stood at 100%. However, all countries had at least one biosimilar
reimbursed for each of the three medicines examined. Considering countries’ GDP per capita, there is a
positive correlation between higher-income countries and share of public reimbursement of new oncology
medicines. The reverse holds true for biosimilars, which are cost-saving alternatives to original biologics.
Performance- or financial-based managed entry agreements are available across most countries to help
patients gain faster access to new cancer medicines despite limited or immature evidence, while controlling
the budget impact on health spending. Other efforts aimed at addressing potential barriers to patient
access of new cancer medicines include population-based early access schemes (e.g. Cyprus), creating
specific budgets to finance pharmaceutical innovation (e.g. France), centralisation of price negotiations
and increases in reimbursement ceilings (e.g. the Slovak Republic), and joint health technology
assessments (HTA) to evaluate cost-effectiveness of new oncology medicines (such as the Beneluxa
initiative or the Joint Nordic HTA-bodies). The implementation of Regulation (EU) 2021/2 282 on HTA from
2025 is a step forward in this direction, mandating collaborative clinical assessments and scientific
consultations involving patients, clinical experts and relevant stakeholders.
Out-of-pocket costs can be an obstacle in accessing cancer care
In addition to national medication coverage decisions and supply of medical equipment, the degree of cost-
sharing can significantly impact access to cancer care, especially for less affluent populations. Although
out-of-pocket payments (based on EUR PPPs) have decreased by 11% in the EU in 2012-22, they still
account for 15% of all health spending in 2022. While a broad range of cancer care is publicly financed,
the Country Cancer Profiles show that financial barriers persist in accessing certain services.
For instance, in Bulgaria, a 2024 survey revealed average copayments of BGN 1 465 (EUR 733) for cancer
treatment, with surgery accounting for the largest share. Until November 2023, 44% of CT scans and 21%
of MRI scans in Belgian hospitals incurred fee supplements, while in Finland, patients face copayments
for sequential therapy in hospitals. Financial barriers also extend to other aspects of cancer care, such as
copayments for screening activities in Iceland and reliance on private financing for genetic testing to identify
optimal treatment and for palliative care services in the Slovak Republic.
Improvements in survival estimates and cancer care quality initiatives are
evident across EU countries
Estimated cancer survival has improved over the past years, although the pace of
progress varies substantially by cancer site
Cancer survival estimates are the best indicator of care quality, since they reflect the health system’s ability
to detect cancer at earlier stages and provide access to effective treatment. Based on the 17
EU+2 countries that had recently available survival estimates reported in the Country Cancer Profiles,
there has been an improvement in five-year survival. For example, in the Netherlands, the estimate of
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overall five-year relative survival increased from 53% in 1995-2004 to 67% in 2015-22. In Estonia, five-year
relative survival estimates increased over the most recent ten-year window, from 54% in 2007-11 to 58%
in 2017-21, while estimates in Latvia increased to 48% in 2017-22 from 44% a decade prior. In Slovenia,
five-year survival estimates for patients diagnosed in 2012-16 improved for both genders compared to a
decade earlier, although improvements among men (46% to 56%) were larger than among women (58%
to 60%).
According to data presented in the Country Cancer Profiles, lung cancer (which has low survival rates),
has seen the largest increase in survival estimates among the main cancer types. Notable improvements
were seen in all 15 of the EU+2 countries with available trend data. In Ireland, the estimated five-year net
lung cancer survival stood at 24% in 2014-18 and in Denmark, the estimated lung cancer survival among
men stood at 25% and at 32% among women in 2017-21. In both Ireland and Denmark, 5-year survival for
lung cancer almost doubled or more compared to the previous decade.
Survival estimates tend to be highest for breast and prostate cancers. Five-year survival estimates have
moderately increased in all countries for breast cancer and in the majority of countries for prostate cancer
where data is available. In Austria, estimated prostate cancer survival improved from 84% to 94% during
the 20-year window leading up to 2014-18, while in Finland, it increased from 93% to 95% in the nine years
between 2011-13 and 2020-22.
Unlike breast cancer, there are concerning trends in survival for cervical cancer. Over the last 10-20 years,
there has been a stagnation in five-year survival estimates for cervical cancer in most of the 12
EU+2 countries with available data, even though cervical cancer survival estimates were already notably
lower than those of breast cancer. Some countries have even seen worsening survival estimates. Iceland
has seen particular improvement in breast cancer five-year survival estimates, increasing from 75% to
88% in the ten-year period between 1998-07 to 2008-17. In contrast, data from the Icelandic Cancer
Registry shows that estimated five-year survival rates for cervical cancer in the country have fallen from
69% to 67% during this period. Similarly, Croatia has seen breast cancer survival estimates increase to
84% in 2016-20 while cervical cancer survival estimates have decreased slightly to 61%, as compared to
figures in 2011-15. In Germany, breast cancer survival remained stable between 2009-10 (87%) and
2019-20 (88%) while cervical cancer survival decreased by 4 percentage points from 68% to 64% during
this period.
Screening programmes play a role in survival rates. Notable improvement in five-year survival estimates
for colorectal cancer for all countries with available data comes alongside the introduction of population-
based colorectal screening programmes in numerous EU countries over the past 15 years (see Section 3).
Given that breast cancer screening participation rates have fallen over time in many EU countries,
improved breast cancer survival estimates may relate to better treatment options that are compensating
for the challenges in uptake of breast cancer screening. For cervical cancer however, the decrease in
screening participation in the majority of EU countries may be contributing to stagnation in survival rates
for this cancer.
Between 2012 and 2022, premature mortality due to cancer has fallen by almost 20%
In addition to survival data, potential years of life lost (PYLL) is an interesting complementary measure of
the impact of different cancers on society, because it puts a higher weight on cancer deaths among
younger individuals. Examining the change in PYLL over time across various cancer sites can point to
improvements in cancer care systems (prevention, early detection and/or treatment) via reductions in
premature mortality. In 2022, cancer was responsible for 1 355 potential years of life lost per
100 000 population in the EU, which is a decrease of 19% compared to the 1 679 figure in 2012. Decreases
were seen in all EU countries, signifying improvements in cancer care across countries.
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Decreases in PYLL were seen on average in the EU across the main cancer types, with the largest
decrease (28%) seen in lung cancer (Figure 4.3). This decrease is likely due to reductions in smoking rates
over the years as well as the improvements seen in lung cancer survival. Similarly, reductions in colorectal
(13%) and breast cancer (14%) PYLL may be related to improvements in treatment, which have increased
survival rates and have come alongside introduction or expansion of population-based colorectal cancer
screening. In contrast, given the stagnant cervical cancer survival rates seen over time in EU countries,
the large reduction in PYLL from cervical cancer (21%) could point to effectiveness of the introduction and
expansion of HPV vaccination programmes over the years.
Figure 4.3. Over the last decade, there has been a reduction in potential years of life lost across all main cancer sites
Note: The rate of PYLL from breast, cervical and ovarian cancer is calculated in women only, while the rate of PYLL from prostate cancer refers
to men. The size of the bubbles is proportional to the PYLL rates in 2022 (or latest available year).
Source: OECD Health Statistics 2024.
Development of concentrated cancer care is a key priority for EU countries
Recognising the benefits of the concentration of cancer care in terms of patient outcomes, countries have
been moving towards organising cancer care around specialised care centres supported by broader cancer
networks.
Specialised cancer care has been centralised in Czechia since 2008, and as of 2022, such centres must
ensure co-ordination of the full spectrum of cancer care within their regional network. A similar centralised
care model with national and regional networks exists in Finland, while in Denmark, a comprehensive
cancer centre was established in 2017 to centralise national efforts on cancer research, prevention and
treatment.
Some countries are implementing important changes towards centralisation of cancer care. In Greece, it
was announced that Agios Savvas Hospital will become the country’s first comprehensive cancer centre.
In recent years, both Germany (2024) and the Slovak Republic (2021) have decided on or launched major
hospital reform efforts geared at centralising specialty care, including based on minimum volume
requirements. In addition to greater care concentration, the reforms also aim to improve cancer care via
allowing patients to compare hospitals on various criteria (Germany) and via the development of quality
indicators (the Slovak Republic). To leverage national efforts on a larger scale across borders, the Joint
Action CraNE laid the groundwork to establish the first Network of Comprehensive Cancer Centres in the
Lung
Colorectal
Pancreas
Stomach
Cervix uteri Breast
Ovary
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Potential years of life lost per 100 000 population
Percentage change in potential years of life lost 2012-22 (or nearest available year)
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EU. The work has been continued in the follow up Joint Action, EUnetCCC, started in October 2024. All
EU member states plus Norway, Ukraine, Moldova and Iceland are partners to this project.
Countries are upgrading data infrastructure and starting to collect patient-reported
outcomes to improve the quality of cancer care
EU countries are improving care quality via a range of methods such as enhancement of data infrastructure
for cancer control, implementation of multidisciplinary tumour boards, use of clinical guidelines, and
assessments and measurement of quality indicators. Italy has an observatory for monitoring the quality of
Regional Oncology Networks, including assessing their ability to meet cancer care pathways designed to
promote timely diagnosis and high-quality care across regions. In Lithuania, the existing health information
system was upgraded in 2023-24, and can now monitor the cancer patient’s diagnosis (for cervical, colon
and breast cancers) and treatment pathway over time. Romania is at an earlier stage in its cancer quality
processes but has made significant recent strides by developing patient pathways for major tumours and
undertaking efforts to establish a national cancer registry by 2025.
Countries are also increasingly recognising the importance of patient-reported outcome measures
(PROMs), although many have not yet implemented standardised, national processes to collect such
information. In Denmark, prostate and breast cancer-specific PROMs are reported at the regional level
while many of Sweden’s 30+ cancer quality registries also incorporate information on patient-reported
outcomes and experiences. Austria collected patient-reported measures for hospitalised patients, including
those with cancer, in 2022, and has various local initiatives underway, including a digital PROMs reporting
tool for young cancer patients at the Medical University of Innsbruck.
The increasing cancer burden has wide-ranging impact on the health system and
the economy
As populations age and the number of cancer diagnoses increases, per capita
healthcare spending on cancer is projected to increase by 59% in the EU
Cancer imposes a direct financial burden on societies through healthcare expenditures related to its
treatment. As populations age and the incidence of cancer increases, the prevalence of cancer is expected
to rise, leading to larger associated treatment costs. According to OECD SPHeP modelling work, per capita
health expenditure on cancer care is projected to grow by an average of 59% in the EU between 2023 and
2050 (OECD, 2024[16]). Assuming the current standard of care and cost per case of cancer remain the
same, the growth in per capita health expenditure on cancer is projected to be the lowest in Sweden,
Finland, Denmark and France – at less than 36% (Figure 4.4). By contrast in Cyprus, Spain and Poland,
the per capita health expenditure on cancer care is projected to grow by an average of more than 80%.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 4.4. On average in the EU, health expenditure on cancer is projected to increase by more than 50% in 2050 compared to 2023
Projected increase in per capita cancer health expenditure, in real terms, from 2023 to 2050
Note: The EU average is unweighted.
Source: OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, https://doi.org/10.1787/85e7c3ba-en.
The burden of cancer not only includes the cost associated with treating cancer, but also cancer’s broader
impact on other healthcare expenditures as it affects other conditions such as mental health or the need
for rehabilitative care. Looking at the burden of cancer on total health expenditure, the OECD SPHeP
modelling work shows that on average over the period 2023-50, health expenditure in 19 EU+2 countries
is estimated to be 7.0% higher due to the presence of cancer. Per person adjusted for purchasing power
parities (PPPs), this equates to EUR PPP 242 per year. Countries with higher average health expenditure,
like Norway, the Netherlands, Germany and Sweden also see higher per capita health spending due to
cancer, above EUR PPP 400 per year.
Cancer is projected to reduce workforce participation and productivity
Beyond its burden on health systems, cancer has a large impact on the economy via its effects on
workforce participation and productivity. People diagnosed with cancer often need to take leave from work
for treatment, recovery, and medical appointments, reducing employment. In addition, people with cancer
may experience fatigue, mental health impairments, and other side effects that can impact their ability to
work effectively, leading to absenteeism and presenteeism (OECD, 2024[16]). According to OECD SPHeP
modelling work, between 2023 and 2050, cancer is expected to lead to a loss of 178 full-time equivalent
(FTE) workers per 100 000 people on average in the EU, due to the need to reduce employment
(Figure 4.5). In addition, a loss of 38 and 43 FTE workers per 100 000 people is also anticipated due to
absenteeism and presenteeism, respectively.
Based on the countries’ average wages, this equates to a loss in workforce output of EUR PPP 49 billion
per year for EU countries. On a per capita basis, EU countries lose on average EUR PPP 161 per year
(OECD, 2024[16]).
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
37
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 4.5. Cancer is expected to have a large impact on workforce participation and productivity
Projected reduction in full-time equivalent workers due to cancer per 100 000 population, average over 2023-50
Note: The EU average is unweighted.
Source: OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, https://doi.org/10.1787/85e7c3ba-en.
Addressing the issue of well-being and workforce participation among people with cancer is key to
minimising income loss at both the micro and macro levels. There are various policies reported in the
Profiles, ranging from workplace adaptations, psycho-social support in the workplace or physical activity
interventions that have been shown to increase return-to-work rates among people with cancer. Return-
to-work programmes are reported in Belgium, Czechia, Finland, France, Germany, Hungary, Iceland,
Luxembourg, the Netherlands, Portugal and Slovenia. Return-to-work programmes are also key to promote
improved quality of life of people with cancer and social reintegration. Germany has invested in
occupational rehabilitation, including continuing education and training for people who need to change
their profession following a cancer diagnosis. The country also offers opportunities for gradual reintegration
into the workplace, including specifying different stages of workload during which people can continue to
receive sickness benefits. In Belgium, initiatives that support a return to work following cancer include the
Kankerenwerk website, financed by the non-governmental organisation Kom Op Tegen Kanker, which
provides information to assist employers and employees in the reintegration process. Hungary has adopted
policies guiding labour market reintegration of people who were previously ill.
Given increasing cancer prevalence, countries are developing follow-up and
rehabilitative care, and implementing policies to address quality of life
Cancer is expected to reduce life expectancy by 1.9 years in the EU and result in an
additional 85 000 more people with depression symptoms annually
Cancer is one of the main causes of death and disability in EU countries, and has a significant impact on
well-being through reducing life expectancy and increasing mental health disorders. According to OECD
SPHeP modelling work, between 2023 and 2050, cancer will reduce population life expectancy on average
by 1.9 years in the EU compared to a scenario without cancer. In some countries this figure is as high as
2.3 years (France, Denmark, Hungary and the Netherlands) (Figure 4.6).
-400
-300
-200
-100
0
Employment (combining unemployment and part-time) Absenteeism Presenteeism
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Recent evidence suggests that cancer-specific disability led to a decline in healthy life expectancy,
reducing the number of years that a person lives in full health (OECD, 2024[16]). On average in the EU,
cancer reduces healthy life expectancy by 1.6 years, related to activity limitations of cancer from symptoms
like fatigue, pain and nausea.
Figure 4.6. Cancer is projected to reduce life expectancy by between 1.4 and 2.5 years across EU countries
Projected reduction in years of life expectancy due to cancer, average over 2023-50
Note: The EU average is unweighted.
Source: OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, https://doi.org/10.1787/85e7c3ba-en.
In addition, cancer takes a substantial toll on the mental health of the population, through its associated
symptoms and treatment side effects, and impact on daily life, social roles and work. According to the
OECD’s SPHeP model, it is estimated that cancer leads to an additional 85 000 cases of depression
annually in the EU. This equates to an age-standardised rate of 17 cases per 100 000 people per year.
This rate varies significantly across countries, from roughly 5 per 100 000 people per year in Poland to
31 per 100 000 people in Portugal.
The impact of cancer on the mental health of the population is also reflected in national data. In Greece, a
2022 study showed that 80% of cancer patients receiving chemotherapy reported feeling of anxiety, fear
and fatigue, 30% reported depressive symptoms and more than 60% reported major challenges in
performing social activities.
Improving quality of life for people with cancer is a policy priority in many EU countries
A range of policies can contribute to increasing quality of life for people living with cancer, including greater
efforts to address psychological health needs, investments in expanded palliative care services in hospitals
and the community, and better management of cancer through rehabilitative care or improved health
literacy.
As reported in 25 Country Cancer Profiles, mental health support for people with cancer has been
extensively developed over the past years. Portugal ensures access to psychological evaluations and at
least five counselling sessions annually for cancer patients and their families. Norway and Sweden have
-2.5
-2
-1.5
-1
-0.5
0
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
mental health support networks, ensuring timely access to psychological care for cancer patients. Ireland
and Belgium have developed specialised psycho-oncology services, incorporating mental health care into
standard cancer treatment, enhancing patients’ overall well-being, with Ireland publishing a
psycho-oncology model of care in 2023 specifically designed to identify and provide for the comprehensive
needs of children, adolescents and young adults with cancer.
Palliative care, which focuses on alleviating suffering and enhancing the quality of life for patients with
life-threatening conditions, is a key lever to meet the physical, emotional, and spiritual needs of cancer
patients. Belgium, Germany, Ireland, Lithuania, Luxembourg, the Netherlands and Sweden have well-
developed palliative care systems, with services fully integrated into their national healthcare systems and
covered by public health insurance. These countries provide comprehensive care both in hospitals and
through community-based services, ensuring that palliative care is accessible and free of charge for those
in need. Estonia and Slovenia are also investing in training health professionals, increasing awareness of
palliative care, and developing a national palliative care services model, while Croatia has established
mobile palliative care teams operating across its 21 counties and practical palliative care learning
programmes in health centres. In 2020, Lithuania introduced a requirement that palliative care is available
24/7 and increased the number of reimbursable visits for outpatient palliative care services.
Development of supportive cancer care and health literacy programmes are also being integrated in the
care pathway of cancer patients. France for example provides supportive oncology care as part of the
cancer care pathway. The supportive care package is comprised of nine services, including four core
services (pain management, dietary support, psychological support and social, family and professional
support) and five supportive services (physical activity, fertility preservation, management of sexual
disorders, lifestyle advice, and psychological support for relatives and informal caregivers). Iceland focuses
on rehabilitation services for people with cancer based on a holistic assessment of the individual’s well-
being to provide counselling, lectures, and educational materials about regaining and maintaining the best
possible physical functioning, health and quality of life. Portugal has launched a patient resource guide
focusing on cancer literacy and informing patients of their rights and available resources.
In addition, protecting people from discrimination based on their medical history, and ensuring fair
treatment in areas such as employment, insurance and financial services can help promote social
inclusion, emotional well-being and financial security. In October 2023, the Directive (EU) 2023/37 was
introduced to reinforce the “right to be forgotten”, ensuring that health information after a certain period of
cancer survival cannot be used for assessing financial creditworthiness. Eight EU countries already had
such a “right to be forgotten” in place before this Directive (Belgium, France, Italy, Luxembourg, the
Netherlands, Portugal, Romania and Spain), with disclosure requirements ranging from limits of five to
ten years.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Over 50% of new cancer diagnoses among children stem from three main cancer
types: Leukaemia, brain and non-Hodgkin’s lymphoma
According to ECIS, it is estimated that 4 161 girls and 5 000 boys up to age 15 were diagnosed with cancer
in 2022 in the EU, for an age-standardised incidence rate of 13.7 per 100 000 (Figure 5.1).
Age-standardised incidence rates are slightly lower among girls (12.8 per 100 000) than boys (14.6 per
100 000). The most common cancer is leukaemia, representing a little under a third of childhood cancers
in the EU (31%), followed by brain and central nervous system cancers (15%) and non-Hodgkin’s
Lymphoma (8%). Eurostat data shows that 3-year average age-standardised mortality rates from cancer
among children stood at 2.1 per 100 000 in the EU as of 2021, with rates ranging from 0.5 (Iceland) to 3.4
(Malta).
Figure 5.1. The paediatric cancer mortality rate in the EU stood at 2.1 per 100 000 children
Age-standardised incidence (estimates) and 3-year average paediatric cancer mortality rates per 100 000 population
Note: 2022 incidence estimates are based on incidence trends from previous years, and may differ from observed rates in more recent years.
Incidence data includes all cancer sites except non-melanoma skin cancer. Incidence and mortality rates refer to children aged 0-14.
Source: European Cancer Information System (ECIS) for cancer incidence. From https://ecis.jrc.ec.europa.eu, accessed on 10 March 2024. ©
European Union, 2024. Eurostat Database for cancer mortality.
0
1
2
3
4
0
5
10
15
20
Mortality rateIncidence rate
Incidence per 100 000 population, 2022 (left axis) Mortality per 100 000 population, 3-year average, 2021 (right axis)
5 Spotlight on paediatric cancer care
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
In 12 EU+2 countries, paediatric cancer patients had access to less than 5% of
oncology clinical trials running in Europe
In Europe between 2010 to 2022, there were 436 oncology clinical trials that enrolled children and young
people, 76% of which involved novel agents. However, access to these trials varied widely by country. The
greatest access was in France, which had 226 paediatric oncology trials (or 52%) taking place in the
country, followed by Spain (43%) and Italy (41%). In contrast, 12 EU+2 countries had each less than 5%
of paediatric oncology clinical trials running in their country (SIOPE, 2024[17]). Access to trials is related to
the population size of a country and the number of paediatric cancers diagnosed, with larger countries
having more paediatric cancer cases and greater access in clinical oncology trials.
Assessing the availability of medicines that are most critical to paediatric oncology care in EU countries
also reveals substantial cross-country disparities. On average, 76% of essential medicines for treatment
of paediatric cancer were available across EU countries in 2018 (Vassal et al., 2021[18]). Access to less
than 60% of essential medicines for treatment of paediatric cancer was reported in five countries: Romania,
Estonia, Latvia, Lithuania and Bulgaria.
The European Society for Paediatric Oncology (SIOPE) evaluated the availability of 13 treatment
modalities and infrastructure for treating paediatric cancer (SIOPE, 2024[17]). Six countries in the top
income tercile (Austria, Belgium, Denmark, Germany, the Netherlands, and Sweden) have all 13 modalities
available, as do four countries in the middle income tercile (Czechia, France, Italy, and Spain). Only one
country (Poland) in the bottom income tercile had all treatments available within the country. However, the
fewest number of treatments available was in the low population countries of Malta and Luxembourg. In
the 27 EU+2 countries assessed, all provided both inpatient and outpatient chemotherapy as well as
surgery for both solid and central nervous system tumours within the country. Paediatric palliative care
was available in all but one country (Greece) and paediatric survivorship clinics were available in
21 countries. Proton radiation therapy was available in the least number of countries – only 11 – followed
by brachytherapy (17) and access to phase I/II treatments (19).
Through bilateral agreements, EU countries with a low number of paediatric cancer cases may arrange
referral of patients to larger treatment centres in neighbouring EU countries. Estonia relies on international
collaboration to ensure access to proton therapy and the Estonian Cancer Control Plan 2021-30 prioritises
improved international co-operation and expansion of access to treatments and clinical trials for paediatric
patients. Iceland funds travel and care costs in other Scandinavian countries for treatment of rare cancers
and in Malta, paediatric cancer patients are referred for care abroad via the Treatment Abroad Unit if the
recommended treatment is unavailable in the country. Such arrangements, which support countries that
have gaps in access to certain treatment modalities, could also be developed to help to address the
challenges of low access to paediatric clinical trials.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Overview: This section includes a Cancer Performance Tracker (CaPTr) for each of the 27 EU countries,
Iceland and Norway that summarise performance on key indicators in the following domains: cancer
prevention, cancer early detection, cancer care capacity and cancer care outcomes. Each tracker (from
Figure 6.1 to Figure 6.29) shows the position of the country relative to the EU average, minimum and
maximum values on each indicator. If comparable national data is not available, the indicator is not shown
for that country. For most indicators, performance refers to 2021, 2022, or 2023, or nearest available year.
The tracker also shows the change in performance over time where trend data is available and relevant.
Moreover, Figure 6.30 shows the distribution of countries by indicator and Figure 6.31 shows the
definitions, time period assessed, number of countries in the EU average, and source for each indicator.
Colours are used to indicate performance compared to the EU and over time:
• Blue lines connect indicator dots when the country’s performance is better than the EU average;
blue text in “Trend over time” column refers to any improvement in performance;
• Pink lines connect indicator dots when the country’s performance is worse than the EU average;
pink text in “Trend over time” column refers to any deterioration in performance;
• Grey lines and grey text for “Trend over time” are used for cancer care capacity, as most indicators
cannot be classified as better or worse and thus no value judgement is made.
EU average: EU averages are weighted for overweight and obesity, air pollution, cancer mortality, and
educational inequalities but unweighted for all other indicators. EU averages do not include Iceland and
Norway.
Age-standardisation: Cancer mortality rates are reported as age-standardised to the revised European
standard population adopted by Eurostat in 2013.
Specific indicator comments:
Screening: The EU average shown in each tracker is based on programme data. For the following
screening sites and countries, the value and trend refer to 2019 survey data as programme data are not
available:
• Breast: Bulgaria, Greece and Romania;
• Cervical: Austria, Bulgaria, Croatia, Cyprus, Germany, Greece and Romania;
• Colorectal: Austria, Cyprus, Greece, Germany and Romania.
Workforce: Workforce data and definitions can be found in Figure 4.1.
Survival: To allow for cross-country comparison purposes, cancer survival estimates used in the trackers
come from the CONCORD-3 project, while the survival estimates used in the Country Cancer Profiles and
the Synthesis report are based on more recent national data.
6 Cancer performance trackers
43
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.1. Belgium’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on radiation therapy
equipment. *Please see Figure 6.31 for information on trend.
Min
EU
BE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.5 pp
Alcohol consumption Litres per capita, population aged 15+
-11 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-34 %
HPV vaccination % of girls aged 15
+11 pp
Breast cancer screening % of target population
-1.8 pp
Cervical cancer screening % of target population
-0.8 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+73 %
MRI units per 1 000 000 population
+9 %
Cancer mortality ASMR per 100 000 population
-18 %
Colorectal cancer mortality ASMR per 100 000 population
-29 %
Breast cancer mortality ASMR per 100 000 women
-25 %
Lung cancer mortality ASMR per 100 000 population
-25 %
Cancer PYLL years per 100 000 population
-24 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.6 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+1.6 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+2.8 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
15.4 6.2
10.0 11.9
9.2 6.3
51.3 62.5
48.9 41.9
11.7 17.8
11.1 4.9
6.1 10.4
3.1 1.2
679 1 094
571 499
3 462 1 8591 376
641
4911
2626
18 38
12 6
64 96
72 7
56 83
57 9
55
85
55
11
42
77
52 3
59 100
77 0
235 310
220 198
72 6860
49
1815 208
83 93
86 74
50 21 27
19
31 37
31 22
47 78
49 33
1 355 1 961
1 113 826
37 106
43 18
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.2. Bulgaria’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for colorectal cancer
screening. Breast and cervical cancer screening values for Bulgaria come from 2019 survey data while the EU averages are based on 2022
programme data. *Please see Figure 6.31 for information on trend.
Min
EU
BG
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
+0.9 pp
Alcohol consumption Litres per capita, population aged 15+
+13 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-5.8 pp
Air pollution Exposure to PM2.5 (µg/m³)
-25 %
HPV vaccination % of girls aged 15
-14 pp
Breast cancer screening % of target population
+3.7 pp
Cervical cancer screening % of target population
+4.6 pp
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+47 %
MRI units per 1 000 000 population
+61 %
Radiation therapy equipment per 1 000 000 population
+113 %
Cancer mortality ASMR per 100 000 population
+0 %
Colorectal cancer mortality ASMR per 100 000 population
+8 %
Breast cancer mortality ASMR per 100 000 women
-5 %
Lung cancer mortality ASMR per 100 000 population
-4 %
Cancer PYLL years per 100 000 population
-16 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+8.5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+7.4 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.9 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
29.1 6.2
10.0 11.9
11.1 6.3
51.3 62.5
53.7 41.9
17.8 17.211.7
4.9
6.1 10.4
3.9 1.2
679 1 094
967 499
3 462 943 1 376
641
8 12
11 5
49
4726
11
18 38
12 6
64 96
7 7
56 83
36 9
55 85
57 11
59 100
85 0
235 310
229 198
72 52 60
49
8 15 208
83 93
78 74
50 3527
19
31 37
30 22
47 78
42 33
1 355 1 961
1 695 826
37 106
86 18
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.3. Czechia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
CZ
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-6.7 pp
Alcohol consumption Litres per capita, population aged 15+
+2 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-5.8 pp
Air pollution Exposure to PM2.5 (µg/m³)
-32 %
HPV vaccination % of girls aged 15
-3 pp
Breast cancer screening % of target population
-0.4 pp
Cervical cancer screening % of target population
-0.3 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+9 %
MRI units per 1 000 000 population
+67 %
Radiation therapy equipment per 1 000 000 population
-1 %
Cancer mortality ASMR per 100 000 population
-15 %
Colorectal cancer mortality ASMR per 100 000 population
-23 %
Breast cancer mortality ASMR per 100 000 women
-9 %
Lung cancer mortality ASMR per 100 000 population
-24 %
Cancer PYLL years per 100 000 population
-19 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+8.1 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+5.7 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+2 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
16.2 6.2
10.0 11.9
11.6 6.3
51.3 62.5
56.5 41.9
17.8 14.111.7
4.9
6.1 10.4
8.1 1.2
679 1 094
737 499
3 462 1 5491 376
641
8 12
8 5
49 16 26
11
18 38
12 6
64 96
71 7
56 83
60 9
55 85
74 11
42 77
29 3
59 100
77 0
235 310
257 198
72 56 60
49
11 15 208
83 93
81 74
50 3227
19
31 37
30 22
47 78
45 33
1 355 1 961
1 367 826
37 106
106 18
46
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.4. Denmark’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
DK
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5.3 pp
Alcohol consumption Litres per capita, population aged 15+
-12 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31 %
HPV vaccination % of girls aged 15
+6 pp
Breast cancer screening % of target population
-1.3 pp
Cervical cancer screening % of target population
-5.5 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+31 %
MRI units per 1 000 000 population
%
Radiation therapy equipment per 1 000 000 population
-13 %
Cancer mortality ASMR per 100 000 population
-15 %
Colorectal cancer mortality ASMR per 100 000 population
-26 %
Breast cancer mortality ASMR per 100 000 women
-24 %
Lung cancer mortality ASMR per 100 000 population
-23 %
Cancer PYLL years per 100 000 population
-29 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+10.1 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+5.8 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+7.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6
29.1
11.7
6.2
10.0 11.9
9.5 6.3
51.3 62.5
54.6 41.9
17.8
8.9 11.7 4.9
6.1 10.4
8.8 1.2
679 1 094
601 499
3 462 1 376
641 1 384
8 12
12 5
49 4326
11
18 38
9 6
64 96
83 7
56 83
83 9
55
85
61
11
42
77
61 3
59 100
69 0
235 310
271 198
72 6260
49
1715 208
83 93
86 74
50 3027
19
31 37
33 22
47 78
57 33
1 355 1 961
1 092 826
37 106
70 18
47
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.5. Germany’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for radiation therapy
equipment. Cervical and colorectal cancer screening values for Germany come from 2019 survey data while the EU averages are based on
2022 programme data. *Please see Figure 6.31 for information on trend.
Min
EU
DE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-6.3 pp
Alcohol consumption Litres per capita, population aged 15+
-9 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-2.2 pp
Air pollution Exposure to PM2.5 (µg/m³)
-36 %
HPV vaccination % of girls aged 15
+25 pp
Breast cancer screening % of target population
-2.7 pp
Cervical cancer screening % of target population
-2.4 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+7 %
MRI units per 1 000 000 population
+22 %
Cancer mortality ASMR per 100 000 population
-10 %
Colorectal cancer mortality ASMR per 100 000 population
-24 %
Breast cancer mortality ASMR per 100 000 women
-9 %
Lung cancer mortality ASMR per 100 000 population
-9 %
Cancer PYLL years per 100 000 population
-13 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+2.8 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+2.1 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.4 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
14.6 6.2
10.0 11.9
10.6 6.3
51.3 62.5
46.5 41.9
17.8 10.3 11.7
4.9
6.1 10.4
6.6
1.2
679 1 094
715 499
3 462 1 8821 376
641
49
3626
11
18 38
35 6
64 96
54 7
56 83
52 9
55 85
78 11
42 77
55 3
59 100
100 0
235 310
236 198
72 6560
49
1815 208
83 93
86 74
50 24 27
19
31 37
34 22
47 78
47 33
1 355 1 961
1 243 826
37 106
33 18
48
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.6. Estonia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
EE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-10.1 pp
Alcohol consumption Litres per capita, population aged 15+
-2 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+1.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31 %
HPV vaccination % of girls aged 15
-5 pp
Breast cancer screening % of target population
+4.6 pp
Cervical cancer screening % of target population
+8.2 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+19 %
MRI units per 1 000 000 population
+73 %
Radiation therapy equipment per 1 000 000 population
+37 %
Cancer mortality ASMR per 100 000 population
-10 %
Colorectal cancer mortality ASMR per 100 000 population
-3 %
Breast cancer mortality ASMR per 100 000 women
-11 %
Lung cancer mortality ASMR per 100 000 population
-16 %
Cancer PYLL years per 100 000 population
-28 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+9.5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+7 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
15.9 6.2
10.0 11.9
11.2 6.3
51.3 62.5
57.4 41.9
17.8 6.1 11.7
4.9
6.1 10.4
8.8 1.2
679 1 094
591 499
3 462 1 121 1 376
641
8 12
5 5
49 21 26
11
18 38
17 6
64 96
43 7
56 83
63 9
55
85
58
11
42
77
55 3
59 100
46 0
235 310
266 198
72 58 60
49
1715 208
83 93
78 74
50 3427
19
31 37
29 22
47 78
44 33
1 355 1 961
1 283 826
37 106
80 18
49
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.7. Ireland’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
IE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5 pp
Alcohol consumption Litres per capita, population aged 15+
-12 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-4.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-21 %
HPV vaccination % of girls aged 15
+7 pp
Breast cancer screening % of target population
-6.2 pp
Cervical cancer screening % of target population
-3.9 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+17 %
MRI units per 1 000 000 population
+38 %
Radiation therapy equipment per 1 000 000 population
+1 %
Cancer mortality ASMR per 100 000 population
-17 %
Colorectal cancer mortality ASMR per 100 000 population
-28 %
Breast cancer mortality ASMR per 100 000 women
-22 %
Lung cancer mortality ASMR per 100 000 population
-23 %
Cancer PYLL years per 100 000 population
-18 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+7.2 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+4.8 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+7.4 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
14.0 18.6 6.2
10.0 11.9
10.2 6.3
51.3 62.5
53.0
41.9
17.8
8.0 11.7 4.9
6.1 10.4
5.9
1.2
1 094 728679
499
3 462 2 6261 376
641
8 12
10 5
49
20 26
11
18 38
17 6
64 96
75 7
56 83
70 9
55 85
73 11
42
77
34 3
59 100
38 0
235 310
248 198
6160 7249
1815 208
83 93
82 74
50 27 27
19
31 37
33 22
47 78
49 33
1 355 1 961
1 165 826
37 106
65 18
50
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.8. Greece’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on HPV vaccination
and cancer survival. Breast, cervical and colorectal cancer screening values for Greece come from 2019 survey data while the EU averages are
based on 2022 programme data. *Please see Figure 6.31 for information on trend.
Min
EU
EL
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2.4 pp
Alcohol consumption Litres per capita, population aged 15+
-24 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-29 %
Breast cancer screening % of target population
+6.1 pp
Cervical cancer screening % of target population
-2.6 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+47 %
MRI units per 1 000 000 population
+71 %
Radiation therapy equipment per 1 000 000 population
+25 %
Cancer mortality ASMR per 100 000 population
-2 %
Colorectal cancer mortality ASMR per 100 000 population
-1 %
Breast cancer mortality ASMR per 100 000 women
+6 %
Lung cancer mortality ASMR per 100 000 population
-4 %
Cancer PYLL years per 100 000 population
-9 %
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 24.918.6
6.2
10.0 11.9
6.3 6.3
51.3 62.5
54.9 41.9
17.8 14.211.7
4.9
6.1 10.4
4.0 1.2
1 094 1 094679
499
3 462 641 1 376
641
8 12
7 5
49 4926
11
18 38
38 6
56 83
66 9
55 85
73 11
42 77
28 3
59 100
54 0
235 310
239 198
50 22 27
19
31 37
32 22
47 78
57 33
1 355 1 961
1 361 826
37 106
33 18
51
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.9. Spain’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
ES
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.2 pp
Alcohol consumption Litres per capita, population aged 15+
+20 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-0.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-22 %
HPV vaccination % of girls aged 15
+19 pp
Breast cancer screening % of target population
-6 pp
Cervical cancer screening % of target population
-0.3 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+25 %
MRI units per 1 000 000 population
+39 %
Radiation therapy equipment per 1 000 000 population
+52 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-19 %
Breast cancer mortality ASMR per 100 000 women
-13 %
Lung cancer mortality ASMR per 100 000 population
-9 %
Cancer PYLL years per 100 000 population
-19 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.8 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+2.4 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+2.7 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 19.818.6
6.2
10.0 11.9
11.8 6.3
51.3 62.5
51.2 41.9
17.8 9.7 11.7
4.9
6.1 10.4
3.6 1.2
1 094 773679
499
3 462 1 106 1 376
641
8 12
7 5
49
21 26
11
18 38
21 6
64 96
85 7
56 83
74 9
55 85
68 11
42 77
32 3
59 100
62 0
235 310
213 198
72 6360
49
14 15 208
83 93
85 74
50 2927
19
31 37
22 22
47 78
45 33
1 355 1 961
1 166 826
37 106
18 18
52
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.10. France’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
FR
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.2 pp
Alcohol consumption Litres per capita, population aged 15+
-12 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-30 %
HPV vaccination % of girls aged 15
+29 pp
Breast cancer screening % of target population
-3.8 pp
Cervical cancer screening % of target population
-
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+50 %
MRI units per 1 000 000 population
+107 %
Radiation therapy equipment per 1 000 000 population
+7 %
Cancer mortality ASMR per 100 000 population
-12 %
Colorectal cancer mortality ASMR per 100 000 population
-19 %
Breast cancer mortality ASMR per 100 000 women
-8 %
Lung cancer mortality ASMR per 100 000 population
-14 %
Cancer PYLL years per 100 000 population
-18 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
-0.1 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.2 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
25.318.6 6.2
10.0 11.9
10.8 6.3
51.3 62.5
46.4 41.9
17.8
9.5 11.7 4.9
6.1 10.4
5.7
1.2
1 094 499 679
499
1 376 1 379 3 462641
8 12
11 5
49
20 26
11
18 38
18 6
64 96
45 7
56 83
48 9
55
85
60
11
42 77
34 3
59 100
54 0
235 310
223 198
72 6460
49
1715 208
83 93
87 74
50 23 27
19
31 37
30 22
47 78
43 33
1 355 1 961
1 269 826
37 106
51 18
53
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.11. Croatia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for HPV vaccination.
The cervical cancer screening value for Croatia comes from 2019 survey data while the EU average is based on 2022 programme data. *Please
see Figure 6.31 for information on trend.
Min
EU
HR
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2.9 pp
Alcohol consumption Litres per capita, population aged 15+
-16 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-2.8 pp
Air pollution Exposure to PM2.5 (µg/m³)
-25 %
Breast cancer screening % of target population
+2 pp
Cervical cancer screening % of target population
+1.1 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+42 %
MRI units per 1 000 000 population
+77 %
Radiation therapy equipment per 1 000 000 population
+18 %
Cancer mortality ASMR per 100 000 population
-10 %
Colorectal cancer mortality ASMR per 100 000 population
-4 %
Breast cancer mortality ASMR per 100 000 women
-24 %
Lung cancer mortality ASMR per 100 000 population
-6 %
Cancer PYLL years per 100 000 population
-14 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.8 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+5 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
-1.2 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 22.118.6
6.2
10.0 11.9
9.0 6.3
51.3 62.5
58.1 41.9
17.8 15.811.7
4.9
6.1 10.4
4.4 1.2
1 094 556 679
499
3 462 1 081 1 376
641
8 12
8 5
49
22 26
11
18 38
17 6
56 83
62 9
55 85
78 11
42 77
26 3
59 100
62 0
235 310
308 198
72 51 60
49
10 15 208
83 93
79 74
50 4927
19
31 37
30 22
47 78
63 33
1 355 1 961
1 761 826
37 106
86 18
54
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.12. Italy’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data on reimbursed medicines.
*Please see Figure 6.31 for information on trend.
Min
EU
IT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2.3 pp
Alcohol consumption Litres per capita, population aged 15+
+10 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+1.6 pp
Air pollution Exposure to PM2.5 (µg/m³)
-27 %
HPV vaccination % of girls aged 15
-3 pp
Breast cancer screening % of target population
-3.5 pp
Cervical cancer screening % of target population
-0.3 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
+23 %
MRI units per 1 000 000 population
+35 %
Radiation therapy equipment per 1 000 000 population
+9 %
Cancer mortality ASMR per 100 000 population
-15 %
Colorectal cancer mortality ASMR per 100 000 population
-17 %
Breast cancer mortality ASMR per 100 000 women
-7 %
Lung cancer mortality ASMR per 100 000 population
-18 %
Cancer PYLL years per 100 000 population
-17 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+5.2 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+1.8 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.9 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 19.818.6
6.2
10.0 11.9
7.7 6.3
51.3 62.5
41.9 41.9
17.8 14.311.7
4.9
6.1 10.4
6.7
1.2
1 094 615 679
499
3 462 947 1 376
641
8 12
7 5
49
4026
11
18 38
33 6
64 96
64 7
56 83
54 9
55 85
40 11
42 77
34 3
235 310
222 198
72 6460
49
1615 208
83 93
86 74
50 25 27
19
31 37
31 22
47 78
44 33
1 355 1 961
1 157 826
37 106
32 18
55
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.13. Cyprus’ Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for CT scanners,
MRI units, radiation equipment and cancer PYLL. Cervical and colorectal cancer screening values for Cyprus come from 2019 survey data while
the EU averages are based on 2022 programme data. In addition, 2019 survey data for breast cancer screening shows substantially higher
uptake (66%) than that of the programme data reported here. *Please see Figure 6.31 for information on trend.
Min
EU
CY
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.2 pp
Alcohol consumption Litres per capita, population aged 15+
-15 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-4.8 pp
Air pollution Exposure to PM2.5 (µg/m³)
-27 %
HPV vaccination % of girls aged 15
+13 pp
Breast cancer screening % of target population
-
Cervical cancer screening % of target population
+4.6 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
Cancer mortality ASMR per 100 000 population
+10 %
Colorectal cancer mortality ASMR per 100 000 population
+17 %
Breast cancer mortality ASMR per 100 000 women
+13 %
Lung cancer mortality ASMR per 100 000 population
+8 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.4 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+3.5 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+0.4 pp
Educational inequalities % difference in cancer mortality by education
-
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
ca p
ac it
y C
an ce
r ca
re o
u tc
o m
es
29.1
22.518.6 6.2
10.0 11.9
9.6 6.3
51.3 62.5
47.9 41.9
17.8
13.411.7 4.9
6.1
10.4 3.1
1.2
1 094 1 017679
499
3 462 1 040 1 376
641
64 96
67 7
56 83
29 9
55 85
69 11
42
77
22 3
59 100
31 0
235 310
213 198
72 7260
49
1915 208
83 93
93 74
50 19 27
19
31 37
37 22
47 78
42 33
37 106
33 18
56
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.14. Latvia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data on radiation therapy equipment.
*Please see Figure 6.31 for information on trend.
Min
EU
LV
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2 pp
Alcohol consumption Litres per capita, population aged 15+
+21 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+3.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-35 %
HPV vaccination % of girls aged 15
-15 pp
Breast cancer screening % of target population
+0.2 pp
Cervical cancer screening % of target population
+27.4 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+23 %
MRI units per 1 000 000 population
+100 %
Cancer mortality ASMR per 100 000 population
-6 %
Colorectal cancer mortality ASMR per 100 000 population
-12 %
Breast cancer mortality ASMR per 100 000 women
-5 %
Lung cancer mortality ASMR per 100 000 population
-8 %
Cancer PYLL years per 100 000 population
-12 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+8.3 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+7.6 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.7 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 22.618.6
6.2
10.0 11.9
11.9 6.3
51.3 62.5
60.4 41.9
11.7 11.8 17.84.9
6.1 10.4
5.1 1.2
1 094 575 679
499
3 462 706 1 376
641
49
4026
11
18 38
20 6
64 96
46 7
56 83
36 9
55
85
55
11
42 77
26 3
59 100
31 0
235 310
284 198
72 49 60
49
1815 208
83 93
77 74
50 3227
19
31 37
34 22
47 78
46 33
1 355 1 961
1 777 826
37 106
83 18
57
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.15. Lithuania’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
LT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-1.4 pp
Alcohol consumption Litres per capita, population aged 15+
-17 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+3.2 pp
Air pollution Exposure to PM2.5 (µg/m³)
-33 %
HPV vaccination % of girls aged 15
+43 pp
Breast cancer screening % of target population
+16.8 pp
Cervical cancer screening % of target population
+8 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+39 %
MRI units per 1 000 000 population
+69 %
Radiation therapy equipment per 1 000 000 population
-6 %
Cancer mortality ASMR per 100 000 population
-9 %
Colorectal cancer mortality ASMR per 100 000 population
-13 %
Breast cancer mortality ASMR per 100 000 women
-4 %
Lung cancer mortality ASMR per 100 000 population
-24 %
Cancer PYLL years per 100 000 population
-14 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+12.4 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+8.9 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 18.6
6.2 18.9
10.0 11.9
11.2 6.3
51.3 62.5
59.4 41.9
17.8 9.2 11.7
4.9
6.1 10.4
5.6
1.2
1 094 773679
499
3 462 1 376
641 1 304
8 12
7 5
49 3326
11
18 38
17 6
64 96
76 7
56 83
58 9
55
85
55
11
42 77
56 3
59 100
38 0
235 310
259 198
72 57 60
49
10 15 208
83 93
74 74
50 3027
19
31 37
30 22
47 78
37 33
1 355 1 961
1 699 826
37 106
94 18
58
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.16. Luxembourg’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. HPV vaccination coverage comes
from WHO data using estimates based on 2016. No data available for cancer medicine reimbursement and cancer survival. *Please see
Figure 6.31 for information on trend.
Min
EU
LU
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
+3.5 pp
Alcohol consumption Litres per capita, population aged 15+
-8 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-33 %
HPV vaccination % of girls aged 15
+1 pp
Breast cancer screening % of target population
-10.3 pp
Cervical cancer screening % of target population
-7.4 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
+4 %
MRI units per 1 000 000 population
+36 %
Radiation therapy equipment per 1 000 000 population
+22 %
Cancer mortality ASMR per 100 000 population
-24 %
Colorectal cancer mortality ASMR per 100 000 population
-28 %
Breast cancer mortality ASMR per 100 000 women
-17 %
Lung cancer mortality ASMR per 100 000 population
-24 %
Cancer PYLL years per 100 000 population
-37 %
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
20.318.6
6.2
10.0 11.9
11.0 6.3
51.3 62.5
49.7
41.9
17.8
8.7 11.7 4.9
6.1
10.4
6.4
1.2
1 094 647 679
499
3 462 2 5381 376
641
8 12
9 5
49 26
11 25
18 38
18 6
64 96
43 7
56 83
52 9
55
85
60
11
42 77
31 3
235 310
203 198
50 22 27
19
31 37
31 22
47 78
41 33
1 355 1 961
826 826
37 106
34 18
59
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.17. Hungary’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on radiation therapy
equipment and cancer survival. *Please see Figure 6.31 for information on trend.
Min
EU
HU
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-0.9 pp
Alcohol consumption Litres per capita, population aged 15+
-2 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+2.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31 %
HPV vaccination % of girls aged 15
+2 pp
Breast cancer screening % of target population
-12.3 pp
Cervical cancer screening % of target population
-9.6 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+39 %
MRI units per 1 000 000 population
+99 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-13 %
Breast cancer mortality ASMR per 100 000 women
-5 %
Lung cancer mortality ASMR per 100 000 population
-14 %
Cancer PYLL years per 100 000 population
-27 %
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
24.918.6 6.2
10.0 11.9
10.6 6.3
51.3 62.5
58.4 41.9
17.8
14.011.7 4.9
6.1
10.4 7.6
1.2
1 094 538 679
499
3 462 845 1 376
641
49
11 26
11
18 38
6 6
64 96
76 7
56 83
30 9
55 85
26 11
42
77
8 3
59 100
38 0
235 310
310 198
50 5027
19
31 37
37 22
47 78
78 33
1 355 1 961
1 961 826
37 106
78 18
60
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.18. Malta’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data for CT scanners, MRI units,
radiation therapy equipment and cancer PYLL. No data on cancer medicines reimbursement for Malta is shown as there were no indications
from the sample assessed that were included in the national coverage list, but the country provides other methods to help ensure access to
cancer medicines. In addition, 2019 survey data shows substantially higher screening uptake (breast: 61%; cervical: 64%; colorectal: 40%) than
that of the programme data reported here. *Please see Figure 6.31 for information on trend.
Min
EU
MT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
+0.5 pp
Alcohol consumption Litres per capita, population aged 15+
+15 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31 %
HPV vaccination % of girls aged 15
-6 pp
Breast cancer screening % of target population
-
Cervical cancer screening % of target population
-
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Cancer mortality ASMR per 100 000 population
-20 %
Colorectal cancer mortality ASMR per 100 000 population
-27 %
Breast cancer mortality ASMR per 100 000 women
-31 %
Lung cancer mortality ASMR per 100 000 population
-7 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+0.5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+7.2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+5.7 pp
Educational inequalities % difference in cancer mortality by education
-
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
ca p
ac it
y
C an
ce r
ca re
o u
tc o
m es
29.1
20.618.6
6.2
10.0 11.9
8.1 6.3
51.3 62.5
62.5 41.9
17.8
11.7
4.9
11.8
6.1
10.4 1.2
1.2
1 094 868679
499
3 462 1 5051 376
641
64 96
82 7
56 83
44 9
55 85
16 11
42
77
25 3
235 310
198 198
72 58 60
49
15 208
15
83 93
87 74
50 23 27
19
31 37
29 22
47 78
40 33
37 106
34 18
61
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.19. The Netherlands’ Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on radiation therapy
equipment. *Please see Figure 6.31 for information on trend.
Min
EU
NL
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5.7 pp
Alcohol consumption Litres per capita, population aged 15+
-7 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+1.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-33 %
HPV vaccination % of girls aged 15
+8 pp
Breast cancer screening % of target population
-9 pp
Cervical cancer screening % of target population
-18.9 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+45 %
MRI units per 1 000 000 population
+28 %
Cancer mortality ASMR per 100 000 population
-15 %
Colorectal cancer mortality ASMR per 100 000 population
-28 %
Breast cancer mortality ASMR per 100 000 women
-17 %
Lung cancer mortality ASMR per 100 000 population
-22 %
Cancer PYLL years per 100 000 population
-25 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+2.7 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.9 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 12.7 18.6
6.2
10.0 11.9
8.5 6.3
51.3 62.5
48.3 41.9
17.8 10.8 11.7
4.9
6.1 10.4
8.6 1.2
1 094 593 679
499
3 462 1 7451 376
641
49
16 26
11
18 38
15 6
64 96
65 7
56 83
70 9
55 85
46 11
42
77
68 3
59 100
92 0
235 310
256 198
72 6360
49
1715 208
83 93
87 74
50 26 27
19
31 37
33 22
47 78
56 33
1 355 1 961
1 180 826
37 106
34 18
62
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.20. Austria’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. Cervical and colorectal cancer
screening values for Austria come from 2019 survey data while the EU averages are based on 2022 programme data. *Please see Figure 6.31
for information on trend.
Min
EU
AT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.7 pp
Alcohol consumption Litres per capita, population aged 15+
-4 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+2.7 pp
Air pollution Exposure to PM2.5 (µg/m³)
-32 %
HPV vaccination % of girls aged 15
+48 pp
Breast cancer screening % of target population
+2.5 pp
Cervical cancer screening % of target population
-1.9 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
-5 %
MRI units per 1 000 000 population
+38 %
Radiation therapy equipment per 1 000 000 population
+18 %
Cancer mortality ASMR per 100 000 population
-12 %
Colorectal cancer mortality ASMR per 100 000 population
-22 %
Breast cancer mortality ASMR per 100 000 women
-4 %
Lung cancer mortality ASMR per 100 000 population
-3 %
Cancer PYLL years per 100 000 population
-24 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+3.1 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.3 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
20.618.6
6.2
10.0 11.9
11.6 6.3
51.3 62.5
52.7
41.9
17.8
10.9 11.7
4.9
6.1
10.4 10.4
1.2
1 094 1 091679
499
3 462 2 1701 376
641
8 12
6 5
49 2826
11
18 38
26 6
64 96
53 7
56 83
41 9
55 85
85 11
42
77
64 3
59 100
77 0
235 310
225 198
72 6460
49
2015 208
83 93
85 74
50 22 27
19
31 37
31 22
47 78
45 33
1 355 1 961
1 081 826
37 106
40 18
63
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.21. Poland’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on HPV vaccination
and colorectal cancer screening. *Please see Figure 6.31 for information on trend.
Min
EU
PL
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5.6 pp
Alcohol consumption Litres per capita, population aged 15+
+10 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+2.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-33 %
Breast cancer screening % of target population
+0.1 pp
Cervical cancer screening % of target population
-4.8 pp
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+52 %
MRI units per 1 000 000 population
+137 %
Radiation therapy equipment per 1 000 000 population
+60 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-8 %
Breast cancer mortality ASMR per 100 000 women
+4 %
Lung cancer mortality ASMR per 100 000 population
-19 %
Cancer PYLL years per 100 000 population
-23 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+7.6 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+5.2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+2.3 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
55 85
11 11
F r a
29.1 17.1 18.6
6.2
10.0 11.9
11.0 6.3
51.3 62.5
58.4 41.9
17.8 17.811.7
4.9
6.1 10.4
2.1 1.2
1 094 647 679
499
3 462 1 057 1 376
641
8 12
6 5
49 23 26
11
18 38
13 6
56 83
37 9
59 100
62 0
235 310
260 198
72 53 60
49
14 15 208
83 93
77 74
50 3327
19
31 37
30 22
47 78
56 33
1 355 1 961
1 508 826
37 106
71 18
64
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.22. Portugal’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
PT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2.6 pp
Alcohol consumption Litres per capita, population aged 15+
-8 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-0.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-21 %
HPV vaccination % of girls aged 15
-5 pp
Breast cancer screening % of target population
+9.2 pp
Cervical cancer screening % of target population
+31.3 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+15 %
MRI units per 1 000 000 population
+94 %
Radiation therapy equipment per 1 000 000 population
+17 %
Cancer mortality ASMR per 100 000 population
-8 %
Colorectal cancer mortality ASMR per 100 000 population
-22 %
Breast cancer mortality ASMR per 100 000 women
-5 %
Lung cancer mortality ASMR per 100 000 population
+3 %
Cancer PYLL years per 100 000 population
-6 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.4 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+6 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+5.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 14.2 18.6
6.2
10.0 11.9
10.4 6.3
51.3 62.5
53.0 41.9
17.8 8.3 11.7
4.9
6.1 10.4
3.2 1.2
1 094 889679
499
3 462 1 169 1 376
641
8 12
5 5
49
18 26
11
18 38
12 6
64 96
91 7
56 83
50 9
55
85
60
11
42 77
14 3
59 100
54 0
235 310
226 198
72 6160
49
1615 208
83 93
88 74
50 2927
19
31 37
26 22
47 78
37 33
1 355 1 961
1 494 826
37 106
33 18
65
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.23. Romania’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data on HPV vaccination and
cancer medicines reimbursement. Breast, cervical and colorectal cancer screening values for Romania come from 2019 survey data while the
EU averages are based on 2022 programme data. *Please see Figure 6.31 for information on trend.
Min
EU
RO
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-1.1 pp
Alcohol consumption Litres per capita, population aged 15+
+16 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-3.2 pp
Air pollution Exposure to PM2.5 (µg/m³)
-30 %
Breast cancer screening % of target population
+2.6 pp
Cervical cancer screening % of target population
-
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
+165 %
MRI units per 1 000 000 population
+288 %
Radiation therapy equipment per 1 000 000 population
+27 %
Cancer mortality ASMR per 100 000 population
-8 %
Colorectal cancer mortality ASMR per 100 000 population
+7 %
Breast cancer mortality ASMR per 100 000 women
+1 %
Lung cancer mortality ASMR per 100 000 population
-17 %
Cancer PYLL years per 100 000 population
-13 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
-
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
-
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
-
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 6.2
18.7 29.1
10.0 11.9
11.6 6.3
51.3 62.5
59.7 41.9
17.8 13.911.7
4.9
6.1 10.4
3.7 1.2
1 094 679
499 694
3 462 1 5481 376
641
8 12
5 5
49 24 26
11
18 38
15 6
56 83
9 9
55 85
39 11
42 77
3 3
235 310
243 198
72 52 60
49
11 15 208
83 93
75 74
50 3327
19
31 37
31 22
47 78
44 33
1 355 1 961
1 946 826
37 106
86 18
66
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.24. Slovenia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
SI
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-1.5 pp
Alcohol consumption Litres per capita, population aged 15+
-3 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+1.2 pp
Air pollution Exposure to PM2.5 (µg/m³)
-25 %
HPV vaccination % of girls aged 15
+8 pp
Breast cancer screening % of target population
+1.1 pp
Cervical cancer screening % of target population
+2.8 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+38 %
MRI units per 1 000 000 population
+94 %
Radiation therapy equipment per 1 000 000 population
+13 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-31 %
Breast cancer mortality ASMR per 100 000 women
-12 %
Lung cancer mortality ASMR per 100 000 population
-12 %
Cancer PYLL years per 100 000 population
-19 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+8.3 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+4.8 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.9 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
17.4 18.6
6.2
10.0 11.96.3
10.0
51.3 62.5
55.7 41.9
17.8
14.011.7 4.9
6.1
10.4
5.4
1.2
1 094 519 679
499
3 462 1 6021 376
641
8 12
7 5
49
17 26
11
18 38
17 6
64 96
52 7
56 83
77 9
55 85
74 11
42
77
65 3
59 100
69 0
235 310
277 198
72 6260
49
15 208
15
83 9374
84
50 3027
19
31 37
32 22
47 78
51 33
1 355 1 961
1 388 826
37 106
31 18
67
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.25. Slovak Republic’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data on HPV vaccination and
cancer medicines reimbursement. *Please see Figure 6.31 for information on trend.
Min
EU
SK
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-1.9 pp
Alcohol consumption Litres per capita, population aged 15+
-6 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+3.9 pp
Air pollution Exposure to PM2.5 (µg/m³)
-28 %
Breast cancer screening % of target population
-1.6 pp
Cervical cancer screening % of target population
-0.5 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
+29 %
MRI units per 1 000 000 population
+67 %
Radiation therapy equipment per 1 000 000 population
-3 %
Cancer mortality ASMR per 100 000 population
-16 %
Colorectal cancer mortality ASMR per 100 000 population
-21 %
Breast cancer mortality ASMR per 100 000 women
-4 %
Lung cancer mortality ASMR per 100 000 population
-23 %
Cancer PYLL years per 100 000 population
-23 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.4 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+0.2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.7 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 21.018.6
6.2
10.0 11.9
9.5 6.3
51.3 62.5
58.4 41.9
17.8 15.311.7
4.9
6.1 10.4
1.6 1.2
1 094 679
499 691
3 462 1 056 1 376
641
8 12
12 5
49 20 26
11
18 38
10 6
56 83
29 9
55 85
46 11
42 77
52 3
235 310
275 198
72 52 60
49
11 15 208
83 93
76 74
50 4127
19
31 37
37 22
47 78
41 33
1 355 1 961
1 516 826
37 106
69 18
68
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.26. Finland’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for reimbursed
medicines. *Please see Figure 6.31 for information on trend.
Min
EU
FI
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5.7 pp
Alcohol consumption Litres per capita, population aged 15+
-22 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-1.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-30 %
HPV vaccination % of girls aged 15
+15 pp
Breast cancer screening % of target population
-1.3 pp
Cervical cancer screening % of target population
+1.4 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
-15 %
MRI units per 1 000 000 population
+55 %
Radiation therapy equipment per 1 000 000 population
+17 %
Cancer mortality ASMR per 100 000 population
-7 %
Colorectal cancer mortality ASMR per 100 000 population
-2 %
Breast cancer mortality ASMR per 100 000 women
-7 %
Lung cancer mortality ASMR per 100 000 population
-9 %
Cancer PYLL years per 100 000 population
-16 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.6 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
11.3 18.6 6.2
10.0 11.9
7.6 6.3
51.3 62.5
59.8 41.9
17.8
4.9 11.7 4.9
6.1
10.4 8.3
1.2
1 094 568 679
499
3 462 2 2231 376
641
8 12
11 5
49 19 26
11
18 38
33 6
64 96
76 7
56 83
82 9
55 85
72 11
42
77
77 3
235 310
210 198
72 6560
49
13 15 208
83 93
89 74
50 22 27
19
31 37
26 22
47 78
37 33
1 355 1 961
986 826
37 106
53 18
69
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.27. Sweden’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
SE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-4.1 pp
Alcohol consumption Litres per capita, population aged 15+
+1 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-4.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-28 %
HPV vaccination % of girls aged 15
+7 pp
Breast cancer screening % of target population
+1 pp
Cervical cancer screening % of target population
-2.6 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+17 %
MRI units per 1 000 000 population
+20 %
Radiation therapy equipment per 1 000 000 population
-22 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-14 %
Breast cancer mortality ASMR per 100 000 women
-18 %
Lung cancer mortality ASMR per 100 000 population
-19 %
Cancer PYLL years per 100 000 population
-25 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.7 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+3.2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+5.6 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
8.7 18.6 6.2
10.0 11.9
7.5 6.3
51.3 62.5
53.2 41.9
17.8
5.6 11.7 4.9
6.1
10.4 4.3
1.2
1 094 746679
499
3 462 1 8441 376
641
8 12
6 5
49 24 26
11
18 38
17 6
64 96
85 7
56 83
81 9
55 85
79 11
42
77
64 3
59 100
85 0
235 310
207 198
72 6560
49
2015 208
83 93
89 74
50 26 27
19
31 37
23 22
47 78
33 33
1 355 1 961
840 826
37 106
54 18
70
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.28. Iceland’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
IS
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-7.6 pp
Alcohol consumption Litres per capita, population aged 15+
+9 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+10.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-22 %
HPV vaccination % of girls aged 15
+5 pp
Breast cancer screening % of target population
-2 pp
Cervical cancer screening % of target population
-11 pp
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+10 %
MRI units per 1 000 000 population
+8 %
Radiation therapy equipment per 1 000 000 population
-15 %
Cancer mortality ASMR per 100 000 population
-17 %
Colorectal cancer mortality ASMR per 100 000 population
-4 %
Breast cancer mortality ASMR per 100 000 women
+29 %
Lung cancer mortality ASMR per 100 000 population
-30 %
Cancer PYLL years per 100 000 population
-10 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.8 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+1.7 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
6.2 18.6 6.2
10.0 11.9
7.4 6.3
51.3 62.5
62.0 41.9
17.8
5.5 11.7 4.9
6.1
10.4 3.8
1.2
1 094 1 025679
499
3 462 3 4621 376
641
8
12
8
5
49
4426
11
18 38
24 6
64 96
96 7
56 83
57 9
55 85
62 11
59 100
69 0
235 310
217 198
72 6860
49
2015 208
83 93
89 74
50 21 27
19
31 37
33 22
47 78
44 33
1 355 1 961
1 040 826
37 106
65 18
71
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.29. Norway’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on colorectal cancer
screening available for 2022 as the programme was gradually rolled out, and no data available on cancer PYLL. *Please see Figure 6.31 for
information on trend.
Min
EU
NO
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-8 pp
Alcohol consumption Litres per capita, population aged 15+
0 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+4.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-23 %
HPV vaccination % of girls aged 15
+20 pp
Breast cancer screening % of target population
+5.3 pp
Cervical cancer screening % of target population
+3 pp
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+82 %
MRI units per 1 000 000 population
+613 %
Radiation therapy equipment per 1 000 000 population
-8 %
Cancer mortality ASMR per 100 000 population
-17 %
Colorectal cancer mortality ASMR per 100 000 population
-15 %
Breast cancer mortality ASMR per 100 000 women
-17 %
Lung cancer mortality ASMR per 100 000 population
-19 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+3 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.3 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 8.0 18.6
6.2
10.0 11.9
6.6 6.3
51.3 62.5
53.5 41.9
17.8 6.1 11.7
4.9
6.1 10.4
3.1 1.2
1 094 724679
499
3 462 2 2671 376
641
8 12
11 5
49 2826
11
18 38
31 6
64 96
93 7
56 83
76 9
55 85
71 11
59 100
69 0
235 310
220 198
72 6560
49
1815 208
83 93
87 74
50 3227
19
31 37
22 22
47 78
44 33
37 106
82 18
72
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.30. EU’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. Grey circles represent EU+2 countries.
*Please see Figure 6.31 for information on trend.
EU Min Max
Trend
over time
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.1 pp
Alcohol consumption Litres per capita, population aged 15+
-3%
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-0.5 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31%
HPV vaccination % of girls aged 15
+9 pp
Breast cancer screening % of target population
-
Cervical cancer screening % of target population
-
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases -
Nurses per 1 000 cancer cases -
Reimbursed cancer medicines % of selected indications -
CT scanners per 1 000 000 population
29%
MRI units per 1 000 000 population
53%
Radiation therapy equipment per 1 000 000 population
9%
Cancer mortality ASMR per 100 000 population
-12%
Colorectal cancer mortality ASMR per 100 000 population
-18%
Breast cancer mortality ASMR per 100 000 women
-9%
Lung cancer mortality ASMR per 100 000 population
-14%
Cancer PYLL years per 100 000 population
-19%
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+4 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+3 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
p re
ve n
ti o
n
E ar
ly c
an ce
r
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y C
an ce
r ca
re o
u tc
o m
es
Improvement ■ Deterioration ■ No value judgement ■
F r a
18.6 29.16.2
51.3 62.541.9
11.7 17.84.9
6.1 10.41.2
679 1 094499
1 376 3 462641
26 4911
18 386
64 967
56 839
55 8511
0 59 100
235 310198
15 208
83 9374
27 5019
31 3722
47 7833
1 355 1 961826
37 10618
42 773
10.0 11.96.3
60 7249
8 125
73
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.31. Cancer Performance Tracker (CaPTr) methods table
Note: EU-SILC = European Statistics on Income and Living Conditions; EHIS = European Health Interview Survey; IARC = International Agency
for Research on Cancer. Information from the EU-CanIneq study led by IARC is available at EU-CanIneq - European Commission.
Dimension Indicator Definition
Year/Perio
d of
change
EU average
(number of
countries) Source
Prevention expenditure Share of total current health expenditure allocated to preventive care 2021 27 Eurostat
Daily smoking Share of people aged 15 and over reporting smoking daily 2012-22 27 OECD Health Statistics and
Eurostat
Alcohol consumption Average litres of alcohol consumption per person aged 15 and over 2010-22 27 OECD Health Statistics and
Eurostat
Overweight and obesity Percentage of individuals aged 18 and over reporting body mass
index is >=25 2017-22 27 EU-SILC and EHIS
Air pollution Estimated mean population exposure to PM2.5 (µg/m³) 2010-20 27 OECD Environment Database
HPV vaccination % of 15-year-old girls who received their full dose of HPV vaccinations 2013-23 22 WHO
Breast cancer screening
Proportion of target population who have undergone breast cancer
screening based on the country’s breast cancer screening policy or
EHIS survey definition
2014-22 24 OECD Health Statistics and EHIS
Cervical cancer screening
Proportion of target population who have undergone cervical cancer
screening based on the country’s cervical cancer screening policy or
EHIS survey definition
2014-22 20 OECD Health Statistics and EHIS
Colorectal cancer screening
Proportion of target population who have undergone colorectal cancer
screening based on the country’s colorectal cancer screening policy
or EHIS survey definition
2022 20 OECD Health Statistics and EHIS
Physicians Number of practising physicians per 1 000 new cancer cases 2022 27 OECD Health Statistics and
European Cancer Information
Nurses Number of practising nurses per 1 000 new cancer cases 2022 27 OECD Health Statistics and
European Cancer Information
Reimbursed cancer medicines Proportion of reimbursed indications among a sample of new cancer
medicines for breast and lung cancers with high clinical benefit 2023 22
Hofmarcher, T., C. Berchet and
G. Dedet (2024)
CT scanners Number of CT scanners per 1 000 000 population 2013-23 25 OECD Health Statistics
MRI units Number of MRI units per 1 000 000 population 2013-23 25 OECD Health Statistics
Radiation therapy equipment Number of radiation therapy equipment per 1 000 000 population 2013-23 20 OECD Health Statistics
Cancer mortality Malignant neoplasms age-standardised mortality rate per 100 000
population 2011-21 27 Eurostat
Colorectal cancer mortality Colon, rectosigmoid junction, rectum, anus and anal canal cancer
age-standardised mortality rate per 100 000 population 2011-21 27 Eurostat
Breast cancer mortality Breast cancer age-standardised mortality rate per 100 000 women 2011-21 27 Eurostat
Lung cancer mortality Trachea, bronchus and lung cancer age-standardised mortality rate
per 100 000 population 2011-21 27 Eurostat
Cancer PYLL Potential Years of Life Lost due to cancer per 100 000 population 2012-22 25 OECD Health Statistics
Colon cancer 5-year survival Age-standardised 5-year net survival estimates (%) for patients
diagnosed with colon cancer, 2010-14
2000/04-
2010/14 24 CONCORD-3
Breast cancer 5-year survival Age-standardised 5-year net survival estimates (%) for women
diagnosed with breast cancer, 2010-14
2000/04-
2010/14 24 CONCORD-3
Lung cancer 5-year survival Age-standardised 5-year net survival estimates (%) for patients
diagnosed with lung cancer, 2010-14
2000/04-
2010/14 24 CONCORD-3
Educational inequalities Socio-economic inequality gap in cancer mortality between people
with higher and low education (%) 2015/19 27 IARC
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y d
et ec
ti o
n C
an ce
r ca
re c
ap ac
it y
C an
ce r
ca re
o u
tc o
m es
74
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Notes
1 According to data from the Cancer Registry Norway, ECIS estimations overestimate the country’s breast
cancer incidence rate (by around 6%).
2 According to data from the Cancer Registry Norway, ECIS estimations overestimate the country’s
colorectal cancer incidence rate (by around 19% among women and 15% among men).
3 Iceland, Norway and 27 EU countries are grouped into three distinct terciles based on 2022 GDP per
capita in purchasing power standard terms: the top tercile includes the highest-income countries (Austria,
Belgium, Denmark, Germany, Iceland, Ireland, Luxembourg, the Netherlands, Norway and Sweden); the
middle tercile includes the middle-income countries (Cyprus, Czechia, Finland, France, Italy, Lithuania,
Malta, Slovenia and Spain); the bottom tercile includes the lowest income-countries (Bulgaria, Croatia,
Estonia, Greece, Hungary, Latvia, Poland, Portugal, Romania and the Slovak Republic).
4 EU+2 countries include 27 EU Member States (EU27), plus Iceland and Norway. EU averages refer to
EU27 countries only.
5 Cancer prevalence refers to the proportion of the population who have been diagnosed with cancer and
are still alive, including those currently undergoing treatment for cancer and those who have completed
treatment. Five‑year cancer prevalence includes people who have been diagnosed within the previous
five years, while lifetime prevalence considers those who have ever received a cancer diagnosis.
6 While programme data are collected from administrative data or national/regional cancer registries,
survey data are obtained from international surveys, limiting the international comparability as responses
may be affected by recall bias.
75
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
References
Aarts, M. et al. (2024), Socioeconomic Differences in the Consequences of Cancer, Integraal
Kankercentrum Nederland (IKNL).
[7]
De Angelis, R. et al. (2024), “Complete cancer prevalence in Europe in 2020 by disease duration
and country (EUROCARE-6): a population-based study”, The Lancet Oncology, Vol. 25/3,
pp. 293-307, https://doi.org/10.1016/s1470-2045(23)00646-0.
[9]
Desimpel F, L. (2024), Lung cancer screening in a high risk population - Synthesis. Health
Technology Assessment (HTA), Federal Knowledge Centre for Health Care (KCE), Brussels.
[11]
European Commission/IARC/Erasmus MC (2024), Mapping Socio-economic Inequalities in
Cancer Mortality across European Countries.
[6]
Global Burden of Disease Collaborative Network (2021), Global burden of disease study 2021
(GBD 2021) results, https://vizhub.healthdata.org/gbd-results/ (accessed on
4 November 2024).
[10]
Hassaine, Y. et al. (2022), “Evolution of breast cancer incidence in young women in a French
registry from 1990 to 2018: Towards a change in screening strategy?”, Breast Cancer
Research, Vol. 24/1, https://doi.org/10.1186/s13058-022-01581-5.
[2]
Hofmarcher, T., C. Berchet and G. Dedet (2024), “Access to oncology medicines in EU and
OECD countries”, OECD Health Working Papers, No. 170, OECD Publishing, Paris,
https://doi.org/10.1787/c263c014-en.
[15]
Koldehoff, A. et al. (2021), “Cost-Effectiveness of Targeted Genetic Testing for Breast and
Ovarian Cancer: A Systematic Review”, Value in Health, Vol. 24/2, pp. 303-312,
https://doi.org/10.1016/j.jval.2020.09.016.
[12]
OECD (2024), Beating Cancer Inequalities in the EU: Spotlight on Cancer Prevention and Early
Detection, OECD Health Policy Studies, OECD Publishing, Paris,
https://doi.org/10.1787/14fdc89a-en.
[8]
OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, OECD
Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/85e7c3ba-en.
[16]
OECD/European Commission (2024), Health at a Glance: Europe 2024: State of Health in the
EU Cycle, OECD Publishing, Paris, https://doi.org/10.1787/b3704e14-en.
[14]
SIOPE (2024), Childhood cancer country profile, https://siope.eu/activities/joint-projects/OCEAN-
Country-Cancer-Profiles.
[17]
76
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Sung, H. et al. (2024), “Differences in cancer rates among adults born between 1920 and 1990
in the USA: an analysis of population-based cancer registry data”, The Lancet Public Health,
Vol. 9/8, pp. e583-e593, https://doi.org/10.1016/S2468-2667(24)00156-7.
[3]
Sung, H. et al. (2025), “Colorectal cancer incidence trends in younger versus older adults: an
analysis of population-based cancer registry data”, The Lancet Oncology, doi:
10.1016/S1470-2045(24)00600-4, pp. 51-63, https://doi.org/10.1016/S1470-2045(24)00600-
4.
[5]
Teppala, S. et al. (2023), “A review of the cost-effectiveness of genetic testing for germline
variants in familial cancer”, Journal of Medical Economics, Vol. 26/1, pp. 19-33,
https://doi.org/10.1080/13696998.2022.2152233.
[13]
Vaccarella, S. et al. (2024), “Prostate cancer incidence and mortality in Europe and implications
for screening activities: population based study”, BMJ, p. e077738,
https://doi.org/10.1136/bmj-2023-077738.
[1]
Vassal, G. et al. (2021), “Access to essential anticancer medicines for children and adolescents
in Europe”, Annals of Oncology, Vol. 32/4, pp. 560-568,
https://doi.org/10.1016/j.annonc.2020.12.015.
[18]
Vuik, F. et al. (2019), “Increasing incidence of colorectal cancer in young adults in Europe over
the last 25 years”, Gut, Vol. 68/10, pp. 1820-1826, https://doi.org/10.1136/gutjnl-2018-
317592.
[4]
E E S T I
European Cancer Inequalities Registry
Riigi vähiprofiil 2025
02 | EESTI | Riigi vähiprofiil 2025
A C (a) C (b)
B D
Inside cover
0 500 1000
Muu
Hingamisteede haigused
Tuvastatud COVID-19
Vähk
Vereringesüsteemi haigused
Eesti EL27
Vanusestandarditud suremus 100 000 elaniku kohta (2021)
76,7
78,8
80,2
81,5
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
Oodatav eluiga sünnihetkel (aastates)
17,7 %
20,2 %
18,0 %
21,3 %
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
65aastaste ja vanemate elanike osakaal (%)
7,0 %
10,4 %
0 %
5 %
10 %
15 %
Eesti EL27
Tervishoiukulud protsendina SKPst (2022 või lähim aasta)
EUR 2 014
EUR 3 533
0
1 250
2 500
3 750
Eesti EL27
Tervishoiukulud eurodes elaniku kohta ostujõu pariteedi alusel (jooksevhinnad, 2022)
# Restricted Use - À usage restreint
A C (a) C (b)
B D
Inside cover
0 500 1000
Muu
Hingamisteede haigused
Tuvastatud COVID-19
Vähk
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Eesti EL27
Vanusestandarditud suremus 100 000 elaniku kohta (2021)
76,7
78,8
80,2
81,5
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
Oodatav eluiga sünnihetkel (aastates)
17,7 %
20,2 %
18,0 %
21,3 %
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
65aastaste ja vanemate elanike osakaal (%)
7,0 %
10,4 %
0 %
5 %
10 %
15 %
Eesti EL27
Tervishoiukulud protsendina SKPst (2022 või lähim aasta)
EUR 2 014
EUR 3 533
0
1 250
2 500
3 750
Eesti EL27
Tervishoiukulud eurodes elaniku kohta ostujõu pariteedi alusel (jooksevhinnad, 2022)
# Restricted Use - À usage restreint
A C (a) C (b)
B D
Inside cover
0 500 1000
Muu
Hingamisteede haigused
Tuvastatud COVID-19
Vähk
Vereringesüsteemi haigused
Eesti EL27
Vanusestandarditud suremus 100 000 elaniku kohta (2021)
76,7
78,8
80,2
81,5
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
Oodatav eluiga sünnihetkel (aastates)
17,7 %
20,2 %
18,0 %
21,3 %
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
65aastaste ja vanemate elanike osakaal (%)
7,0 %
10,4 %
0 %
5 %
10 %
15 %
Eesti EL27
Tervishoiukulud protsendina SKPst (2022 või lähim aasta)
EUR 2 014
EUR 3 533
0
1 250
2 500
3 750
Eesti EL27
Tervishoiukulud eurodes elaniku kohta ostujõu pariteedi alusel (jooksevhinnad, 2022)
# Restricted Use - À usage restreint
A C (a) C (b)
B D
Inside cover
0 500 1000
Muu
Hingamisteede haigused
Tuvastatud COVID-19
Vähk
Vereringesüsteemi haigused
Eesti EL27
Vanusestandarditud suremus 100 000 elaniku kohta (2021)
76,7
78,8
80,2
81,5
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
Oodatav eluiga sünnihetkel (aastates)
17,7 %
20,2 %
18,0 %
21,3 %
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
65aastaste ja vanemate elanike osakaal (%)
7,0 %
10,4 %
0 %
5 %
10 %
15 %
Eesti EL27
Tervishoiukulud protsendina SKPst (2022 või lähim aasta)
EUR 2 014
EUR 3 533
0
1 250
2 500
3 750
Eesti EL27
Tervishoiukulud eurodes elaniku kohta ostujõu pariteedi alusel (jooksevhinnad, 2022)
# Restricted Use - À usage restreint
Riikide vähiprofiilide sari Vähktõve ebavõrdsuse register on Euroopa vähktõvevastase võitluse kava juhtalgatus. Sellest saab kindlat ja usaldusväärset teavet vähktõve ennetamise ja ravi kohta, et selgitada välja suundumused ning erinevused ja ebavõrdsus liikmesriikide, piirkondade ja elanikkon- narühmade vahel. Riikide vähiprofiilides tuuakse välja tugevad küljed, probleemid ja konkreetsed tegevusvaldkonnad kõigis 27 ELi liikmesriigis, Islandil ja Norras, et suunata Euroopa vähktõvevastase võitluse kava alusel investeeringuid ja sekkumisi ELi, riigi ja piirkonna tasandil. Lisaks toetab Euroopa vähktõve ebavõrdsuse register nullsaaste tegevuskava 1. juhtalgatust. Profiilid koostab Majanduskoostöö ja Arengu Organisatsioon (OECD) koostöös Euroopa Komisjoniga. Töörühm on tänulik riiklikele ekspertidele väärtusliku panuse ning OECD tervisekomiteele ja ELi vähktõve ebavõrdsuse registri eksperdirühmale märkuste eest.
Andme- ja teabeallikad Enamik riikide vähiprofiilides esitatud andmetest ja teabest põhineb riikide poolt Eurostatile ja OECD-le esitatud ametlikul statistikal, mis valideeriti, et tagada andmete võimalikult suur võrreldavus. Teave andmete algallikate ja alusmeetodite kohta on kättesaadav Eurostati andmebaasis ja OECD terviseandmebaasis.
Lisaks saadi andmeid ja teavet sellistest allikatest nagu Euroopa Komisjoni Teadusuuringute Ühiskeskus, sissetulekuid ja elamistingimusi käsitlev ELi statistika, Maailma Terviseor- ganisatsioon (WHO), Rahvusvaheline Vähiuurimiskeskus (IARC), Rahvusvaheline Aatomienergiaagentuur (IAEA), Euroopa pediaatrilise onkoloogia ühing, Euroopa Liidu Põhiõiguste Amet (LGBTIQ kogukonda käsitlev uuring), kooliealiste laste tervisekäitumist käsitlev uuring ja 2023. aasta riikide tervise- ja vähiprofiilid ning muudest riiklikest allikatest (mis on sõltumatud era- ja ärihuvidest). ELi kohta arvutatud keskmised on 27 liikmesriigi kaalutud keskmised, kui ei ole märgitud teisiti. ELi keskmised ei hõlma Islandit ja Norrat. Suremus- ja haigestumuskordajad on standarditud vanuse järgi 2013. aastal Eurostati poolt kinnitatud Euroopa standardrahvastiku põhjal.
Ostujõu pariteet on valuutavahetuskurss, mille abil võrdsustatakse eri vääringute ostujõud, kõrvaldades riikide hinnatasemete erinevused.
Vastutuse välistamine: Käesolev dokument avaldatakse OECD peasekretäri ja Euroopa Komisjoni presidendi vastutusel. Dokumendis e itatud arv mused ja väited ei pruugi tingimata kajastada OECD või Euroopa Liidu liikmesriikide ametlikke seisukohti. Käesoleva dokumendiga ega ka selles esitatud andmete ja diagrammidega ei piirata ühegi territooriumi staatust ega selle suveräänsust, rahvusvaheliste piiride ja riigipiiride piiristamist ega ühegi territooriumi, linna või piirkonna nime. Käesolevas ühisväljaandes kasutatud riikide ja territooriumide nimed ja kaardid on kooskõlas OECDs järgitava tavaga.
OECD vastutuse välistamine seoses konkreetsete territooriumidega:
Märkus Türgi Vabariigilt: käesolevas dokumendis sisalduv teave Küprose kohta puudutab saare lõunaosa. Ükski ametlik võim saarel ei esinda korraga nii türgi kui ka kreeka rahvusest küproslasi. Türgi tunnustab Põhja-Küprose Türgi Vabariiki. Türgi jääb Küprose küsimuses oma seisukohale seni, kuni ÜRO raames on leitud alaline ja erapooletu lahendus.
Märkus kõigilt OECDsse kuuluvatelt Euroopa Liidu liikmesriikidelt ja Euroopa Liidult: Küprose Vabariiki on tunnustanud kõik Ühinenud Rahvaste Organisatsiooni liikmed peale Türgi. Käesolevas dokumendis esitatud teave puudutab piirkonda, mis on Küprose Vabariigi tegeliku kontrolli all.
© OECD / Euroopa Liit, 2025 Käesoleva dokumendi originaali ja tõlke mis tahes vastuolu korral tuleks lugeda kehtivaks üksnes dokumendi originaal.
Peamised tervisesüsteemi ja demograafilised näitajad
Allikas: Eurostati andmebaas.
Sisukord 1. PÕHIPUNKTID 3
2. VÄHKTÕBI EESTIS 4
3. RISKITEGURID JA ENNETUSPOLIITIKA 8
4. VARAJANE AVASTAMINE 13
5. VÄHIRAVI TOIMIVUS 17
5.1. Kättesaadavus 17
5.2. Kvaliteet 20
5.3. Kulud ja kulutõhusus 23
5.4. Heaolu ja elukvaliteet 24
6. PILGUHEIT LASTE VÄHKTÕVELE 26
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Riigi vähiprofiil 2025 | EESTI | 03
1. Põhipunktid
Vähktõbi Eestis 2022. aastal oli hinnanguline vähihaigestumus Eestis meeste seas suurem, kuid naiste seas väiksem kui ELi keskmine. Sooline erinevus vähisuremuses oli üks ELi suurimaid: meeste suremus ületas naiste oma enam kui kaks korda. Tänu pidevatele edusammudele suurenes vähielulemus aastatel 2010–2020 peaaegu 40 %. 2025. aastal toimub Eesti vähitõrje tegevuskava 2021–2030 eesmärkide vahehindamine.
Riskitegurid ja ennetuspoliitika Kuigi igapäevane suitsetamine on märkimisväärselt vähenenud, on Eesti elanike tulemused mitme riskiteguri puhul, mille hulka kuuluvad ülekaalulisus ning puu- ja köögiviljade tarbimine, viletsamad kui ELi keskmine. Sotsiaal-majanduslikud erinevused naiste ülekaalulisuses on Eestis siiski väiksemad kui ELis keskmiselt ja need on viimastel aastatel vähenenud. Alkoholi- tarbimine on riigis tänu alkoholi taskukohasemaks muutumisele kasvanud ja on üks kõrgemaid ELis, ulatudes 2022. aastal 11,2 liitrini elaniku kohta. Lisaks võib osa suitsetajate osakaalu vähenemisest seostada suurenenud e-sigarettide kasutamisega, mis on eriti levinud noorte seas.
Varajane avastamine 2023. aastal oli Eesti rinna-, emakakaela- ja kolorektaalvähi sõeluuringu programmides osalusmäär läbi aegade kõrgeim. Seda tänu jõupingutustele parandada mitmesuguste vahendite abil, nagu HPV kodutestid ja maapiirkondi külastavad mammograafiabussid, programmide kättesaadavust ja teadlikkust neist programmidest. Ühes maakonnas on katsetatud ka kopsuvähi sõeluuringut ja samuti uuritakse eesnäärmevähi sõeluuringu teostatavust.
Vähiravi toimivus Viie aasta elulemus paranes 54 %-lt aastatel 2007–2011 diagnoositud vähijuhtude puhul 58 %-le vähijuhtude puhul, mis diagnoositi aastatel 2017–2021. Eestis toimub tsentral- iseeritud vähiravi ning arendatakse personaalmeditsiini ja inimesekeskseid lähenemisviise ravi kvaliteedi hindamiseks. Samas on oluline tagada ülevaade ooteaegadest, mis praegu puudub, ja piisav tööjõud. Esmatähtsaks peetakse ka vähiravimite ning diagnoosimis- ja raviviiside kättesaadavust. Palliatiivne ravi on Eestis killustunud ja teenustes esineb lünki, eriti hajuasustusega piirkondades. On oodata, et vähktõvest põhjustatud depressioonijuhtumite esinemissagedus on Eestis aastatel 2023–2050 suurem kui ELis keskmiselt, ehkki vähktõve mõju oodatavale elueale on sarnane.
A. Cancer in Eesti B (a). Adolescent risk factors and prevention policies
C. Early detection (ver. 1) D. (a) Cancer care performance (health expenditure)
Highlights pg1
B (b
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is k
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s0 100 200 300 400 500 600 700 800 900
Eesti EL27 Mehed Naised
Vanusestandarditud kordajad 100 000 elaniku kohta
Vähihaigestu mus (2022)
Vähisuremus (2021)
3,6 %
6,8 %
0 %
3 %
5 %
8 %
Vähiga seotud kulude prognoositud osakaal tervishoiukuludes (2023.– 2050. aasta keskmine)
1,9 1,9
0,0
0,5
1,0
1,5
2,0
2,5
Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
0 %
10 %
20 %
30 %
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50 %
60 %
70 %
Eesti EL27 Eesti EL27
2017 2022 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
63 % 58 % 55 % 0 %
20 %
40 %
60 %
80 %
Rinnavähk Emakakaelavähk Kolorektaalvähk
2022 2019
% sihtrühma kuulunud elanikest, kes osales sõeluuringus (2022 või lähim aasta)
0 % 10 % 20 % 30 % 40 % 50 % 60 % 70 %
Eesti EL27 Eesti EL27
2017 2022 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
0 5 10 15 20 25
0 10 20 30
5 15 25 35 45
40,045,00,055,060,065,070,075,080,085,090,095,01 ,01 5,0110,015,020,0125,0130,0135,0140,0145,01 0,0155,0160,0165,0170,0175,0180,0185,0190,0195,0200,02 5,0210,0215,0220,025,030,0235,0240,0245,02 0,0255,0260,0265,0270,0275,0280,0
Eesti - Alumised 20% Eesti - Ülemised 20% EL27 - Alumised 20% EL27 - Ülemised 20%
Suitsetamine
% 11–15aastastest
Alkoholitarbimine % 11–15aastastest
Ülekaal (sh rasvumine) % 11–15aastastest
1,9 1,9
0,0
0,5
1,0
1,5
2,0
2,5
Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
23
17
0
5
10
15
20
25
Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
1,9 1,9
0,0
0,5
1,0
1,5
2,0
2,5
Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
23
17
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10
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25
Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
Use alternative below
# Restricted Use - À usage restreint
A. Cancer in Eesti B (a). Adolescent risk factors and prevention policies
C. Early detection (ver. 1) D. a) Cancer care performance (h alth expenditure)
Highlights pg1
B (b
). Ri
sk fa
ct or
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co no
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in eq
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ie s
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Eesti EL27 Mehed Naised
Vanusestandarditud kordajad 100 000 elaniku kohta
Vähihaigestu mus (2022)
Vähisuremus (2021)
3,6 %
6,8 %
0 %
3 %
5 %
8 %
Vähiga seotud kulude prognoositud osakaal tervishoiukuludes (2023.– 2050. aasta keskmine)
1,9 1,9
0,0
0,5
1,0
1,5
2,0
2,5
Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
0 %
10 %
20 %
30 %
40 %
50 %
60 %
70 %
Eesti EL27 Eesti EL27
22027102 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
63 % 58 % 55 % 0 %
20 %
40 %
60 %
80 %
Rinnavähk Emakakaelavähk Kolorektaalvähk
2022 2019
% sihtrühma kuulunud elanikest, kes osales sõeluuringus (2019-2022 või lähim aasta)
0 % 10 % 20 % 30 % 40 % 50 % 60 % 70 %
Eesti EL27 Eesti EL27
22027102 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
0 5 10 15 20 25
0 10 20 30
5 15 25 35 45
40,045,00,055,060,065,070,075,080,085,090,095,01 ,01 5,0110,015,020,0125,0130,0135,0140,0145,01 0,0155,0160,0165,0170,0175,0180,0185,0190,0195,02 0,02 5,0210,0215,0220,025,030,0235,0240,0245,02 0,0255,0260,0265,0270,0275,0280,0
Eesti - Alumised 20% Eesti - Ülemised 20% EL27 - Alumised 20% EL27 - Ülemised 20%
Suitsetamine
% 11–15aastastest
Alkoholitarbimine % 11–15aastas est
Ülekaal (sh rasvumine) % 11–15aastastest
1,9 1,9
0,0
0,5
1,0
1,5
2,0
2,5
Eesti EL27
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23
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25
Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
1,9 1,9
0,0
0,5
1,0
1,5
2,0
2,5
Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
23
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10
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20
25
Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
Use alternative below
# Restricted Use - À usage restreint
A. Cancer in Eesti B (a). Adolescent risk factors and prevention policies
C. Early detection (ver. 1) D. (a) Cancer care performance (health expenditure)
Highlights pg1
B (b
). R
is k
fa ct
or s
an d
so ci
oe co
no m
ic in
eq ua
lit ie
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A. Cancer in Eesti B (a). Adolescent risk factors and prevention policies
C. Early detection (ver. 1) D. (a) Cancer care performance (health expenditure)
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Eesnäärmevähk 219 (28 %) Eesnäärmevähk 154 (23 %) Rinnavähk 110 (24 %) Rinnavähk 148 (30 %)
Kolorektaalvähk 107 (14 %)
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Kopsuvähk 29 (6 %) Kopsuvähk 44 (9 %)
Põievähk 48 (6 %)
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Emakakehavähk 32 (7 %) Emakakehavähk 27 (5 %)
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Eesnäärmevähk 219 (28 %) Eesnäärmevähk 154 (23 %) Rinnavähk 110 (24 %) Rinnavähk 148 (30 %)
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Kolorektaalvähk 93 (14 %) Kolorektaalvähk 62 (14 %)
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2. Vähktõbi Eestis
1 Kopsuvähk hõl ab ka hingetoru- ja bronhivähki.
Vähihaigestumus on Eestis meeste seas suurem, kuid naiste seas väiksem kui ELi keskmine Teadusuuringute Ühiskeskuse Euroopa vähiteabesüsteemi (ECIS) andmete kohaselt oli Eestis 2022. aastal – tuginedes pandeemi- aeelsete aastate haigestumussuundumustele – hinnanguliselt 7817 vähijuhtumit: 3726 naiste ja 4091 meeste seas. Vanusestandarditud hinnanguline haigestumus oli meeste puhul 780 juhtumit 100 000 elaniku kohta, mis oli suuruselt kuues ELis ja 14 % suurem kui ELi keskmine (Joonis 1). Naiste seas oli hinnanguline haigestumus 452 juhtumit 100 000 elaniku kohta, mis jääb 7 % alla ELi keskmise.
Eesti meeste vähijuhtumite seas oli suurim osakaal eesnäärmevähil (28 %), kusjuures selle esinemissagedus oli 42 % suurem kui ELi keskmine. Teine meeste seas kõige enam levinud vähivorm oli kolorektaalvähk (14 %), millele järgnes kopsuvähk1 (14 %). Naiste seas oli Eestis levinuim vähivorm rinnavähk, mis moodustas 24 % kõigist vähijuhtumitest, kuigi selle esinemissagedus oli 26 % väiksem kui ELi keskmine. Eesti maakondade lõikes oli vähihaigestumus 2021. aastal väga erinev. See oli mõlema soo puhul kõige suurem Lõuna- ja Ida-Eesti maakondades ning kõige väiksem Tallinna ja Tartu piirkonnas (Tervise Arengu Instituut, 2024a).
Joonis 1. Eestis on vähihaigestumus meeste seas suurem, kuid naiste seas väiksem kui ELi keskmine
Märkused. 2022. aasta näitajad on varasemate aastate haigestumussuundumustel põhinevad hinnangud ja võivad hilisematel aastatel täheldatud haigestumusest erineda. Kõik vähipaikmed, v.a. mittemelanoomne nahavähk. Emakakehavähk ei hõlma emakakaela ähki. Allikas: Euroopa vähiteabesüsteem (ECIS), https://ecis.jrc.ec.europa.eu (vaadatud 10. märtsil 2024), © Euroopa Liit, 2024. Haigestumuse protsentuaalne jaotus arvutati vanusestandarditud haigestumuse põhjal ümber ja seetõttu erineb see ECISe veebisaidil esitatud absoluutarvude protsentuaalsest jaotusest.
Võrreldes 2000. aastaga oli vanusestandardimata vähihaigestumus 2019. aastaks Eestis mõlema soo puhul suurenenud: 55 % meeste ja 44 % naiste seas (Tervise Arengu Instituut, 2024a). Pärast korrigeerimist elanikkonna vananemise mõju arvesse võtmiseks on siiski näha, et
vähihaigestumus on püsinud alates 2010. aastast nii meeste kui ka naiste puhul stabiilne. Meeste hulgas on alates 1990. aastate lõpust vähenenud vanusestandarditud haigestumus kopsuvähki (Zimmermann et al., 2024), samas kui rinnavähki haigestumus naiste seas on suurenenud (Tervise
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Arengu Instituut, 2024b). 2021. aastal oli koguvähi- haigestumus mõlema soo puhul Eestis 8 % väiksem kui COVID-19 pandeemia eelne viie aasta keskmine (2015–2019), osaliselt viivituste tõttu mõne vähivormi diagnoosimisel, mida täheldati nii 2020. kui ka 2021. aasta puhul. Haigestumuse vähenemist saab osaliselt seostada riskitegurite pikaajalise vähenemisega (nt kopsu- ja maovähi puhul) ning emakakaelavähi sõeluuringu programmi mõjuga (Zimmermann et al., 2024). Tulevikku vaadates prognoosib ECIS siiski, et vähijuhtumite arv suureneb 2022.–2040. aastal 19 %.
Vähk põhjustab Eestis viiendiku kõigist surmadest 2021. aastal oli vähktõvest tingitud vanusestandarditud suremus Eestis 266 juhtumit
2 Riigid on jaotatud tertsiilidesse, võttes aluseks 2022. aasta SKP elaniku kohta ostujõu standardina. Eesti jaoks on sarnase ostujõuga riigid Bulgaaria, Horvaatia, Kreeka, Läti, Poola, Portugal, Rumeenia, Slovakkia ja Ungari.
100 000 elaniku kohta – vähk põhjustas 20 % kõigist surmadest ja suremus oli 13 % suurem kui ELis keskmiselt. Eesti meeste vähisuremus oli ELis suuruselt neljas (34 % üle ELi keskmise), naiste suremus oli keskmisele lähemal (4 % üle keskmise). Koguvähisuremus oli alates 2011. aastast siiski vähenenud 11 % nii meeste kui ka naiste puhul. Tuleb märkida, et meeste seas kahanes suremus vähem kui ELis ja sarnase ostujõuga riikides keskmiselt,2 ent naiste puhul rohkem kui teistes riikides keskmiselt (Joonis 2).
Ehkki suremus kopsuvähki on vähenenud Eestis alates 2011. aastast 16 %, oli kopsuvähk 2021. aastal endiselt kõige sagedasem surma kaasa toonud vähiliik, põhjustades 16 % kõigist vähisurmadest; sellele järgnes kolorektaalvähk 13 %ga.
Joonis 2. Eestis on ühed ELi suurimaid soolised erinevused vähisuremuses
Märkused. Riigid on jaotatud tertsiilidesse, võttes aluseks 2022. aasta SKP elaniku kohta ostujõu standardina. Eesti jaoks on sarnase ostujõuga riigid Bulgaaria, Horvaatia, Kreeka, Läti, Poola, Portugal, Rumeenia, Slovakkia ja Ungari. Allikas: Eurostati andmebaas.
Soolised erinevused vähisuremuses on Eestis ühed ELi suurimad Eesti on Läti ja Leedu kõrval üks kolmest ELi riigist, kus vähisuremus on meeste seas enam kui kaks korda suurem kui naiste seas, mis kujutab endast ühte suurimaid soolisi erinevusi ELis. Kõige suurem erinevus võrreldes ELi keskmisega oli vanemate meeste hulgas: üle 65aastaste suremus ületas ELi keskmist 37 %, olles Horvaatia ja Läti näitaja järel ELis suuruselt kolmas. Nagu mujalgi ELis, vähenes suremus aastatel 2011–2022 märksa enam
nooremate inimeste hulgas. Langus oli suurem alla 65aastaste meeste seas (25 %) kui üle 65aastastel meeste seas (7 %) ja alla 65aastaste naiste seas (26 %) kui üle 65aastastel naiste seas (5 %).
Eestis on eriti suured haridustasemest tingitud sotsiaalsed erinevused vähisuremuses. Meeste seas on erinevus madalama ja kõrgema haridustasemega inimeste vahel peaaegu 130 % (võrreldes 84 %ga ELis), naiste seas peaaegu 60 % (võrreldes 36 %ga ELis) (Joonis 3).
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Joonis 3. Eestis on madalama haridustasemega meeste suremus üle kahe korra suurem kui kõrgema haridustasemega meeste suremus
Märkused. Andmed tulevad ELi CanIneqi uuringust ja on aastate 2015–2019 kohta. EL 15 keskmine on 14 ELi riigi ja Norra kaalumata keskmine. Allikas: Euroopa Komisjon / IARC / Erasmus MC (2024), „Mapping Social-economic Enequalities in Cancer Mortality in European Countries“, vähktõve ebavõrdsuse registri teabeleht vähktõvega seotud erinevuste kohta.
3 Välditav suremus hõlmab ennetatavaid surmajuhtumeid, mida on võimalik ära hoida tõhusate rahvatervise ja ennetusmeetmetega, kui ka raviga välditavaid surmajuhtumeid, mida saab ära hoida õigeaegse ja tõhusa raviga.
Ehkki ennetatav suremus kopsuvähki väheneb, on probleemiks raviga välditav suremus kolorektaalvähki 2021. aastal oli ennetatavaks suremuseks liigituv välditav suremus3 kopsuvähki naiste seas 12 juhtumit 100 000 elaniku kohta (41 % väiksem kui ELi keskmine) ja meeste seas 51 juhtumit 100 000 elaniku kohta (17 % suurem kui ELi keskmine). Võrreldes 2011. aastaga on see näitaja kahanenud naiste puhul 9 % ja meeste puhul 27 % (Joonis 4), mis on kooskõlas suitsetamise vähenemisega (vt punkt 3).
Raviga välditav suremus rinnavähki oli Eestis 2021. aastal 18 juhtumit 100 000 naise kohta, mis on 4 % väiksem kui ELi keskmine. Seda on 23 % vähem kui 2011. aastal, mis tähendab suuremat kahanemist kui ELi keskmine. Raviga välditav suremus kolorektaalvähki oli Eestis märkimisväärselt suurem – naiste seas 37 % ja meeste seas 24 % üle ELi keskmise. Võrreldes 2011. aastaga oli standarditud suremus 2021. aastal naiste puhul 23 % suurem, kuid raviga välditavate surmajuhtumite arv vähenes nii 2022. kui ka 2023. aastal mõlema soo puhul. Siinkohal tuleks arvesse võtta seda, et kolorektaalvähi sõeluuring hõlmab Eestis kitsast vanusevahemikku (vt punkt 4), mis võib kaasa tuua hilisema diagnoosimise ja keerukama ravi.
Joonis 4. Hoolimata vähenemisest meeste seas, on suremus kolorektaalvähki Eesti naiste seas suurenenud
Märkus. Välditava suremuse näitajad hõlmavad alla 75aastaseid inimesi. Allikas: Eurostati andmebaas. Andmed on 2021. aasta kohta.
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Vähilevimus on suurenenud Eestis alates 2010. aastast rohkem kui kolmandiku võrra 2022. aastal oli viie aasta levimus4 Eestis 1780 vähijuhtumit 100 000 elaniku kohta, mis on 5 % väiksem kui ELi keskmine. Tänu muutustele mõne vähivormi esinemissageduses ja elulemuse paranemisele (vt punkt 5.2) suurenes vanusestandarditud vähilevimus riigis 2010.–2020. aastal 39 % (Joonis 5). Kuigi
4 Vähi levimus osutab sellele osale elanikkonnast, kellel on diagnoositud vähk ja kes on endiselt elus, hõlmates nii neid, kes saavad praegu vähiravi, kui ka neid, kelle ravi on lõppenud. Viie aasta levimus hõlmab inimesi, kellel on diagnoositud vähk viimase viie aasta jooksul.
see on üks suuremaid suhtelisi kasve kogu ELis, tuleb märkida, et 2010. aastal oli Eesti vähilevimus poolest ELis tagantpoolt kuuendal kohal. Muutused levimuses kajastavad varajase avastamise ning vähiravi kättesaadavuse ja kvaliteedi paranemist ning neil on ulatuslik mõju vajadusele tagada vähktõvega elavatele inimestele ja vähktõvest jagusaanutele pikaajaline hooldus ja psühhosotsiaalne tugi.
Joonis 5. Vähilevimus suureneb Eestis kiiresti
Allikad: Rahvusvahelise Vähiuurimiskeskuse (IARC) Globocani andmebaas, 2024; uuring EUROCARE-6 (De Angelis et al., 2024).
2025. aastal toimub Eesti vähitõrje tegevuskava 2021–2030 vahehindamine Eestis on tehtud alates 2021. aastast ulatuslikke jõupingutusi, et parandada vähktõve tõrjet, rakendades vähitõrje tegevuskava 2021–2030 (sotsiaalministeerium ja Tervise Arengu Instituut, 2021) (Tekstikast 1). Kasutusel on jooksev rakenduskava, et vaadata regulaarselt läbi eri sidusrühmade tegevus. Hoolimata COVID-19 põhjustatud viivitustest vähitõrje tegevuskava elluviimisel hinnatakse 2025. aastal tegevuskava eesmärkide saavutamisel tehtud edusamme kooskõlas Eesti riikliku tervisekava 2020–2030 vahehindamisega.
Eesti vähiregister sisaldab enam kui 50 aasta andmeid, mis hõlmavad kõiki pahaloomulisi kasvajaid, sealhulgas in situ kasvajaid ja mõningaid piirpahaloomulisi kasvajaid. Register jälgib vähidiagnoosi saanud isikuid kogu nende elu jooksul, kogudes eri allikatest andmeid haigestumuse, suremuse, elulemuse, vähi staadiumide, diagnoosimise ja ravi kohta. Tervise Arengu Instituut juhib ennetustegevust ja sõeluuringute korraldamist, mida rahastab Tervisekassa. Andmete kogumine ja protsessinäitajad on valdkond, mis vajab parandamist, kuna oluline teave, näiteks vähikahtl se ning diagnoosi ja ravi vahele jäävate ooteaegade kohta, puudub. Jälgimise parandamiseks tehakse tööd vähikeskuste andmestruktuuride ühtlustamiseks.
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Tekstikast 1. Eesti vähitõrje tegevuskava 2020–2030 on üldjoontes kooskõlas Euroopa vähktõvevastase võitluse kava põhisammastega Eesti avaldas uuendatud vähitõrje tegevuskava aastateks 2021–2030, viies oma prioriteedid kooskõlla Euroopa vähktõvevastase võitluse kavaga selle mitme samba ja valdkonnaülese teema puhul (Tabel 1). Tegevuskava eesmärk on vähendada kõige sagedasemate riskitegurite levimust, lahendada kvaliteedinäitajate abil probleeme sõeluuringuprogrammide koordineerimisel ja hindamisel, rakendada diagnoosimisel patsiendikeskset, personaalset ja süstemaatilist lähenemisviisi ning parandada vähipatsientide juurdepääsu psühholoogilisele ja sotsiaalsele toele ning rehabilitatsiooniteenustele. Tegevuskavas on seatud tähtsale kohale ka lastele pakutavad teenused (vt punkt 6). Kuigi tegevuskava erinevates jagudes käsitletakse ebavõrdsust ja teadusuuringuid, ei ole neile eraldi keskendutud.
Tabel 1. Eesti vähitõrje tegevuskava on osaliselt kooskõlas Euroopa vähktõvevastase võitluse kavaga
Euroopa kava sambad Euroopa kava valdkonnaülesed
teemad
Ennetus Varajane
avastamine Diagnoosimine
ja ravi Elukvaliteet Ebavõrdsus Pediaatria
Teadusuuringud ja innovatsioon
Märkused. Sinine tähendab, et vähitõrje tegevuskava sisaldab eraldi jagu sel teemal; oranž tähendab, et teemat käsitletakse mõnes tegevuskava jaos, kuid sellele ei ole eraldi keskendutud, ning roosa tähendab, et seda teemat tegevuskavas ei käsitleta. Allikas: Euroopa vähktõvevastase võitluse kava rakendamise kaardistamist ja hindamist käsitleva veel avaldamata uuringu põhjal.
3. Riskitegurid ja ennetuspoliitika
5 Tervishoiu arvepidamissüsteemis kajastatavad ennetuskulutused peaksid hõlmama riiklike programmide väliseid tegevusi (nt oportunistlikud vähi sõeluuringud või suitsetamisest loobumise alane nõustamine tavalise arstivisiidi ajal), kuid tegelikkuses võib riikidel olla keeruline eristada kulutusi, mis tehakse ennetusele väljaspool riiklikke programme.
Eesti peab esmatähtsaks vähendada vähi riskitegurite levimust elanikkonna seas 2019. aastal oli ennetuse eesmärgil tehtud tervishoiukulutuste osakaal Eestis 4 %5. Järgmistel aastatel kulus kuni 9 % tervishoiuku- lutustest COVID-19ga seotud tegevusele, mille järel oli ennetusele kulutatud vahendite osakaal 2022. aastal 6 %. Oluline on märkida, et Eesti kulutab tervishoiule ELi keskmisega võrreldes vähe ning kuigi ennetusele kulutatud osa tervishoiuku- lutustest oli suurem kui ELi keskmine, olid Eesti ennetuskulutused elaniku kohta (mida on kohandatud ostujõu erinevuste alusel) 2019. aastal ELi keskmisest 31 % väiksemad.
Eesti vähitõrje tegevuskava 2021–2030 üks põhieesmärke on vähendada riskitegurite levimust elanikkonnas. Iga riskiteguriga tegelemiseks on algatatud mitmeid meetmeid, sealhulgas pandud rõhku noorukite kaitsmisele riskide eest
terviklikuma koolitervishoiu kaudu. 1995. aastal vastu võetud määruse alusel on kogu riigis tööle võetud riigi palgal olevad kooliõed, kes tegelevad peamiselt tervise edendamise ja haiguste ennetamisega. Lisaks, et rakendada koordineeritud strateegiaid ja parimaid tavasid, osaleb Tervise Arengu Instituut ELi ühisprojektis (Joint Action PreventNCD), mille eesmärk on ennetada mitmesuguste riskiteguritega seotud meetmete abil vähktõbe ja muid mittenakkuslikke haigusi.
Joonisel 6 on näidatud Eesti paiknemine valitud riskitegurite osas võrreldes teiste ELi riikide, Islandi ja Norraga. Teiste riikidega võrreldes läheb Eestil hästi õhusaastega kokkupuutumise vaatenurgast. Samas on kõrge levimuse tõttu jätkuvalt olulisteks riskideks alkoholitarbimine, ülekaalulisus ja viletsad toitumisharjumused ning inimeste papilloomiviiruse (HPV) vastu vaktsineerituse tase Eestis oli 2023. aastal üks madalamaid ELis. Kuigi sissetulekuid ja elamistingimusi käsitleva
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6a: Prevalence of behavioral cancer risk factors among adults & environmental risk factors
Igapäevane suitsetamine
Alkoholitarbimine
Ülekaal ja rasvumine
Vähene kehaline aktiivsus
Vähene puuviljade tarbimineVähene köögiviljade tarbimine
Riskitegurid töökeskkonnas
Õhusaaste
HPV vastu vaktsineerimine
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ELi uuringu (EU-SILC) andmetest on näha, et Eesti tulemused igapäevase suitsetamise ja vähese kehalise aktiivsuse osas on teiste ELi riikidega
võrreldes suhteliselt head, osutavad riiklikud uuringud, et need riskitegurid on jätkuvalt probleemiks.
Joonis 6. Eestis on võrreldes ELi keskmisega laialt levinud sellised olulised vähi riskitegurid nagu alkoholitarbimine ning ülekaalulisus ja rasvumine
Märkused. Mida lähemal on punkt keskpunktile, seda paremad on riigi tulemused võrreldes teiste ELi riikidega. Valgel n-ö sihtalal ei ole ükski riik, kuna kõigil riikidel on kõigis valdkondades arenguruumi. Õhusaastet mõõdetakse tahkete osakestena, mille läbimõõt jääb alla 2,5 mikromeetri (PM2,5). Allikad: sissetulekuid ja elamistingimusi käsitleval 2022. aasta ELi uuringul (EU-SILC) põhinevad OECD arvutused (ülekaalulisuse, rasvumise, kehalise aktiivsuse ning puu- ja köögiviljade tarbimise puhul (täiskasvanud)); Eurofoundi uuring töökeskkonnas esinevate ohutegurite kohta; OECD tervisestatistika (suitsetamise ja alkoholitarbimise (täiskasvanud) ning õhusaaste puhul) ning WHO (HPV vastu vaktsineerimise puhul (15aastased tüdrukud)).
Suitsetamise levimuse vähenemist varjutavad uued riskid – noored on hakanud üha rohkem veipima Igapäevane suitsetamine on Eestis alates 2010. aastast märkimisväärselt vähenenud, olles kahanenud 2022. aastaks rohkem kui 10 protsendipunkti võrra 16 %-le. Kahanemine on olnud eriti järsk meeste seas – 37 %-lt 2010. aastal 21 %-le 2022. aastal –, mis on kooskõlas kopsuvähki haigestumuse ja suremuse vähenemisega. Viimase
30 päeva jooksul vähemalt korra suitsetanute osakaal 15aastaste seas vähenes Eestis aastatel 2014–2022 mõlema soo puhul, ehkki poiste seas rohkem (vähenes 49 %) kui tüdrukute seas (36 %) (Joonis 7). Seda saab osaliselt seostada viimati 2019. aastal muudetud tõhusa tubakatoodete tarbimise piiramise poliitikaga, millega reguleeritakse tubakatoodete ja nendega seotud toodete reklaami ja väljapanekut.
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Elus rohkem kui korra purjus olnute osakaal 15aastaste seas (%)
Ülekaaluliste (sh rasvunute) osakaal 15aastaste seas (%)
Joonis 7. Eesti 15aastased tüdrukud suitsetavad ja teatavad, et nad on olnud purjus, suurema tõenäosusega kui samas vanuses poisid
Märkus. ELi keskmine on kaalumata keskmine. Andmed on 2022. aasta kohta. Allikas: kooliealiste laste tervisekäitumist käsitlev uuring.
Paraku on osa suitsetamise vähenemisest tingitud ka sellest, et alternatiivsed nikotiinitooted on muutunud laialdasest kättesaadavaks – 2022. aastal kasutas neid 10 % Eesti elanikest. Kogunäitajast ei ole näha, kui ulatuslik on see probleem noorte hulgas: 15–24aastastest teatas regulaarsest veipimisest peaaegu 30 % (35 % naistest ja 24 % meestest); 15aastastest oli viimase 30 päeva jooksul suitsetanud vähemalt üks kord e-sigaretti 20 % poistest ja 30 % tüdrukutest. Alates 2019. aastast on olnud tubakaseadusega keelatud kasutada e-sigarettide vedelikes muid maitse- ja lõhnaained peale tubaka ning samuti on keelatud tubakatoodete kaugmüük. Samas on endiselt võimalik teha internetioste välismaalt.
Pärast alkoholiaktsiisi vähendamist 2019. aastal suurenes Eestis alkoholitarbimine Kuigi alkoholitarbimine inimese kohta vähenes tänu alkoholipoliitika rohelises raamatus ette nähtud meetmete süstemaatilisele rakendamisele 12 liitrilt 2012. aastal 10 liitrile 2018. aastal, suurenes see 2022. aastal 11 liitrile, kuna alkohol muutus 2019. aasta aktsiisivähenduse tulemusel taskukohasemaks. Alkoholitarbimise reguleerimist riigis raskendab tava osta alkoholi üle piiri Lätist, mis nõuab ühtlustatud poliitikameetmeid. Kuigi Eesti on piiranud kellaaegu, mil alkohol on kauplustes kättesaadav, ei ole kehtestatud piiranguid müügikohtade tihedusele, maksustamist ei kohandata vastavalt inflatsioonile ning alkoholi puhul ei ole kasutusel spetsiaalseid terviseohust hoiatavaid etikette (OECD, 2024a).
2021. aastal oli Eestis 4 % kõigist vähijuhtumitest seostatavad alkoholiga. Samas selgus 2022. aastal
alkoholitarbijate seas korraldatud uuringust, et vaid 11 % naistest pidas alkoholi rinnavähi riskiteguriks ja üksnes 27 % inimestest pidas seda riskiteguriks kolorektaalvähi puhul, mis näitab, et üldsuse teadlikkus on suhteliselt madal. Teadlikkuse suurendamiseks on korraldatud avalikke kampaaniaid, et juhtida tähelepanu alkoholi rollile vähktõve puhul, nagu kampaania „Septembris ei joo“, veebipõhine eneseabialgatus „Selge“ ning Euroopa Sotsiaalfondi programm „Kainem ja tervem Eesti“. Vaid 9 % neist inimestest, kelle iganädalane alkoholitarbimine kujutab endast suurt riski (7 standardühikut naiste ja 14 meeste puhul), teatasid, et nad on saanud tervishoiutöötajalt soovituse tarbimist vähendada, mis osutab vajadusele tervishoiutöötajaid täiendavalt koolitada ära tundma probleeme ja vajaduse korral sekkuma (Tervise Arengu Instituut, 2023).
Tarbimisharjumused on mõnevõrra muutunud: aastatel 2012–2022 vähenes rohkem kui üks kord nädalas alkoholi tarbivate meeste osakaal (33 %-lt 27 %-le), samal ajal kui naiste seas see osakaal suurenes (11 %-lt 12 %-le). Naiste hulgas on suurenenud korrapärane veinijoomine (Tervise Arengu Instituut, 2023). Alkoholitarbimine Eesti noorukite seas on vähenenud: purjus olnute osakaal 15aastaste noorukite hulgas kahanes 2014.–2022. aastal 9 protsendipunkti, kuigi see on endiselt suurem kui ELi keskmine. Vastupidiselt varasematele suundumustele oli neid 15aastaseid, kes olid viimase 30 päeva jooksul purjus olnud, 2022. aastal tüdrukute seas rohkem kui poiste seas (vt Joonis 7).
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Ülekaalulisus ja rasvumine sageneb Eestis mõlema soo puhul Peaaegu kolm täiskasvanut viiest (57 %) on Eestis ülekaalulised (sh rasvunud) ja 22 % täiskasvanutest on rasvunud. Ülekaalulisus ja rasvumine on rohkem levinud Eesti meeste seas (62 %) kui naiste hulgas (53 %), kuigi rasvumine üksi on naiste
seas sagedasem (23 %) kui meeste hulgas (21 %). Ülekaaluliste osakaal on võrreldes 2017. aastaga suurenenud mõlema soo puhul. Naiste puhul on ülekaalul seos haridustasemega (Joonis 8), kuid mitte meeste puhul, kuigi rasvumisest teatavad nii madalama haridustasemega mehed kui ka naised suurema tõenäosusega kui kõrgema haridustasemega mehed ja naised.
Joonis 8. Eesti on ülekaaluliste (sh rasvunud) naiste osakaalu poolest ELis viiendal kohal
Märkus. Ülekaalulised (sh rasvunud) inimesed on inimesed, kelle kehamassiindeks on üle 25. Allikas: Eurostati andmebaas.
Eestis suurenes 15aastaste seas ülekaalulisus 2014.–2022. aastal 5 protsendipunkti võrra (vt Joonis 7). Olulised soolised erinevused ilmnevad juba selles vanuses, kuna 2022. aastal teatas ülekaalulisusest 29 % poistest võrreldes 13 %ga tüdrukutest.
Jätkuvalt on probleemiks kehalise aktiivsuse ja toitumisega seotud riskitegurid Enam kui pool Eesti elanikest teatas, et nad tarbivad puu- (51 %) ja köögivilju (50 %) harvem kui kord päevas, mida on üle 10 protsendipunkti rohkem kui ELi keskmine (39 % puuviljade ja 40 % köögiviljade puhul). Väiksema tõenäosusega teatasid vähesest tarbimisest naised ja kõrgharidusega inimesed. 15aastastest teatas üle kahe kolmandiku, et nad ei söö vähemalt kord päevas puuvilju (tüdrukud veidi vähem (67 %) kui poisid (74 %)), samal ajal kui peaaegu kolm neljandikku (73 %) teatas, et nad ei söö iga päev köögivilju.
Toitumise parandamiseks on koostatud toidu koostise muutmise kava, mille üle hakatakse pidama 2023. aasta septembris läbirääkimisi toidutööstusega. 2023. aastal võeti vastu käitumiskoodeks, mis käsitleb ebatervisliku toidu ja joogi vastutustundlikku telereklaami
lastesaadete ajal, kuigi seda juhendit kohaldatakse ainult alla 12aastaste laste puhul. Lisaks on juhend vabatahtlik ja see ei hõlma digiturundust, otseturundust ega avalikus ruumis korraldatavaid kampaaniaid. 2024. aastal arutati suhkrumaksu kehtestamist suhkruga magustatud jookidele ja 1995. aasta rahvatervise seaduse läbivaatamist lisapiirangute osas reklaamidele, kuid neist loobuti.
Ehkki sissetulekuid ja elamistingimusi käsitleva ELi uuringu (EU-SILC) andmed osutavad sellele, et Eesti elanike seas on vähene kehaline aktiivsus (treenimine vähem kui kolm korda nädalas) suhteliselt harv (Joonis 6), on 2021. aasta riiklike andmete kohaselt peaaegu kolm neljandikku Eesti täiskasvanutest mitteaktiivsed (vähem kui 120 minutit treenimist nädalas) (Tervise Arengu Instituut, 2024b). Eesti 15aastased tüdrukud teatasid vähem igapäevasest kehalisest aktiivsusest (9 %) kui poisid (15 %) ja mõlema tulemus jääb alla ELi keskmise. Eesti on rakendanud noorte kehalise aktiivsuse suurendamiseks programme, nagu 2016. aastal käivitatud programm „Liikuma kutsuv kool“, mille eesmärk on tuua liikumine ja kehaline aktiivsus kõigi Eesti õpilasteni.
Share of overweight (including obese) adult women, by educational attainment, 2022
8: Share of overweight (including obese) adult women, by educational attainment, 2022
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Eesti on teinud edusamme õhusaaste valdkonnas, kuid töökeskkonnast tulenevad riskid on endiselt laialt levinud Pärast mitut õhukvaliteedi parandamiseks võetud poliitikameedet oli Eesti 2023. aastal üks seitsmest maailma riigist, kus õhukvaliteet vastas WHO kehtestatud PM2,5 kontsentratsiooni standardile (alla 5 μg/m³). See kajastub nii elanikkonna keskmises kokkupuutes PM2,5-osakestega kui ka sellest kokkupuutest tingitud enneaegsete surmade hinnangulises määras, mis on langenud varasemate aastakümnete märksa kõrgematelt tasemetelt ELi madalaimate hulka.
Samas tekitavad muret riskitegurid töökeskkonnas, kuna ligikaudu 26 % nii meestest kui ka naistest on teatanud, et nad puutuvad tööl kokku selliste keemiliste toodete või ainetega, mis võivad põhjustada vähktõbe. Eestis puudub tööst tingitud vähisurm de registreerimise süstee , kuid hinnangute kohaselt võib kuni 11 % aastatel 2016–2020 diagnoositud vähijuhtudest, millest suurima osa moodustasid kopsuvähk ja mittemelanoomne nahavähk, seostada tööalase kokkupuutega. 2020. aast l täiend ti Eesti töökeskkonnas esinevate keemiliste ohtude loetelu, lisades sellesse vähki tekitavad ained.
Eesmärkide saavutamiseks tuleb suurendada inimeste papilloomiviiruse ja B-hepatiidi vastu vaktsineerituse taset Selleks et kaotada kooskõlas WHO ülemaailmse strateegiaga 2040. aastaks emakakaelavähk,
algatas Eesti 2018. aastal 12–14aastaste tüdrukute HPV vastu vaktsineerimise programmi; 2024. aasta veebruaris laiendati programmi ka poistele ja programm võimaldab järelvaktsineerimist. 2023. aastal oli saanud 15. eluaastaks kõik HPV vaktsiini doosid 43 % tüdrukutest, mida on vähem kui 60 % aastal 2022 ning oluliselt vähem kui WHO eesmärk 90 % ja ELi keskmine 64 %. Murettekitavalt on viimastel aastatel vähenenud üheaastaste laste kolme doosiga vaktsineerimine B-hepatiidi vastu – 2023. aastal kahanes see 72 %-le, võrreldes 90 %ga 2020. aastal ja 95 %ga 2007. aastal. Reageerides madalale üldisele vaktsineerituse tasemele, eraldas Tervisekassa aastatel 2024–2028 sihtotstarbeliselt rahalisi vahendeid teadlikkuse suurendamise kampaaniate korraldamiseks.
Eesti saaks ära hoida suure hulga vähijuhtumeid, võttes otsustavaid meetmeid riskide vähendamiseks OECD rahvatervise strateegilise planeerimise modelleerimise (SPHeP) andmed, võttes arvesse praegust vähihaigestumust, osutavad sellele, et Eesti igal saaks igal aastal ära hoida hulga vähijuhtumeid, kui oleksid täidetud riskitegurite levimusega seotud eesmärgid. Näiteks tubakaga seotud eesmärkide saavutamisega oleks võimalik hoida aastatel 2023–2050 ära peaaegu 4000 vähijuhtumit ning alkoholitarbimise vähendamisega rohkem kui 2000 vähijuhtumit (Joonis 9).
Joonis 9. Aastatel 2023–2050 oleks võimalik ära hoida tuhandeid vähijuhtumeid, võttes otsustavaid meetmeid tubaka ja alkoholiga seotud eesmärkide saavutamiseks
Märkused. Tubaka puhul on seatud eesmärk vähendada aastatel 2010–2025 tubakatarbimist 30 % ja saavutada 2040. aastaks olukord, kus tubakat tarbib alla 5 % elanikkonnast. Alkoholi puhul on eesmärk vähendada aastatel 2010–2030 vähemalt 20 % üldist alkoholitarbimist ja 20 % alkoholi liigtarbimist (korraga kuus või rohkem alkohoolset jooki (täiskasvanud)). Õhusaaste valdkonnas on eesmärk tagada, et aasta keskmine PM2,5 tase on 2030. aastaks maksimaalselt 10 μg/m³ ja 2050. aastaks maksimaalselt 5 μg/m³. Rasvumise puhul on eesmärk alandada rasvumise taset 2025. aastaks 2010. aasta tasemele. Allikas: OECD (2024b), „Tackling the Impact of Cancer on Health, the Economy and Society“, OECD Health Policy Studies, OECD Publishing, Pariis, DOI: https://doi.org/10.1787/85e7c3ba-en
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Rinnavähk Emakakaelavähk Kolorektaalvähk
% sihtrühma kuulunud elanikest, kes osales sõeluuringus
COVID-19
2021: 1) emakakaelavähi sõeluuringu sihtrühma vanusepiiri tõstmine 30.– 65. eluaastale, 2) PAP-testi asendamine HPV-testiga
2021: kindlustamata inimeste tasuta kaasamine kõikidesse sõeluuringu- programmidesse
2003: rinnavähi sõeluuringu programm 50–62aastastele naistele
2006: emakakaelavähi sõeluuringu programm 30– 55aastastele naistele
2009: mobiilsete üksuste (mammograafiabusside) kasutuselevõtt
2016: kolorektaalvähi sõeluuringu programm 60– 68aastastele elanikele
2024: peaaegu kõik rinnavähi sõeluuringu korraldajad võimaldavad broneerida aja veebis
2024–25: 1) rinnavähi sõeluuringu sihtrühma vanusepiiri tõstmine 50.– 74. eluaastale, 2) personaalsel riskihinnangul põhineva rinnavähi sõeluuringu programmi katsetamine
2022–2024: HPV kodutesti katsetamine ja kasutuselevõtt emakakaela sõeluuringu puhul
2024: peaaegu kõik rinnavähi sõeluuringu korraldajad võimaldavad broneerida aja veebis
# Restricted Use - À usage restreint
Sellel on ka mitmesugune positiivne kõrvalmõju: vähenevad muud kroonilised haigused ja koormus tervishoiusüsteemile, sealhulgas tööjõupuudus (vt punkt 5.1). Kõikide riskitegurite lõikes saab terviseseisundit parandada ka terviseteadlikkuse
edendamisega, mis suurendab kontrolli oma tervise üle. Eestil puudub riiklik strateegia terviseteadlikkuse suurendamiseks elanike seas või organisatsioonides.
4. Varajane avastamine
Eesti vähi sõeluuringu programmides osalusmäär oli 2023. aastal kõigi aegade kõrgeim Eesti on otsinud viise vähi sõeluuringu programmides osalemise suurendamiseks, töötades selle nimel, et parandada nende programmide kättesaadavust ja teadlikkust neist programmidest. Joonisel 10 on näidatud sõeluuringutes osalusmäära muutumine Eestis ning toimunud või kavandatud olulised muudatused. 2023. aasta paistis silma sellega, et kõigis kolmes rahvasti- kupõhises sõeluuringuprogrammis osalusmäär oli läbi aegade kõrgeim (üle 60 %). Sellele oli eelnenud COVID-19 pandeemia, mille ajal riiklikud sõeluuringuprogrammid ajutiselt peatati ja paljud
tervishoiuteenused olid piiratud. Selle tõttu olid vähenenud sõeluuringute käigus avastatud juhtumite arv ja tervisekontrolli käigus juhuslikult avastatud kergete sümptomitega juhtumite arv (Zimmermann et al., 2024). Oluline areng toimus 2021. aastal, kui programmiga hõlmati kindlustamata inimesed, kelle sõeluuringut hakkas rahastama Eesti Haigekassa (Tervisekassa varasem nimi); varem oli neil tulnud tasuda sõeluuringu eest ise. Aastatel 2022–2023 suurenes põgenike ja pagulaste seas 20 % rinna- ja kolorektaalvähi sõeluuringu eesmärgil tehtud arstivisiitide arv ning 12 % emakakaelavähi sõeluuringu eesmärgil tehtud arstivisiitide arv, mille peamine põhjus oli põgenike suur sissevool Ukrainast (Tervisekassa, 2023).
Joonis 10. Osalusmäär rinna, emakakaela ja kolorektaalvähi sõeluuringuprogrammides on oluliselt suurenenud alates 2020. aastast
Märkus. Kõigi vähivormide ja aastate puhul on esitatud riiklikest andmebaasidest saadud programmiandmed, mis hõlmavad asjaomasel aastal sõeluuringule kutsutud elanikke. Allikas: OECD Tervisestatistika 2024. (aastad 2000–2022); Tervise Arengu Instituut, 2024a (aasta 2023).
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Vähi sõeluuringute register areneb, võimaldades paremini toetada sõeluuringute korraldamist Vähi sõeluuringute juhtrühm, mida juhib sotsiaalministeerium, hõlmab peamisi sidusrühmi ja patsientide organisatsioone ning hindab olemasolevaid ja algatab uusi sõeluurin- guprogramme. Tervisekassa korraldab ulatuslikke teadlikkuse suurendamise kampaaniaid ning Tervise Arengu Instituut haldab vähi sõeluuringute registrit, mis hõlmab nii rahvastikupõhiseid kui ka oportunistlikke sõeluuringuid, ning rakendab juurdepääsu- ja kvaliteedimõõtmeid kvaliteedi parandamiseks. Tervisekassa avaldab kindlustusnõuete andmetele tuginedes interaktiivse platvormi kaudu reaalajas kolme programmi andmed, sealhulgas tuvastatud juhtumid ning osalusmäärad tervishoiuasutuste, asukohtade ja vanuserühmade kaupa.
Vähi sõeluuringute register saab rahvasti- kuregistrist esialgse sihtrühma kohordi, mis põhineb konkreetsetel sünniaastatel ja sool. Register sisaldab elanike kontaktandmeid ja on seotud elektrooniliste terviselugudega (Terviseportaal). Eesti digitaliseeritud tervise infosüsteem võimaldab kõrvale jätta need inimesed, kellel on teatava aja jooksul diagnoositud pahaloomuline kasvaja või kes on hiljuti asjaomases sõeluuringus osalenud. Vähi sõeluuringute register saadab sihtrühma kuuluvatele elanikele posti ja e-posti teel ning tervise infosüsteemi kaudu osalemiskutsed koos meeldetuletuste ja tekstisõnumitega. Samuti teavitab register tervishoiutöötajaid ja proviisoreid tuletama tervishoiuasutusse või apteeki pöörduvatele inimestele, kes ei ole sõeluuringus osalenud, meelde, et nad laseksid end kontrollida.
Alates 2024. aastast tõstetakse rinnavähi sõeluuringu sihtrühma vanusepiiri Rinnavähk on Eesti naiste seas kõige enam levinud vähivorm ja umbes veerandil juhtudel on vähk diagnoosimise hetkel juba kaugele arenenud staadiumis. Eesti rinnavähi sõeluuringu programmi raames kutsutakse 50–68aastaseid naisi üles tegema iga kahe aasta tagant mammogramm, kui nad ei ole seda teinud viimase 12 kuu jooksul ja kui neil ei ole olnud viimase viie aasta jooksul rinnavähki. Alates 2024. aastast tõstetakse sihtrühma vanuse ülempiir järk-järgult 74. eluaastale, millega sihtrühma vanusevahemik viiakse lähemale vahemikule 45–74, mida soovitatakse nõukogu 2022. aasta ajakohastatud soovituses (joonis 10). 2023. aastal kontrolliti 65 % sihtrühma kuulunud elanikkonnast, mis tähendab märkimisväärset kasvu võrreldes 2003. aastaga,
mil see määr oli 37 %. Vähitõrje tegevuskava 2021–2030 üks põhieesmärke on siiski saavutada kõigis rühmades 70 % osalusmäär (sotsiaalmin- isteerium ja Tervise Arengu Instituut, 2021). 2023. aastal saavutati see eesmärk rinnavähi puhul 15 Eesti maakonnast neljas, kusjuures kahes maakonnas jäi puudu vähem kui 1 protsendipunkt. Kõik kuus maakonda asuvad eemal suurematest linnadest, mis näitab, et rinnavähi sõeluuring on maaelanikele kättesaadav. Ida-Viru maakonnas oli osalusmäär siiski oluliselt väiksem, jäädes alla 60 % (Joonis 11), mis võib olla tingitud väiksemast teadlikkusest, keelebarjäärist või kättesaadavusest (ERR, 2024). Ilmselt jääb eesmärk saavutamata ka madalama haridustasemega inimeste puhul, kes teatavad pidevalt väiksema tõenäosusega, et nad on teinud mammogrammi.
Eestis rakendatakse mitmeid meetmeid, et parandada juurdepääsu sõeluuringule. 2024. aastast alates on kõik rinnavähi sõeluuringu korraldajad pakkunud võimalust broneerida aeg veebis, 2023. aastal oli see võimalik vaid ühes haiglas. Juurdepääsu parandamiseks maapiirkondades sõidavad kogu aasta mööda Eestit ringi kolm mammograafiabussi, et muuta sõeluuring kättesaadavamaks kohtades, kuis naised elavad ja töötavad. See algatus on hästi vastu võetud ja elanike nõudmisel külastavad bussid samu paiku rohkem kui kord aastas, mis aitab saavutada maapiirkondades kõrgemaid osalusmäärasid (ERR, 2024).
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Osalusmäär
74.1 %
58.0 % 68.8 %
67.1 %
67.4 % 69.7 %
62.6 %
71.2 %
58.0 % 68.0 %
72.5 %
70.5 %
68.3 % 65.3 %
64.2 %
69.3 %
74.1 %
Joonis 11. Kättesaadavuse parandamine Eestis on võimaldanud mitmel suurematest linnadest eemal asuval maakonnal saavutada rinnavähi sõeluuringu osalusmääraks 70 %
Märkus. Jämeda oranži joonega tähistatud maakondades ulatub osalusmäär 70 %ni, peenema rohelise joonega tähistatud maakondades jääb sellest puudu vähem kui üks protsendipunkt. Allikas: Kohandatud allikast Tervise Arengu Instituut (2024a).
Sõeluuringute tõhususe suurendamiseks töötab Eesti välja täiustatud programmi, kus kasutatakse geneetilistel andmetel põhinevaid personaalseid riskiskoore, mis on olemas viiendiku Eesti elanikkonna kohta. Programm on suunatud neile 40aastastele naistele, kes annavad oma nõusoleku personaalse rinnavähiriski hinnangu koostamiseks geneetilise teabe põhjal. Naised, kelle risk leitakse olevat suurem, kutsutakse iga kahe aasta tagant sõeluuringule alates 40. eluaastast, ülejäänud lisatakse tavapärasesse sõeluuringuprogrammi alates 50. eluaastast.
Eesti on võtnud eesmärgi kaotada 2040. aastaks emakakaelavähk, kasutades osalusmäära suurendamiseks inimeste papiloomviiruse koduteste Emakakaelavähi sõeluuringu programmi raames kutsutakse 30–65aastaseid naisi osalema uuringus iga viie aasta tagant. 2021. aastal võeti PAP-testi asemel kasutusele HPV-test (vt joonis 10). 2023. aastal oli sõeluuringus osalusmäär riigis 64 %, võrreldes 45 %ga 2020. aastal ja 30 %ga 2006. aastal, mil selle programmiga alustati. See märkimisväärne edasiminek ei kajasta erinevusi riigi sees: osalusmäärad ulatusid 49 %st Ida-Viru maakonnas 71 %ni Saare maakonnas. Tuleb siiski märkida, et pärast mitut sihipärast sekkumist on osalusmäär Ida-Viru maakonnas alates 2021. aastast kasvanud rohkem kui
10 protsendipunkti (Tervise Arengu Instituut, 2024a).
Osalusmäära suurendamiseks katsetati 2022. aastal HPV kodutesti ning 2023. aasta teises pooles võeti see kasutusele naiste puhul, kes ei olnud end veel kontrollida lasknud, millega kaasnes oluline ajakokkuhoid ja suurenes privaatsus kasutajate vaatenurgast. 2023. aastal otsustas kodutesti kasuks enam kui 10 % sõeluuringus osalejatest, sealhulgas – mis on oluline – 14 % osalejatest Ida-Viru maakonnas. 2023. aastal pakkusid koduteste täiendavad 89 apteeki väiksema osalusmääraga maakondades. 2022. aastal tehtud analüüs näitas, et haigestumus emakakaelavähki on Eestis alates 2014. aastast vähenenud ning et märkimisväärset vähenemist mõnes vanuserühmas võib seostada sõeluurin- guprogrammi positiivse mõjuga (Zimmermann et al., 2024).
Uuenduslike sõeluuringulahenduste rakendamiseks osaleb Tartu Ülikool ühisprojektis, mille eesmärk on integreerida teaduslikud teadmised rahvastikupõhiste terviseregistrite, tervishoiuteenuste, uuringute ja Eesti geenipanga andmetega, et töötada välja ja valideerida tehisintellekti tehnoloogia, mis modelleerib emakakaelavähi sõeluuringu raames patsientide tulemusi ja hindab vähiriske riskipõhiseks lähenemiseks sõeluuringule.
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% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
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Mammogramm viimase 12 kuu
jooksul
Emakakaela proov viimase 5 aasta jooksul
Eesti EL27
% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
18 %
70 %
83 %
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64 % 74 %
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Eesti EL27
% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
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74 %
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40-54 aastad 25-39 aastad 40-55 aastad
Mammogramm viimase 12 kuu
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Eesti EL27
% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
18 %
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Mammogramm viimase 12 kuu jooksul
Emakakaela proov viimase 5 aasta jooksul
Eesti EL27
% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
18 %
70 %
28 %
64 %
0 %
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40-54 aastad 25-39 aastad
Mammogramm viimase 12 kuu jooksul
Emakakaela proov viimase 5 aasta jooksul
Eesti EL27
% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
LGBTIQ-inimesed osalevad Eestis rinnavähi sõeluuringus vähem kui ELis ELi kolmanda LGBTIQ kogukonda käsitleva uuringu andmete kohaselt teatas Eestis 18 % sellesse kogukonda kuuluvatest cis-soolistest naistest, transsoolistest naistest ja intersoolistest inimestest vanuses 40–54, et neile on viimase 12 kuu jooksul tehtud mammogramm, mis on vähem kui ELi keskmine 28 % (Joonis 12). Mis puudutab emakakaelavähi sõeluuringut, siis sellest, et nad on andnud viimase viie aasta jooksul emakakaela proovi, teatas Eestis 70 % LGBTIQ-inimestest vanuses 25–39 (rohkem kui ELi 64 %) ja 83 % LGBTIQ-inimestest vanuses 40–55 (rohkem kui ELi 74 %).
Joonis 12. LGBTIQ kogukonnas on emakakaela prooviga hõlmatus Eestis kõrgem kui ELis
Märkus. LGBTIQ kogukonda käsitleva uuringu tulemused viitavad vanuserühmadele ja/või sõeluuringute intervallidele, mis ei ole kooskõlas ELi riikides rahvastikupõhiste sõeluuringute tegemisel rakendatava lähenemisviisiga, mistõttu ei tohiks neid võrrelda. Allikas: Euroopa Liidu Põhiõiguste Amet (ELi kolmas LGBTIQ kogukonda käsitlev uuring).
Kolorektaalvähi sõeluuringu programmi laiendamisel on probleemiks diagnostiliste uuringute kättesaadavus Kolorektaalvähi sõeluuringu programm loodi 2016. aastal ja see on suunatud 60–68aastastele elanikele, keda kutsutakse iga kahe aasta tagant tegema esmatasandi tervishoius immunokeemilist peitveretesti. Programmist jäetakse välja need inimesed, kellele on tehtud varasema sõeluuringu käigus kolonoskoopia või kellel on kunagi diagnoositud kolorektaalvähk (OECD, 2024a). 2023. aastal oli kolorektaalvähi sõeluuringu osalusmäär 60 % (55 % meeste puhul ja 65 % naiste puhul), mis on suurem kui 2021. aasta 49 %.
Osalusmäär ulatus 51 %st Ida-Viru maakonnas 74 %ni Võru maakonnas (Tervise Arengu Instituut, 2024a). Programmi üks suur puudus on sihtrühma kitsas vanusevahemik – hõlmatud on vaid osa 50–74aastaste vanuserühmast, mida on soovitatud kolorektaalvähi sõeluuringu programmide puhul nõukogu 2022. aasta ajakohastatud soovituses vähi sõeluuringute kohta. Ehkki vähi sõeluuringute juhtrühmas on arutatud selle vanusevahemiku laiendamise üle, on kahtlusi, kas Eesti suudab täita nõuet, et kõigile, kes saavad positiivse tulemuse, peavad olema kiiresti kättesaadavad endoskoopilised või radioloogilised uuringud.
Töötatakse välja sõeluuringuprogramme kopsuvähi ja eesnäärmevähi jaoks 2021. aastal tehtud teostatavusuuringu järel laiendati 2022. ja 2023. aastal kopsuvähi sõeluuringu katseprogrammi, et hõlmata enamik Tartu maakonna perearstikabinette. Tartu maakonna perearstid ja -õed esitasid 55–74aastastele inimestele küsimusi suitsetamise ja kopsuvähi esinemise kohta perekonnas ning suunasid suure riskiga patsiendid väikesedoosilise kompuutertomograafia uuringule, et teha kindlaks võimalik kopsuvähk. Tänu esmatasandil toimunud süstemaatilisele osalejate otsimisele oli sihtrühma kuulunud inimeste osalusmäär 87 %, mis näitab, et see lähenemisviis võib olla tõhus (OECD, 2024a). 2024. aastal jätkus programm Tartu maakonnas, kuid arutatakse ka laienemist Ida-Viru maakonda. Eesmärk on käivitada 2027. aastaks riiklik rahvasti- kupõhine sõeluuringuprogramm, mida rahastab Tervisekassa.
Käimas on eesnäärmevähi sõeluuringu teostata- vusuuring. 2024. aasta aprillis alustas Tervise Arengu Instituut kutsete saatmist enam kui 13 000-le Tallinnas või Tartus elavale 50–69aastasele mehele, kes ei ole teinud viimase 12 kuu jooksul prostataspetsiifilise antigeeni (PSA) testi ja kellel ei ole kunagi olnud eesnäärmevähki. Kõrge PSA tasemega mehed suunatakse uroloogi juurde, kes küsitleb patsienti, hindab riske ja saadab kõrge riskiga isikud magnetresonant- stomograafia (MRI) uuringule. See programm on oluline areng, kuna eesnäärmevähk on Eesti meestel enim diagnoositud vähivorm ja Eesti on eesnäärmevähi suremuse poolest ELi riikide seas kolmandal kohal.
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5. Vähiravi toimivus
5.1. Kättesaadavus
Eesti tervishoiusüsteemis on probleemiks pikad ooteajad; vähitõrje tegevuskavas on kavandatud eesmärkide süstemaatiline jälgimine Eesti oli 2023. aastal ELis riik, kus rahuldamata vajadusest arstiabi järele teatas suurim osa elanikkonnast – 13 % võrreldes ELi keskmise 2 %ga –, ehkki see osakaal on viimastel aastatel kahanenud. Linnapiirkondades elavad inimesed teatasid pidevalt suuremast rahuldamata vajadusest eriarstiabi järele kui maapiirkondades elavad inimesed. Kui kuludel ja arstiabi kaugusel oli väike roll, siis enam kui 90 % rahuldamata vajadusest teatanud inimestest nimetas peamise põhjusena ooteaegu (Riigikontroll, 2022).
Kuigi 2011. aastal seati vähiravi ooteajaga seoses eesmärk alustada kiiritusravi 28 päeva jooksul alates vähi diagnoosimisest, ei ole ooteaegu veel süstemaatiliselt analüüsitud. Vähitõrje tegevuskavas 2021–2030 on kindlaks määratud maksimaalsed ooteajad raviprotsessi eri osades alates esma- ja teise tasandi arstiabist kuni vähikeskuseni ja ravi alustamiseni (sotsiaalmin- isteerium ja Tervise Arengu Instituut, 2021). Andmetaristus esinevate lünkade tõttu ei ole keskmist ooteaega võimalik arvutada, kuid selle võimaldamiseks on käimas tervise infosüsteemi läbivaatamine.
Eesti otsib digitaalseid lahendusi, et kiirendada diagnoosi- ja raviotsuste tegemist. Nende hulka kuuluvad perearstide ja spetsialistide vahelised e-konsultatsioonid diagnoosimisel ning veebikonsultatsioonid patsientidele, mis moodustasid 2021. aastal üle 40 % arstide ja õdede töökoormusest (Tervise Arengu Instituut, 2023a). Lisaks aitaks riiklik veebipõhine broneerimisteenus valitsusel jälgida, millistel tervishoiuteenustel on pikemad ootenimekirjad, ja analüüsida selle põhjuseid.
Hoolimata sellest, et rahalised takistused vähiravi pakkumisel on väikesed, võivad erinevused tööealiste inimeste kindlustuskattes põhjustada viivitusi diagnoosimisel Rahaliste vahendite piiratus ei tekita Eestis olulisi takistusi juurdepääsul vähiravile. Kohaldatakse omaosalust, kuid seda hoitakse nii ravi kui ka
ravimite puhul väiksena. Ravimite puhul, millega ravitakse raskeid, eluohtlikke või valutekitavaid haigusi, nagu vähktõbi, tasuvad patsiendid 2,5 euro suuruse fikseeritud omaosaluse, mitte teatud protsendi ravimi hinnast. Kui aasta jooksul makstud omaosaluse kogusumma ületab 100 eurot, on võimalik saada lisahüvitist. Omaosaluse arvutamine ja arvestamine toimub ostu hetkel automaatselt, kasutades ulatuslikku tervisesüsteemi digitaristut. Sotsiaalkindlustus on seotud Eestis tööalase staatusega (kuid hõlmab lapsi ja pensionäre). Sellega seoses oli 2022. aastal 5 % Eesti elanikest kindlustamata (Tervise Arengu Instituut, 2023a). Kuigi patsiendid on pärast vähidiagnoosi saamist kindlustatud invaliidsu- shüvitiste kaudu, võib muret tekitavate sümptomite esinemise korral arstivisiit kindlustuskatte puudumise tõttu viibida.
Eesti on suurendanud vastuvõttu meditsiiniõppesse, et tegeleda olulise tööjõupuuduse probleemiga Eesti tervishoiusüsteemi murekohana on pidevalt esile tõstetud tervishoiutöötajate nappust. 2021. aastal oli Eestis 100 000 elaniku kohta 347 arsti, mis jääb 17 % alla ELi keskmise. Võttes arvesse vähktõve esinemissagedust, on Eestis arste 1000 uue vähijuhtumi kohta 13 % vähem kui ELis keskmiselt (Joonis 13). Peale selle arstkond vananeb ning peremeditsiini ja psühhiaatria valdkonnas, eriti väljaspool suuremaid linnu, valitseb arstide nappus, mis võib põhjustada lünki ravi integreerimisel ning vähipatsientidele ja vähktõvest jagusaanutele pakutava toe kättesaadavuses.
2023. aastal oli riigis 56 onkoloogi ehk neli onkoloogi 100 000 elaniku kohta, kuigi täistööajale taandatud töötajate arv oli väiksem. Radiolooge oli 100 000 elaniku kohta 15 ja see arv ei ole vaatamata suurenenud nõudlusele 2013. aastaga võrreldes eriti muutunud. Radioloogide nappust on nimetatud ka takistusena kopsuvähi sõeluuringu programmi laiendamisel (vt punkt 4), eriti kuna uuenduslikke lahendusi, nagu tehisintellekti kasutamine analüüsimisel, peetakse täiendavateks lahendusteks, mis ei asenda spetsialiste (Alloja et al., 2023).
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11: Supply of nurses and physicians per new cancer cases
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Arste palju Õdesid väheELi keskmine: 679
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Joonis 13. Eestis on uute vähijuhtumite arvu arvesse võttes vähem õdesid ja arste kui ELis keskmiselt
Märkused. Andmed õdede kohta hõlmavad kõiki õdede kategooriaid (mitte üksnes neid, mis vastavad ELi kutsekvalifikatsioonide tunnust mise direktiivile). Andmed on praktis erivate õdede kohta, välja arvatud Portugal ja Slovakkia, kelle andmed osutavad ametialaselt aktiivsetele õdedele. Kreeka puhul on õdede arv hinnatud tegelikust väiksemaks, kuna arvesse on võetud üksnes haiglates töötavaid õdesid. Portugali ja Kreeka puhul hõlmavad andmed kõiki tegevusloaga arste, mis tähendab, et praktiseerivate arstide arv on hinnatud tegelikust palju suuremaks. ELi keskmine on kaalumata keskmine. Allikas: OECD 2024. aasta tervisestatistika. Andmed on 2022. aasta kohta või viimase aasta kohta, mille andmed on kättesaadavad.
2022. aastal oli Eestis 100 000 elaniku kohta 658 õde , mida on 22 % vähem kui ELis keskmiselt. See teeb 1121 õde 1000 vähijuhtumi kohta, mis jääb 19 % alla ELi keskmise. Õdede arv 100 000 elaniku kohta on suurenenud alates 2013. aastast peaaegu 100 võrra. 2023. aastal töötas onkoloogiakliinikutes kokku 177 õde (12,9 õde 100 000 elaniku kohta) (Tervise Arengu Instituut, 2024a).
Kõnealuse nappuse leevendamiseks suurendas Eesti 2023. aastal kuuendiku võrra (700ni) õenduse õppekohtade miinimumarvu, kuigi kulub aastaid, et see kajastuks suuremas tööjõus (Tervise Arengu Instituut, 2023a). Eestis on kasutatud mõningal määral ka võimalust jagada ümber tööülesanded, et laiendada õdede rolli, kuna pereõed on sageli esimene kontaktpunkt esmatasandi tervishoius, ning eriõdede (magistrikraadile vastava kvalifikatsiooniga) teenust on hakatud rahastama eraldi teenusena kõigil ravitasanditel. Õdede onkoloogiaalane eriväljaõpe toimub siiski peamiselt töökohal, mis tähendab võimalikku lünka koolituskavas võrreldes mõne teise Euroopa riigiga. Eesti Onkoloogiaõdede Ühing, mis on Eesti Õdede Liidu allorganisatsioon, määrab kindlaks koolitusprogrammide eesmärgid ja sisu ning annab soovitusi õdede heaolu ning patsientide ja nende hooldajate ohutuse parandamiseks (sotsiaalmin- isteerium ja Tervise Arengu Instituut, 2021).
Varasema diagnoosimise saavutamiseks on vaja pöörata suuremat tähelepanu tervisetead- likkusele ja diagnostiliste uuringute kättesaa- davusele 2021. aastal diagnoositi Eestis üle poole vähijuhtudest 70aastastel ja vanematel inimestel, kusjuures peaaegu veerand rinnavähi juhtudest diagnoositi 75aastastel ja vanematel, mis osutab vajadusele teha vanuseliselt piiratud sõeluurin- guprogrammidele lisaks jõupingutusi varajase diagnoosimise vallas (Tervise Arengu Instituut, 2024a). Vähitõrje tegevuskavas 2021–2030 on seatud eesmärk suurendada elanikkonna teadlikkust vähisümptomitest, parandades seeläbi õigeaegset jõudmist perearsti juurde, kes suunab ligipääsu tervishoiusüsteemile, ning seejärel õigeaegset vähktõve diagnoosimist ja staadiumi määramist. Selleks töötatakse välja standardsed patsienditeekonnad alates esmasest pöördumisest kuni ravi alustamiseni (sotsiaalministeerium ja Tervise Arengu Instituut, 2021).
2021. aastal diagnoositi umbes pooltel vähipatsientidel lokaalne kasvaja enne selle levimist külgnevatesse kudedesse; viiendikul meestest ja enam kui kuuendikul naistest olid siiski diagnoosimise ajal juba kaugmetastaasid. Eriti valmistab muret kõhunäärmevähk, mille puhul olid metastaasid ligikaudu pooltel
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patsientidel. Sapipõievähi, söögitoruvähi või maksavähiga naiste ning kopsuvähiga meeste seas oli kaugemetastaasidega juhtumite osakaal üle 40 % (Zimmermann et al., 2024).
2022. aastal oli Eestis pildidiagnostikaseadmeid elaniku kohta vähem kui ELis keskmiselt ning 100 000 elaniku kohta tehti vähem kompuuter- tomograafia (3 % vähem), magnetresonantsto- mograafia (33 % vähem) ja positronemissioon- tomograafia uuringuid (58 % vähem). Selleks et parandada juurdepääsu diagnoosimisele, eelkõige piirkondades, mis asuvad suurematest haiglatest kaugemal, ostab Eesti Vähiliit mobiilse kompuuter- tomograafia skänneri, kasutades heategevu- sorganisatsioonidelt saadud rahalisi vahendeid (Heinsalu, 2024). See toetab ka kopsuvähi sõeluuringu programmi laiendamist, tagades juurdepääsu diagnostilistele uuringutele, eelkõige maapiirkondades (vt punkt 4).
Pikk aeg, mis kulub ravimi hüvitatavate ravimite loetellu kandmiseks, võib takistada juurdepääsu uutele ravimitele Eestis on nimetatud probleemina juurdepääsu uutele ravimitele, kuna paljudest uuetest ravimitest, mis on mujal Euroopas kättesaadavad, saavad Eestis riiklikult hüvitatavad ravimid alles palju hiljem. Seda seostatakse sellega, et väikeses riigis kulub taotluste läbivaatamiseks ja hinnaläbirääkimisteks rohkem aega. Uute ravimite heakskiitmisest Euroopa Ravimiametis (EMA) kuni hüvitamiseni Eestis kulus 559 päeva, mida on rohkem kui ELi keskmine 516 päeva. Riik hüvitab või katab valitud kliiniliselt tõhusatest uuematest vähiravimitest 46 %, mida on vähem kui keskmiselt ELis (59 %) ja sarnase ostujõuga riikides (54 %) (Joonis 14). Mõnel juhul kasutatakse Eestis müügiloata ravimite ja ettenähtust erinevalt kasutatavate ravimite / hüvitamisele mittekuuluvate näidustuste puhul patsiendipõhist hüvitamist, et tagada varajane juurdepääs. Lisaks kohaldatakse Eestis umbes poolte uuemate ravimite puhul seoses patsiendi õigusega ravimi hüvitamisele rohkem piiranguid kui on näinud ette Euroopa Ravimiamet ravimi heakskiitmisel (OECD, 2024a).
Joonis 14. Kuigi tõendid näitavad, et Eesti tagab juurdepääsu biosimilaridele, jääb uuemate ravimite hüvitamine maha keskmisest ELis ja sarnase ostujõuga riikides
Märkused. Analüüs hõlmab valimit, kuhu kuuluvad kümme uut kliiniliselt tõhusat rinnavähi ja kopsuvähi ravimit, mida kasutatakse kolmeteistkümne näidustuse puhul, ning kolme vähiravimi (bevatsisumaab, rituksimab, trastusumaab) üheksateist biosimilari, millel on 26. märtsi 2023. aasta seisuga kehtiv Euroopa Ravimiameti müügiluba. Andmed kajastavad nende ravimite ja biosimilaride osakaalu, mis olid kantud 1. aprilli 2023. aasta seisuga riiklikku hüvitatavate ravimite loetellu. Riigid on jaotatud tertsiilidesse, võttes aluseks 2022. aasta SKP elaniku kohta ostujõu standardina. Eesti jaoks on sarnase ostujõuga riigid Bulgaaria, Horvaatia, Kreeka, Läti, Poola, Portugal ja Ungari. ELi keskmine on kaalumata keskmine. Allikas: Hofmarcher, Berchet ja Dedet (2024), „Access to oncology medicines in EU and OECD countries“, OECD Health Working Papers, nr 170, OECD Publishing, Pariis, https://doi.org/10.1787/c263c014-en.
Samal ajal hüvitati Eestis kõik valimisse valitud kolme vähiravimi 19 biosimilari, millel oli kehtiv Euroopa Ravimiameti müügiluba, võrreldes keskmiselt 67 %ga sarnase ostujõuga riikides. Selle põhjuseks on asjaolu, et biosimilare ei hüvitata mitte kaubamärgi, vaid toimeaine alusel; kaubamärgi valik sõltub hanke tulemustest.
Juurdepääs kliinilistele uuringutele on Eestis keskmiselt väiksem kui teistes riikides, mis võib olla tingitud sellest, et paberimajanduse, eetiliste aspektide hindamise ja kohalikku keelde tõlkimise kulud on väikestes riikides suuremad. Olukorra parandamiseks luuakse riiklik vähikeskus, mis tõhustab teadus- ja arendustegevust, hõlbustab kõigi sidusrühmade koostööd ning hakkab tegutsema rahvusvaheliste kliiniliste ja
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teadusuuringute keskusena, et saada Euroopa Liidu kõikehõlmava vähikeskuse akrediteering (sotsiaalministeerium, 2023).
Eesti hindab kiiritusravi optimaalseks kasutamiseks vajadusi, et tagada piisavate seadmete kättesaadavus 2023. aastal oli Eestis seitse kiiritusraviseadet, mis tähendab, et varustatus inimese kohta on 35 % väiksem kui ELi keskmine (Joonis 15). 2024. aastaks oli Eesti ostnud seadmeid juurde, lähenedes sellega ELi keskmisele. Kõik seadmed on suhteliselt uued, vaid kaks on vanemad kui 15 aastat. Probleemiks võib olla geograafiline ligipääsetavus, sest kiiritusravi pakutakse ainult Tallinna ja Tartu vähikeskuses ning sageli peab patsient viibima seal kaua, et saada mitu päeva järjest väikeseid annuseid.
Rinnavähi diagnoosiga naiste seas korraldatud uuring näitas, et kiiritusravi saamine 12 kuu jooksul pärast esmast operatsiooni oli sagedasem kõrgema haridustasemega naiste ja abielus naiste seas, kuid ei sõltunud geograafilisest elukohast. Uuring näitas ka seda, et kiiritusravi kasutamine on aja jooksul märkimisväärselt kasvanud: 39 %-lt aastatel 2007–2009 diagnoosi saanud patsientidest 58 %-le aastatel 2016–2018 diagnoosi saanutest, mis on kooskõlas kättesaadavate seadmete arvu suurenemisega (Shahrabi Farahani, Paapsi & Innos, 2021). Käimas on analüüs, et hinnata kiiritusravi praegust kasutamist eri vähipaikmete puhul, võttes arvesse rahvusvahelisi soovitusi optimaalse kasutamise kohta. Selle raames hinnatakse vajadust kiiritusravi järele kuni aastani 2040 ning praegust ja tulevast vajadust seadmete ja tööjõu järele.
Joonis 15. Eestis on vähem kiiritusraviseadmeid kui ELis keskmiselt
Märkused. Suur enamus kiiritusraviseadmetest ELi liikmesriikides asub haiglates. Portugali ja Prantsusmaa andmed hõlmavad ainult haiglates asuvaid seadmeid, teiste riikide andmed on kõigi seadmete kohta. Riigid on jaotatud tertsiilidesse, võttes aluseks 2022. aasta SKP elaniku kohta ostujõu standardina. Eesti jaoks on sarnase ostujõuga riigid Bulgaaria, Horvaatia, Kreeka, Poola, Portugal, Rumeenia ja Slovakkia. ELi keskmine on kaalumata keskmine. Allikas: OECD 2024. aasta tervisestatistika.
5.2. Kvaliteet
Elulemus on mitme vähivormi puhul Eestis paranenud Vähipatsientide elulemus on üks peamisi Eesti vähitõrje tegevuskava 2021–2030 tulemusnäitajaid, kuna see võimaldab terviklikult hinnata vähitõrjemeetmeid, hõlmates nii varajast diagnoosimist kui ka vähiravi tõhusust. Aastatel 2017–2021 oli kõigi Eestis diagnoositud vähijuhtude (v.a mittemelanoomne nahavähk) puhul ühe aasta suhteline elulemus 74 %, viie aasta suhteline elulemus 58 % ja kümne aasta suhteline elulemus 53 %. Võrreldes 2007.–2011. aastal diagnoositud vähijuhtudega oli viie aasta elulemus paranenud kõige rohkem nahamelanoomi, pärasoolevähi ja leukeemia puhul (8 protsendipunkti) (Joonis 16).
Eesti eesmärk on jõuda elulemuse näitajateni, mis on lähedal Põhjamaade näitajatele. Mõne vähipaikme puhul on see juba saavutatud, kuid teiste, sealhulgas mitte-Hodgkini lümfoomi ning pea- ja kaelavähi puhul, on veel puudujääke. Ehkki enamiku vähipaikmete puhul oli elulemus naiste seas suurem kui meeste seas, on mõne puhul (kõhunäärme-, mao-, käärsoole- ja neeruvähk) erinevus vähenenud, mis on üks vähitõrje tegevuskava 2021–2030 eesmärke (Zimmermann et al., 2024).
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Joonis 16. Viie aasta elulemus paranes 2017.–2021. aastal diagnoositud vähijuhtude puhul 2007.–2011. aastal diagnoositud vähijuhtudega võrreldes 4 protsendipunkti
Allikas: Zimmermann et al. (2024).
Kõige rohkem potentsiaalseid eluaastaid kaotati Eestis kopsuvähi tõttu Lisaks elulemusandmetele on näitaja, mis võimaldab mõõta erinevate vähivormide mõju ühiskonnale, kaotatud potentsiaalsed eluaastad, sest see suurendab nooremate inimeste seas esinevate vähisurmade kaalu. Aja jooksul eri vähipaikmete puhul toimunud muutused kaotatud potentsiaalsete eluaastate arvus võivad osutada sellele, et vähiravisüsteem on tänu enneaegse suremuse vähendamisele paranenud. Eesti elanikud kaotasid 2022. aastal vähktõve tõttu 1283 potentsiaalset eluaastat 100 000 elaniku kohta, mida on 5 % vähem kui ELi keskmine ja 28 % vähem kui 2012. aastal. See näitaja oli meeste seas 58 % suurem kui naiste seas. 2022. aastal langes kõige enam aastaid – 186 eluaastat 100 000 elaniku kohta – kopsuvähi arvele, kuigi see näitaja oli vähenenud 2012. aastaga võrreldes 46 % (Joonis 17). Naiste seas kaotati rinnavähi tõttu 203 eluaastat 100 000 naise kohta. Kuigi enamiku vähivormide puhul täheldati kahanemistrendi, suurenes kõhunäärmevähi tõttu kaotatud eluaastate arv samal ajavahemikul 12 %.
Joonis 17. Kaotatud potentsiaalsete eluaastate arv on enamiku peamiste vähipaikmete puhul vähenemas
Märkused. Rinna-, emakakaela- ja munasarjavähi puhul hõlmab kaotatud potentsiaalsete eluaastate arv vaid naisi ja eesnäärmevähi puhul üksnes mehi. Roosa ring tähendab kaotatud potentsiaalsete eluaastate arvu suurenemist aastatel 2012–2022 (või viimasel aastal, mille kohta andmed on kättesaadavad), sinised ringid tähendavad vähenemist. Ringide suurus on võrdeline kaotatud potentsiaalsete eluaastate arvu suurusega 2022. aastal. Allikas: OECD 2024. aasta tervisestatistika.
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Kuigi inimesekesksust peetakse oluliseks, on vaja jõupingutusi suurendada Eestis minnakse vähiravis üle personali- seeritud, väärtuspõhisele ja patsiendikesksele lähenemisviisile, mille kohaselt peaksid olema ravi ja selle talutavuse hindamise lahutamatu osa patsiendi poolt teatatud ravitulemused. Eestis on vähikeskustes ellu viidud mitu asjakohast katseprojekti ning selle lähenemisviisi rakendamist rinna- ja kopsuvähki põdevate patsientide puhul peetakse teostatavaks. Sellest hoolimata ei koguta patsientide teatatud ravitulemusi ja ravikogemusi tsentraalselt riigi tasandil ning puudub üldine mudel nende ravitulemuste jälgimiseks – see on vajakajäämine, mis püütakse vähitõrje tegevuskavaga 2021–2030 kaotada.
Käivitatud on mitu inimesekesksust edendavat algatust, nagu e-platvorm KAIKO, mille eesmärk on toetada patsienti kodus ning hõlbustada pidevat suhtlemist ja sümptomitest teatamist patsiendi
ja tervishoiuteenuse osutaja vahel. Tervikliku patsienditeekonna tagamiseks on vähikeskustes loodud õe-koordinaatori teenus, et patsiendil oleks üks kontaktisik, kellele ta saab helistada kogu ravi vältel. Patsiendikesksust on kavas veelgi arendada, parandades patsienditeekonda alates vähikahtlusest kuni ravijärgsesse perioodi, sealhulgas patsientide rahulolu mõõtmist eri etappides. Mõningaid edusamme on juba tehtud: kopsuvähi diagnoosiga patsientide jaoks on välja töötatud spetsiifiline raviteekond ja patsientide organisatsioonid on kaasatud juhtorganite tegevusse, näiteks ravijuhiste väljatöötamisse. Nähes võimalusi kasutada oma digitaliseeritud tervishoiusüsteemi ja parandada geneetilise teabe kättesaadavust, et teha paremaid raviotsuseid, on Eesti alustanud jõupingutusi teatavate ravi aspektide personaliseerimiseks, et suurendada tõhusust konkreetse patsiendi vaatenurgast (tekstikast 2).
Tekstikast 2. Eesti digitaalne tervise infosüsteem võimaldab arendada personaalmeditsiini, et paremini suunata vähktõve sõeluuringuid ja ravi Inimesekesksus ja personaalmeditsiin on üks viiest Eesti e-tervise strateegia fookusvaldkonnast. Eesti ühtne tervise infosüsteem sisaldab kõiki terviseandmeid, sealhulgas 20 % täiskasvanud elanikkonna genoomiandmeid, mis annab võimaluse teha paremaid ennetus- ja raviotsuseid. Tervise Arengu Instituut juhtis Euroopa Regionaalarengu Fondi toel aastatel 2019–2023 projekti, et suurendada valmisolekut personaalmeditsiini rakendamiseks. Tähelepanu keskmes olid infotehnoloogiasüsteemi ja õigusraamistiku väljaarendamine, tervishoiu- töötajate koolitamine ja üldsuse teadlikkus. Esimesed teenused, mida kavatsetakse arendada, on rinnavähi ennetamine ja varajane avastamine ning personaalsed ravimisoovitused (Tervise Arengu Instituut, 2024d).
Eesti vaatab vähiravi kvaliteedi parandamiseks läbi ravikorralduse Rakendades ulatuslikke tsentraliseerimis- meetmeid ja -kavu, korraldas Eesti ümber oma vähiravivõrgustiku – nüüd toimub täiskasvanute vähiravi enamjaolt riigi põhja- ja lõunaosas asuvais kolmes vähikeskuses. Väiksemad haiglad pakuvad peamiselt süsteemset ravi vähikeskuste järelevalve all. Kavas on edasine tsentraliseerimine ning arutatakse ideed jagada operatsioonid vähipaikmete kaupa haiglate vahel ära, et tagada piisava oskusteabe kättesaadavus.
2021. aastal viibisid vähipatsiendid Eestis haiglas keskmiselt 7,4 päeva, mida on rohkem kui ELi keskmine 6,9 päeva. Kuna pikemat haiglaravi seostatakse suuremate riskidega, on mitu Euroopa riiki, kus on olemas suutlikkus pakkuda operatsiooni läbinud patsientidele terviklikku järelravi, hakanud rakendama vähiravis rohkem päevakirurgiat, kui see on ohutu. 2022. aastal ei tehtud Eestis päevakirurgia osakonnas siiski ühtki täielikku mastektoomiat ja rinnanäärme ekstsisioonidest tehti seal üksnes 13 %.
Eesti parandab vähiravi seiret täiustatud digitaalse tervishoiutaristu kaudu Eestis on tehtud viimastel aastatel süstemaatiliselt vähiravi tulemuslikkuse seiret ja auditeid. Tervisekassal on kvaliteedinäitajate nõuandekogu, et töötada välja tulemustele suunatud tervishoiu- teenused, kuid seire- ja infosüsteemides on mitmeid vajakajäämisi. Vähitõrje tegevuskavas 2021–2030 tunnistatakse lünka juhiste järgimise süstemaatilises järelevalves. Tänu digitaalsele tervise infosüsteemile saavad Eesti arstid otsuste tegemisel tõenduspõhist tuge, omades ligipääsu patsiendi terviseteabele, sealhulgas diagnoosidele ning teabele ravimite, analüüside ja protseduuride kohta. Raviotsuste tegemises osalevad Eestis tavaliselt multidistsiplinaarses onkoloogilises konsiiliumis, keda rahastab Tervisekassa, kuigi praktika on konkreetsete juhiste puudumise tõttu erinev.
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5.3. Kulud ja kulutõhusus
Vähktõve põhjustatud koormus tervishoiuku- lutustele on Eestis eeldatavasti väiksem kui ELis Eesti tervishoiusüsteemi rahastab suures osas Tervisekassa, mis korraldab tervishoiu- teenuste ostmist. Tegemist on poolautonoomse avalik-õigusliku organisatsiooniga, mis hangib enamiku rahalistest vahenditest palgafondimaksu kaudu, kuigi üha suurem roll on ka riigi tehtavatel ülekannetel. Eesti tervishoiukulutused osana SKPst on ühed ELi väiksemad (2022. aastal 7 %). 2022. aastal hüvitas Tervisekassa 51 000 inimese vähiravi, eraldades operatsioonide, ravi ja ravimite jaoks üle 171 miljoni euro (sotsiaalministeerium, 2023). Tervisekassa 2023. aasta finantsaruande kohaselt oli 15 % eriarstiabiga seotud tervishoiukuludest seotud vähktõvega, mida on rohkem kui 2022. aasta 14 % (Tervisekassa, 2023). 2023. aastal moodustasid kallite vähiravijuhtude (maksumusega üle 104 000 euro) kulud 12 % kõigist kallite ravijuhtude kuludest.
OECD rahvatervise strateegilise planeerimise modelleerimise andmete kohaselt on kogukulutused tervishoiule aastatel 2023–2050 vähktõvest tingitud koormuse tõttu Eestis hinnanguliselt 3,6 % suuremad. See teeb aastas keskmiselt 37 eurot inimese kohta, mida on tunduvalt vähem kui EL 19 keskmine (242 eurot). Tuleb siiski märkida, et Eesti praegust rahastamismudelit ei peeta jätkusuutlikuks ning Eesti tervishoiusüsteemi peamised kapitaliinvest- eeringud on tuginenud ELi struktuurifondidele.
Arvestades suurenevat vähihaigestumust ja -elulemust, on oodata, et rohkem inimesi vajab tugiteenuseid pikemat aega, mis toob kaasa kulude kasvu. Prognooside kohaselt suurenevad vähiraviga seotud tervishoiukulutused elaniku kohta Eestis 2023.–2050. aastal 61 %, võrreldes 59 %ga ELis.
Käivitatud on kulutõhususe algatused, keskendudes sõeluuringute ja ravimite rahastamisele Eestis on kasutatud seni vähem meetmeid vähiravi kulude piiramiseks, kuna pidevalt on rõhutatud vajadust parandada ravi kättesaadavust. Kulude piiramiseks varasema diagnoosimisega, mille järel ravi on odavam, eraldati 2023. aastal lisavahendeid sõeluuringuprogrammide jaoks, et laiendada vanusevahemikke, katsetada uuenduslikke lahendusi ja töötada välja uued programmid (vt punkt 4). Võrreldes 2022. aastaga
6 Persentism viitab tootlikkuse vähenemisele, mis leiab aset siis, kui tööl viibiv töötaja ei ole haiguse, vigastuse või muu seisundi tõttu täielikult töövõimeline.
kasvasid sõeluuringuprogrammide jaoks eraldatud eelarvevahendid 2023. aastal rinnavähi puhul 5 %, emakakaelavähi puhul 13 % ja kolorektaalvähi puhul 19 % (Tervisekassa, 2023).
Ravimihindade tõusu tõttu on suurenenud ravimihindade mõju eelarvele. Uuemate vähiravimitega seotud kulude piiramiseks kohaldatakse umbes poolte ravimite hüvitamisel piiranguid – ravim hüvitatakse väiksema arvu näidustuste puhul, kui on heaks kiitnud Euroopa Ravimiamet (OECD, 2024a). Ravimite hüvitamine on toimainepõhine, mis võimaldab haiglatel teha eelarvet mõjutavaid otsuseid ja osutab sellele, et rõhku pannakse eelarve jätkusuut- likkusele. Hüvitamisotsustes järgib Tervisekassa üldpõhimõtteid – näiteks peaks geneeriline ravim olema vähemalt 30 % ja biosimilar vähemalt 15 % odavam kui riiklikku retseptiravimite loetellu kantud originaalravim.
Vähktõbi mõjutab laialdaselt Eesti tööturgu ja majandust Lisaks otsesele kahjule inimese tervisele, nagu haigestumise tagajärjed ja surm, ning vaimsele ja psühholoogilisele kahjule, mida vähktõbi põhjustab patsiendile ja tema lähedastele, tekitab vähktõbi märkimisväärset kaudset koormust ühiskonnale laiemalt. See tuleneb töölt kõrvalejäämise, absentismi ja presentismi6 suurenemisest, mille tulemuseks on mõju SKP-le ja sissetulekute vähenemine, mis mõjutab inimeste heaolu ja tervishoiuteenustesse investeerimiseks kättesaadava raha kogust. OECD rahvatervise strateegilise planeerimise modelleerimise andmete kohaselt on tööjõu kadu Eestis hinnanguliselt üks suuremaid ELis (Joonis 18). Aastatel 2023–2050 on kadu, mis on tingitud vajadusest vähendada vähi tõttu töötamist, Eestis eeldatavasti keskmiselt 213 täistööajale taandatud töötajat 100 000 elaniku kohta, mida on rohkem kui ELi keskmine 178 täistööajale taandatud töötajat 100 000 elaniku kohta. Samuti on oodata, et absentismist ja presentismist tingitud kadu on Eestis 89 täistööajale taandatud töötajat 100 000 elaniku kohta, mida on rohkem kui ELi keskmine 81 täistööajale taandatud töötajat 100 000 elaniku kohta.
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16: Impact of cancer on the average population life expectancy in years, average over 2023-2050
-2,5
-2
-1,5
-1
-0,5
0 Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
-2,5
-2
-1,5
-1
-0,5
0 Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
# Restricted Use - À usage restreint
15b: Impact of cancer on workforce through employment (combining unemployment and part-time work), absenteeism and presenteeism in FTEs, average over 2023-2050 per 100 000 people
-400
-300
-200
-100
0
Tööhõive (töölt kõrvale jäämine ja osaline tööaeg) Absentism Presentism
Vähist tingitud prognoositud kadu täistööajale taandatud töötajate arvuna 100 000 elaniku kohta (2023.–2050. aasta)
-400
-300
-200
-100
0
Tööhõive (töölt kõrvale jäämine ja osaline tööaeg) Absentism Presentism
Vähist tingitud prognoositud kadu täistööajale taandatud töötajate arvuna 100 000 elaniku kohta (2023.–2050. aasta)
Joonis 18. Vähktõbi avaldab aastatel 2023–2050 suurt mõju Eesti tööjõule, mille tulemuseks on keskmine aastane kadu suurusega enam kui 300 täistööajale taandatud töötajat 100 000 elaniku kohta
Märkus: ELi keskmine on kaalumata keskmine. Allikas: OECD (2024b), „Tackling the Impact of Cancer on Health, the Economy and Society“, OECD Health Policy Studies, OECD Publishing, Pariis, DOI: https://doi.org/10.1787/85e7c3ba-en.
5.4. Heaolu ja elukvaliteet
2020. aasta seisuga oli diagnoositud kunagi elu jooksul vähk enam kui 5 %-l Eesti elanikest OECD rahvatervise strateegilise planeerimise modelleerimise andmete põhjal prognoositakse, et vähktõbi vähendab aasatel 2023–2050 Eestis oodatavat eluiga võrreldes vähivaba stsenaariumiga 1,9 aasta võrra, mis sarnaneb ELi
keskmisega (Joonis 19). Peale selle seostatakse vähktõbe oluliste vaimse ja füüsilise tervise probleemidega, mis mõjutavad nii patsienti kui ka tema lähedasi. Riiklike andmete põhjal oli 2020. aasta seisuga saanud oma elus vähidiagnoosi üle 67 000 inimese (5 % Eesti elanikkonnast), mis tõstab esile tugiteenuste kättesaadavuse tähtsuse, et parandada elukvaliteeti ja aidata inimestel toime tulla vähktõve mõjuga.
Joonis 19. Vähktõve mõju elanike keskmisele oodatavale elueale aastatel 2023–2050 on Eestis lähedal ELi keskmisele
Märkus: ELi keskmine on kaalumata keskmine. Allikas: OECD (2024b), „Tackling the Impact of Cancer on Health, the Economy and Society“, OECD Health Policy Studies, OECD Publishing, Pariis, DOI: https://doi.org/10.1787/85e7c3ba-en.
Tugi- ja rehabilitatsiooniteenused kannatavad struktuuri puudumise tõttu Avaldatud on kaks palliatiivse ravi juhendit, mis hõlmavad sümptomaatilist ravi, soovitusi konkreetsete juhtude käsitlemiseks ning interdistsiplinaarse ravi korraldamist, kaasates vaimse tervise keskused ja eriväljaõppe saanud spetsialistid. See on eriti oluline, võttes arvesse, et eelduste kohaselt suureneb aastatel 2023–2050
Eestis vanusestandarditud depressioonijuhtumite arv 100 000 elaniku kohta vähktõve tõttu 23 võrra aastas, mida on märksa rohkem kui 17 juhtumit 100 000 elaniku kohta ELis. Samal ajal on psühholoogilise toe kättesaadavust raskendanud tööjõupuudus, sest kuigi psühholoogide ja psühhoterapeutide arv suurenes 13-lt 100 000 elaniku kohta 2013. aastal 27-le 100 000 elaniku kohta 2023. aastal, on nõudlus hooldusasutustes ja
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kogukonnas hüppeliselt kasvanud (Tervise Arengu Instituut, 2024a).
Eestis ei toimu süstemaatilist suunamist onkoloogilise rehabilitatsiooniteenuse pakkuja juurde eesmärgiga parandada vähipatsientide ja vähktõvest jagusaanute elukvaliteeti. Vaatamata mitmes valdkonnas tehtud edusammudele, puuduvad vähipatsientide viljakuse säilitamisega seotud meetmed ja vähktõvest jagusaanute õigus olla unustatud ning Eestis ei ole vähktõvest jagusaanute kliinikute organiseeritud võrgustikku. Järelravi puhul sõltuvad patsiendid esmatasandi tervishoiusüsteemist.
Palliatiivse ravi kättesaadavus on piirkonniti erinev Palliatiivne ravi, sealhulgas statsionaarne ja ambulatoorne palliatiivne ravi ning elulõpuravi, kuulub Eestis Tervisekassa hüvitatavate teenuste hulka. Ambulatoorsete teenuste ja hooldekodude puhul kohaldatakse omaosalust ning kasutajad tasuvad osa ravikuludest, näiteks opioidide ja muu valuravi eest. Patsiendid maksavad hooldekodudes ja hospiitsides ka voodipäevatasu.
2019. aastal osutati Eestis rohkem palliatiivse ravi teenuseid kui ELis keskmiselt. Neid teenuseid osutasid haiglad, kutseliidud ja patsientide ühendused, kusjuures alates 2020. aastast on 48 teenuseosutajat pakkunud koduõendusteenust (kõigis maakondades). Analüüsis leiti siiski, et teenused on jaotatud ebaühtlaselt ja juurdepääs, eelkõige vaimse tervise teenustele, on piirkonniti väga erinev. Äärealade elanikel on keeruline terviklikele teenustele ligi pääseda, kuna puudub hüvitis, sealhulgas reisikulude katmiseks.
Lisaks takistavad õigeaegset juurdepääsu tervishoiutöötajate vähene teadlikkus, koordineeritud palliatiivse ravi võrgustiku puudumine ja rahaliste vahendite nappus. Seega sõltub juurdepääs sageli patsiendi või tema hooldaja teadlikkusest. Vaja on paremat integreerimist, meeskonnatööd ja juhtumite haldamist, et vältida patsientide süsteemis kaotsiminekut (HAAP Consulting, 2023).
Eesti töötab välja palliatiivse ravi teenuste mudelit, mis vastaks paremini patsientide vajadustele Vähitõrje tegevuskavas 2021–2030 on püstitatud eesmärk parandada veelgi palliatiivse ravi kättesaadavust, koolitades tervishoiutöötajaid, suurendades patsientide ja töötajate teadlikkust ning tagades piisava rahastamise. Pidades esmatähtsaks vähipatsientide elukvaliteeti, on tegevuskavas ette nähtud riikliku palliatiivse ravi teenuste mudeli väljatöötamine. Eesti kavatseb
ühineda ELi algatustega tervishoiu ja palliatiivse ravi, sealhulgas pediaatrilise palliatiivse ravi valdkonnas. Tuginedes sotsiaalministeeriumi tellitud aruandele (HAAP Consulting, 2023), kujundatakse ümber palliatiivse ravi võrgustik, et jõuda kõikides piirkondades paremini patsientideni, pöörates tähelepanu esmatasandi arstiabi rollile ja mitteametlike hooldajate suuremale toetamisele. Selles strateegias on kesksel kohal koduõendus, mille eesmärk on vähendada haiglas viibimist, pakkudes hooldust kodus. Lisaks on vähitõrje tegevuskavas seatud eesmärk tagada patsientidele terviklik, kvaliteetne ja õigeaegne onkoloogilise rehabilitatsiooni teenus ning standardida selle teenusega seotud terminoloogia ning kodeerimis- ja hindamissüsteem.
Palliatiivse ravi alast koolitust pakutakse tervishoiutöötajatele osana meditsiiniharidusest, samal ajal soovitatakse palliatiivse ravi juhendis lisakoolitust, kuid see ei ole kohustuslik. Nõrgaks kohaks peetakse praktilise koolituse võimalusi. Palliatiivse ravi teenuste koolitusmudeli väljatöötamise raames on kavas koolitust laiendada, muuta see kohustuslikuks ja koostada spetsiaalne koolituskava koordinaatoritele.
Kuigi Tervisekassa teeb kõigi oma partnerite puhul kvaliteediauditeid ja tervishoiuteenuste osutajatel on seadusest tulenev kohustus teha patsiend- ikogemust käsitlevaid uuringuid, sealhulgas palliatiivse ravi ja elulõpuravi valdkonnas, puuduvad andmed konkreetselt vähipatsientidele mõeldud palliatiivse ravi kättesaadavuse ja kvaliteedi kohta riigis.
Suur osa elulõpuravist sõltub Eestis mitteametlikest hooldajatest, kuigi kavas on välja arendada spetsialistide võrgustik Eestis pakutakse elulõpuravi kodus ja haiglates, hooldekodudes ja hospiitsides. Ravi võib juhendada pere- või eriarst, sealhulgas kaugkonsultatsiooni teel. Suur osa hoolduskoormusest jääb siiski mitteametlikele hooldajatele, kellel on õigus saada pereliikme hooldamise eest hüvitist vaid 80 % ulatuses kuni seitsme päeva eest. Puudub palgata puhkuse süsteem ja paindlikku töökorraldust ei toetata. Mitteametlikule hooldajale makstava rahalise toetuse määrab kindlaks omavalitsus, kes teeb otsuse toetuse saamise õiguse ja antava toetuse liigi kohta (Rocard & Llena-Nozal, 2022). Vähitõrje tegevuskavas 2021–2030 peetakse esmatähtsaks parandada elulõpuravi teenuste kättesaadavust, tagada, et tervishoiutöötajatel on palliatiivse ravi jaoks vajalikud oskused, arendada elu lõpus pakutavat psühholoogilist tuge ning reguleerida patsientidele ja peredele elulõpuraviga seotud otsuste kohta teabe andmist.
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17: Age-standardised incidence rate per 100 000 in 2022
31%
15% 15%
6%
Leukeemia: 4,3
Ajuvähk, kesknärvisüsteemi kasvaja: 2,1
Lümfoomid (Hodgkini lümfoom ja mitte-Hodgkini lümfoomid): 2,0
Neeruvähk: 0,8
Muu: 4,5
36 %
23 % 3 %
6 %
Leukeemia: 5,1
Ajuvähk, kesknärvisüsteemi kasvaja: 3,2
Lümfoomid (Hodgkini lümfoom ja mitte-Hodgkini lümfoomid): 0,4
Neeruvähk: 0,9
Muu: 4,6
EL27Eesti
Kõik vähipaikmed: 13,7 100 000 elaniku kohtaKõik vähipaikmed: 14,2 100 000 elaniku kohta
Hinnanguline vanusestandarditud haigestumus 100 000 elaniku kohta (0–14aastased) (2022)
9 161 uut vähijuhtumit 2022. aastal31 uut vähijuhtumit 2022. aastal
Vanusestandarditud suremus 100 000 elaniku kohta (0–14aastased) (kolme aasta keskmine, 2021)
2.9 (Eesti) > 2.1 (EL27)
6. Pilguheit laste vähktõvele
Euroopa vähiteabesüsteemi andmete kohaselt oli 2022. aastal Eestis laste ja noorukite seas hinnanguliselt 31 vähijuhtumit. Haigestumus 0–14aastaste seas oli 2022. aastal hinnanguliselt 14,2 juhtumit 100 000 elaniku kohta, mis on sarnane 13,7 juhtumiga 100 000 elaniku kohta EL 27s (Joonis 20). Kõige sagedamini diagnoositud
vähk oli hinnangute kohaselt leukeemia (5 juhtumit 100 000 elaniku kohta), millele järgnesid ajuvähk ja kesknärvisüsteemi kasvajad, lümfoomid ja neeruvähk. Eurostati andmetest on näha, et laste vähktõvest põhjustatud suremus oli 2,9 inimest 100 000 elaniku kohta, ja see näitaja on olnud pidevalt üks ELi kõrgemaid.
Joonis 20. Laste vähihaigestumus on Eestis veidi suurem kui ELi keskmine
Märkused. 2022. aasta näitajad on varasemate aastate haigestumussuundumustel põhinevad hinnangud ja võivad hilisematel aastatel täheldatud haigestumusest erineda. „Kõik vähipaikmed“ ei hõlma mittemelanoomset nahavähki. Allikad: Euroopa vähiteabesüsteem (vähihaigestumuse puhul), https://ecis.jrc.ec.europa.eu (vaadatud 10. märtsil 2022), © Euroopa Liit, 2024.
Eestis diagnoositakse ja ravitakse laste vähktõbe kahes laste hematoloogia-onkoloogia keskuses (Tartu Ülikooli Kliinikum ja Tallinna Lastehaigla). Eesti vähitõrje tegevuskavas 2021–203 osutatakse meditsiinitöötajate ebapiisavale teadlikkusele sellest, et 0–18aastaste patsientide pahaloomuliste kasvajate diagnoosimist ja ravi juhib lasteonkoloog.
Enamik laste vähktõve puhul kasutatavaid raviviise on Eestis kättesaadavad. Lastest vähipatsientidel ei ole siiski võimalik saada riigis prootonkiir- itusravi, samuti ei pakuta vähktõvest jagusaanud lastele ellujääja-spetsiifilist hooldust. Eesti vähikeskused tagavad juurdepääsu prootonravile läbi rahvusvahelise koostöö. Lisaks oli Euroopas aastatel 2010–2022 korraldatud 436st kliinilisest uuringust, milles osalesid vähki põdevad lapsed, alla 18aastastele Eesti elanikele ligipääsetav vaid 1 %, mis on üks ELi väiksemaid näitajaid. 68st pediaatria valdkonnas oluliseks tunnistatud ravimist oli Eestis 2018. aastal kättesaadav 59 %, mida on vähem kui ELi keskmine 76 %, kuid
rohkem kui 49 % naabruses asuvas Lätis ja Leedus (Vassal et al., 2021).
Eesti vähitõrje tegevuskavas 2021–2030 on lisaks kindlaks tehtud olulised lüngad sotsiaal- abisüsteemis lastevanematele, kelle laps on saanud vähidiagnoosi, sealhulgas ebapiisav tugi laste arengu tagamiseks pikaajalise haiglaravi ajal ja laste naasmisel lasteaeda või kooli ning haiglavälise psühholoogilise abi puudumine. Laste vähktõbi on üks vähitõrje tegevuskava 2021–2030 prioriteete. Tegvuskavas on seatud eesmärk parandada teenuste kättesaadavust, tõhustada koostööd rahvusvaheliste pädevuskeskustega ning suurendada vähki põdevate laste juurdepääsu kliinilistele uuringutele.
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Country abbreviations (translated)
Austria AT Iirimaa IE Leedu LT Portugal PT Sloveenia SI Belgia BE Island IS Luksemburg LU Prantsusmaa FR Soome FI Bulgaaria BG Itaalia IT Madalmaad NL Rootsi SE Taani DK Eesti EE Kreeka EL Malta MT Rumeenia RO Tšehhi CZ Hispaania ES Küpros CY Norra NO Saksamaa DE Ungari HU Horvaatia HR Läti LV Poola PL Slovakkia SK
Riikide lühendid
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Palume käesolevale väljaandele viidata järgmiselt: OECD/European Commission (2025), „Riigi vähiprofiil: Eesti 2025“, ELi riikide vähiprofiilid, OECD Publishing, Pariis, https://doi.org/10.1787/664a014c-et. Algselt avaldatud inglise keeles pealkirja all: OECD/European Commission (2025), EU Country Cancer Profile: Estonia 2025, OECD Publishing, Paris, https://doi.org/10.1787/bb4eec73-en. Mis tahes lahknevuse korral loetakse kehtivaks ainult ingliskeelne tekst. © OECD/European Union 2025 selle Eesti väljaande jaoks.
European Cancer Inequalities Registry
Riigi vähiprofiil 2025 Vähktõve ebavõrdsuse register on Euroopa vähktõvevastase võitluse kava juhtalgatus. Sellest saab kindlat ja usaldusväärset teavet vähktõve ennetamise ja ravi kohta, et selgitada välja suundumused ning erinevused ja ebavõrdsus liikmesriikide ja piirkondade vahel. Register sisaldab veebisaiti ja andmetööriista, mille on välja töötanud Euroopa Komisjoni Teadusuuringute Ühiskeskus (https://cancer-inequalities. jrc.ec.europa.eu/), samuti vaheldumisi iga kahe aasta järel koostatavaid riiklikke vähiprofiile ja üldist aruannet vähktõve ebavõrdsusest Euroopas.
Riikide vähiprofiilides tuuakse välja tugevad küljed, probleemid ja konkreetsed tegevusvaldkonnad kõigis 27 ELi liikmesriigis, Islandil ja Norras, et suunata Euroopa vähktõvevastase võitluse kava alusel investeeringuid ja sekkumisi ELi, riigi ja piirkonna tasandil. Lisaks toetab Euroopa vähktõve ebavõrdsuse register nullsaaste tegevuskava 1. juhtalgatust.
Profiilid koostab Majanduskoostöö ja Arengu Organisatsioon (OECD) koostöös Euroopa Komisjoniga. Töörühm on tänulik riiklikele ekspertidele, OECD tervisekomiteele ja ELi vähktõve ebavõrdsuse registri eksperdirühmale väärtuslike märkuste ja ettepanekute eest.
Iga riigi terviseprofiilis esitatakse lühikokkuvõte järgmisest:
• vähktõvest tulenev koormus riigis
• vähi riskitegurid, keskendudes käitumuslikele ja keskkonnast tulenevatele riskiteguritele
• varajase avastamise programmid
• vähiravi tulemuslikkus, keskendudes kättesaa- davusele, ravi kvaliteedile, kuludele ja elukvaliteedile
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European Cancer Inequalities Registry
EU Country Cancer Profiles
Synthesis Report
2025
1
EU Country Cancer Profiles
EU Country Cancer Profiles Synthesis Report 2025
This work is published under the responsibility of the Secretary-General of the OECD and the President of
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The names of countries and territories and maps used in this joint publication follow the practice of the
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Note by the Republic of Türkiye
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Please cite this publication as:
OECD/European Commission (2025), EU Country Cancer Profiles Synthesis Report 2025, OECD
Publishing, Paris, https://doi.org/10.1787/20ef03e1-en.
Photo credits: Cover design using image from © gmast3r/istockphoto.com.
© OECD/European Union 2025. In the event of any discrepancy between the original work and any
translated versions of this work, only the text of original work should be considered valid.
Attribution 4.0 International (CC BY 4.0)
This work is made available under the Creative Commons Attribution 4.0 International licence. By using this work, you accept to be bound by the terms
of this licence (https://creativecommons.org/licenses/by/4.0/).
Attribution – you must cite the work.
Translations – you must cite the original work, identify changes to the original and add the following text: In the event of any discrepancy between the
original work and the translation, only the text of original work should be considered valid.
Adaptations – you must cite the original work and add the following text: This is an adaptation of an original work by the OECD and the European
Union. The opinions expressed and arguments employed in this adaptation should not be reported as representing the official views of the OECD or of
its Member countries or of the European Union.
Third-party material – the licence does not apply to third-party material in the work. If using such material, you are responsible for obtaining permission
from the third party and for any claims of infringement.
You must not use the OECD’s or the European Commission’s logo, visual identity or cover image without express permission or suggest the OECD or
European Commission endorses your use of the work.
Any dispute arising under this licence shall be settled by arbitration in accordance with the Permanent Court of Arbitration (PCA) Arbitration Rules 2012.
The seat of arbitration shall be Paris (France). The number of arbitrators shall be one.
3
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Foreword
Europe’s Beating Cancer Plan (EBCP) addresses the longstanding threat posed by cancer. One of the
Plan’s ten flagship initiatives, the European Cancer Inequalities Registry assesses inequalities in cancer.
Under this umbrella, the OECD and European Commission present this synthesis report, highlighting
findings from the 2025 Country Cancer Profiles. These country-specific assessments, authored by the
OECD and the European Commission, provide the latest data and developments across the cancer
spectrum, from prevention to survivorship in EU Member States, Iceland and Norway.
The 2025 synthesis report brings to light four main messages. First, cancer is only growing as a public
health concern in the EU, as the share of people under active treatment or living with a history of cancer
expands due to population ageing and notable decreases in cancer mortality. However, even with the
reductions, mortality rates remain much higher among lower income countries in the EU, as well as among
men and those with lower levels of education.
Second, there is evidence of improvement on a number of cancer risk factors in the EU over time, with the
notable exception of overweight and obesity, which are an increasing challenge. Smoking rates have
decreased in the vast majority of EU countries. Trends in alcohol use show more variability by country, but
point to an overall decrease at the EU level. However, even with substantial policy measures addressing
the intersecting risk factors of overweight, low physical activity and poor diet – over half of adults in
EU countries are overweight and rates are rising among adolescents.
Third, early detection efforts via screening programmes show worrying trends. One in two EU countries
saw a decline in breast cancer screening participation, while two out of three saw decreases in cervical
cancer screening. However, many countries have introduced population-based colorectal cancer
screening in the last 15 years, promoting earlier detection and improved outcomes. Other positive efforts
aim at making self-sampling for cancer screening more widely available and closing gaps in screening
participation between population groups.
Finally, improved cancer survival rates and increasing cancer prevalence are propelling efforts to develop
rehabilitation and quality of life programmes for people with cancer. Countries are making wide-ranging
investments in palliative care services and developing new programmes to address the psychological,
social, occupational and economic reintegration of cancer survivors.
This synthesis report provides insight on the performance of countries across the cancer care spectrum,
identifying common challenges and parallel improvements. The second part of the report presents a
Cancer Performance Tracker (CaPTr) for each country across several cancer domains: prevention, early
detection, care capacity, and outcomes. The Country Cancer Profiles and synthesis report reveal that there
is still great need to collect better, more comprehensive, internationally comparable data. Actionable and
comparable information on cancer incidence trends, effectiveness of screening programmes, timeliness
and quality of cancer care, patient-reported outcomes, and cancer survival have the potential to catalyse
improved cancer care monitoring and policy making across the EU, in line with the vision of EBCP.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Table of contents
Foreword 3
Acronyms and abbreviations 7
1 Cancer burden 8
In Europe, the ageing population and lower cancer mortality rates are leading to an increase in
the number of people living with cancer 8
In virtually all EU countries, national cancer plans align with Europe’s Beating Cancer Plan 13
2 Risk factors and prevention policies 15
Tobacco smoking has decreased in all but three EU+2 countries between 2012 and 2022 15
Alcohol consumption has decreased in two out of three EU countries between 2010 and 2022 16
Trends in tobacco and alcohol consumption among adolescents reflect those seen in adults 16
More than half of the adult population is overweight in 23 EU+2 countries, while overweight
rates among adolescents have increased in all but three countries 18
Although countries are investing in prevention, additional efforts are needed to reduce the key
cancer risk factors 19
3 Early detection 22
Although cancer screening programmes are expanding and using new outreach methods,
participation rates are stagnating or even declining 22
Countries are working to overcome screening inequalities and are making self-sampling more
accessible 25
Lung, prostate and gastric cancer screening and expanded genetic testing are under
consideration 26
4 Cancer care performance 28
Growing cancer prevalence is driving efforts to improve accessibility and quality of cancer care 28
Improvements in survival estimates and cancer care quality initiatives are evident across
EU countries 32
The increasing cancer burden has wide-ranging impact on the health system and the economy 35
Given increasing cancer prevalence, countries are developing follow-up and rehabilitative care,
and implementing policies to address quality of life 37
5 Spotlight on paediatric cancer care 40
Over 50% of new cancer diagnoses among children stem from three main cancer types:
Leukaemia, brain and non-Hodgkin’s lymphoma 40
In 12 EU+2 countries, paediatric cancer patients had access to less than 5% of oncology clinical
trials running in Europe 41
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
6 Cancer performance trackers 42
Notes 74
References 75
FIGURES
Figure 1.1. Breast cancer is responsible for almost one in three new cancer cases among women in the EU,
while prostate cancer accounts for almost one in four new cases among men 9 Figure 1.2. While decreasing over the last decade, cancer mortality rates are almost 70% higher among men
than women 11 Figure 1.3. Avoidable lung cancer mortality among men decreased in all EU countries, but increased among
women in 16 countries 12 Figure 1.4. Cancer prevalence increased by over 20% in 24 EU+2 countries over the last ten years 13 Figure 2.1. Tobacco smoking rates among adults have decreased across almost all EU countries over the
past decade 16 Figure 2.2. Adolescent smoking is strongly associated with the prevalence of smoking among adults 17 Figure 2.3. Tobacco smoking and drunkenness have decreased among adolescents in the EU 17 Figure 2.4. While about a third of women with high education levels are overweight in the EU, that figure
jumps to over half of women with low education 19 Figure 2.5. Almost 2 million cancer cases could be prevented in the EU between 2023-50 by meeting tobacco
reduction targets 21 Figure 3.1. Breast cancer screening coverage declined in more than half of EU+2 countries over the last
decade 23 Figure 3.2. Cervical cancer screening participation rates decreased in two-thirds of EU+2 countries 24 Figure 3.3. Colorectal cancer screening programmes have recently expanded in EU countries alongside
initiatives to better reach target populations 25 Figure 4.1. The availability of nurses per cancer case varies more than 5-fold across EU+2 countries 29 Figure 4.2. Volume of radiotherapy equipment varies almost threefold across EU countries 31 Figure 4.3. Over the last decade, there has been a reduction in potential years of life lost across all main
cancer sites 34 Figure 4.4. On average in the EU, health expenditure on cancer is projected to increase by more than 50% in
2050 compared to 2023 36 Figure 4.5. Cancer is expected to have a large impact on workforce participation and productivity 37 Figure 4.6. Cancer is projected to reduce life expectancy by between 1.4 and 2.5 years across EU countries 38 Figure 5.1. The paediatric cancer mortality rate in the EU stood at 2.1 per 100 000 children 40 Figure 6.1. Belgium’s Cancer Performance Tracker (CaPTr) 43 Figure 6.2. Bulgaria’s Cancer Performance Tracker (CaPTr) 44 Figure 6.3. Czechia’s Cancer Performance Tracker (CaPTr) 45 Figure 6.4. Denmark’s Cancer Performance Tracker (CaPTr) 46 Figure 6.5. Germany’s Cancer Performance Tracker (CaPTr) 47 Figure 6.6. Estonia’s Cancer Performance Tracker (CaPTr) 48 Figure 6.7. Ireland’s Cancer Performance Tracker (CaPTr) 49 Figure 6.8. Greece’s Cancer Performance Tracker (CaPTr) 50 Figure 6.9. Spain’s Cancer Performance Tracker (CaPTr) 51 Figure 6.10. France’s Cancer Performance Tracker (CaPTr) 52 Figure 6.11. Croatia’s Cancer Performance Tracker (CaPTr) 53 Figure 6.12. Italy’s Cancer Performance Tracker (CaPTr) 54 Figure 6.13. Cyprus’ Cancer Performance Tracker (CaPTr) 55 Figure 6.14. Latvia’s Cancer Performance Tracker (CaPTr) 56 Figure 6.15. Lithuania’s Cancer Performance Tracker (CaPTr) 57 Figure 6.16. Luxembourg’s Cancer Performance Tracker (CaPTr) 58 Figure 6.17. Hungary’s Cancer Performance Tracker (CaPTr) 59 Figure 6.18. Malta’s Cancer Performance Tracker (CaPTr) 60 Figure 6.19. The Netherlands’ Cancer Performance Tracker (CaPTr) 61 Figure 6.20. Austria’s Cancer Performance Tracker (CaPTr) 62
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.21. Poland’s Cancer Performance Tracker (CaPTr) 63 Figure 6.22. Portugal’s Cancer Performance Tracker (CaPTr) 64 Figure 6.23. Romania’s Cancer Performance Tracker (CaPTr) 65 Figure 6.24. Slovenia’s Cancer Performance Tracker (CaPTr) 66 Figure 6.25. Slovak Republic’s Cancer Performance Tracker (CaPTr) 67 Figure 6.26. Finland’s Cancer Performance Tracker (CaPTr) 68 Figure 6.27. Sweden’s Cancer Performance Tracker (CaPTr) 69 Figure 6.28. Iceland’s Cancer Performance Tracker (CaPTr) 70 Figure 6.29. Norway’s Cancer Performance Tracker (CaPTr) 71 Figure 6.30. EU’s Cancer Performance Tracker (CaPTr) 72 Figure 6.31. Cancer Performance Tracker (CaPTr) methods table 73
TABLES
Table 1.1. While EU+2 countries closely align national cancer plans with the four pillars of the Europe’s
Beating Cancer Plan, inequalities and paediatrics are not always fully addressed 14
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Acronyms and abbreviations
ASMR Age standardised mortality rate
BGN Bulgarian lev
CaPTr Cancer Performance Tracker
CT Computed tomography
EBCP Europe’s Beating Cancer Plan
eCAN Joint Action on strengthening eHealth for Cancer Patients
ECIS The European Cancer Information System
EU European Union
EU CraNE Joint Action on network of Comprehensive Cancer Centres
EUNetCCC European Network of Comprehensive Cancer Centres
EUR Euro
FIT Faecal immunochemical testing
FTE Full-time equivalent
GDP Gross domestic product
HPV Human papillomavirus
HTA Health Technology Assessment
ICER Incremental cost-effectiveness ratio
MRI Magnetic resonance imaging
NCP National Cancer Plan
OECD Organisation for Economic Co-operation and Development
PET Positron emission tomography
PM Particulate matter
PRAISE-U Prostate cancer Awareness and Initiative for Screening in the European Union
PROMs Patient Reported Outcome Measures
PPP Purchasing power parities
PSA Prostate-specific antigen
PYLL Potential years of life lost
QALY Quality-adjusted life years
SIOPE European Society for Paediatric Oncology’s
SOLACE Strengthening the screening of Lung Cancer in Europe
SPHeP OECD Strategic Public Health Planning model
TOGAS Towards gastric cancer screening implementation in the European Union
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Large variation across countries is seen in both age-standardised cancer incidence and mortality rates.
Cancer mortality rates remain highest in the lower-income countries in the EU but have decreased across
almost all countries between 2011-21. Cancer mortality rates are also much higher among men than
women and among people with low education levels. The combination of population ageing, which
increases cancer incidence, and declining cancer mortality rates is resulting in higher cancer prevalence.
Recognising the growing burden of cancer, most countries have developed national cancer plans that align
closely with the key elements in Europe’s Beating Cancer Plan.
In Europe, the ageing population and lower cancer mortality rates are leading to
an increase in the number of people living with cancer
Every minute, five people in the EU find out they have cancer
According to the European Cancer Information System (ECIS) of the EC Joint Research Centre based on
incidence trends from pre-pandemic years, a total of 2 742 447 new cancer cases were expected to be
diagnosed in the EU in 2022. Estimated age-standardised cancer incidence in the EU is 572 per
100 000 population. Cancer incidence is higher among men (684 per 100 000) compared to women (488
per 100 000) (Figure 1.1), partly due to higher prevalence of cancer risk factors among men. Countries
with the highest incidence rates include Denmark, Ireland, the Netherlands and Croatia. In addition to
cancer risk factors, estimated cancer incidence is influenced by the quality of national cancer surveillance
and coding systems, by cancer screening programmes that can facilitate earlier detection of asymptomatic
cancer cases and by access to diagnostic capacity.
1 Cancer burden
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 1.1. Breast cancer is responsible for almost one in three new cancer cases among women in the EU, while prostate cancer accounts for almost one in four new cases among men
Age-standardised incidence rate per 100 000, EU average, 2022 estimates
Note: 2022 figures are estimates based on incidence trends from previous years, and may differ from observed rates in more recent years.
Includes all cancer sites except non-melanoma skin cancer. Corpus uteri does not include cancer of the cervix.
Source: European Cancer Information System (ECIS). From https://ecis.jrc.ec.europa.eu, accessed on 10 March 2024. © European Union,
2024. The incidence percentage breakdown was re-computed based on age-standardised incidence rates and as such differs from the
percentage breakdown based on absolute numbers shown on the ECIS website.
About half of cancer incidence is driven by four main cancer types: Colorectal, lung,
prostate and breast
In 2022, three cancer sites (prostate, colorectal and lung) accounted for 51% of all age-standardised
cancer cases in men in the EU. A similar share of 51% of cancers among women were caused by breast,
colorectal and lung cancer, with breast cancer accounting for the majority, or 30% of all cancer cases.
Colorectal cancer accounted for a similar proportion of all cancers among men (14%) and women (12%).
In contrast, lung cancer accounted for a greater proportion of cancer cases among men (14%) than women
(9%), related to higher smoking prevalence among men over time.
Prostate cancer incidence varies 2.5-fold and breast cancer incidence 2-fold across
EU countries
Countries with the highest incidence of prostate cancer were Lithuania, Norway and Sweden. Incidence
ranged from 104 per 100 000 in Bulgaria to 265 per 100 000 in Lithuania, 72% higher than the EU average
of 154 per 100 000 population. Prostate cancer incidence is highly influenced by prostate cancer screening
practices, which differ considerably across the EU and may explain the much higher incidence observed
in some EU countries (Vaccarella et al., 2024[1]).
Breast cancer incidence ranged from 88 per 100 000 in Bulgaria to 190 per 100 000 in Luxembourg, 28%
higher than the EU average of 148 per 100 000 population. Other countries with breast cancer incidence
above 170 per 100 000 women were Belgium, Cyprus, France, the Netherlands, Denmark, Finland and
Norway.1 Differences in breast cancer incidence are largely accounted for by differences in prevalence of
obesity and alcohol consumption, as well as genetic factors and cancer screening participation. Some
national data reported in the Country Cancer Profiles indicate concerning trends in incidence, such as an
Breast 30%
Prostate 23%
Colorectum 12%
Lung 14%
Lung 9%
Colorectum 14%
Corpus uteri 5%
Bladder 9%
All other cancer sites 43%
All other cancer sites 41%
0 100 200 300 400 500 600 700 800
Women
Men
488
684
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
increased risk of breast cancer each year from 2012 to 2021 (Finland) or a faster increase in breast cancer
incidence among younger ages (the Slovak Republic), mirroring trends observed in France (Hassaine
et al., 2022[2]) and the United States (Sung et al., 2024[3]).
Men have more than double the lung cancer incidence and 60% higher colorectal cancer
incidence rates than women
Lung cancer incidence in men ranged from 39 per 100 000 in Sweden to 139 per 100 000 in Hungary, 46%
higher than the EU average of 95 per 100 000. Lung cancer rates among women in the EU (at 44 per
100 000) are about half those of men, but there are also large differences among countries, with incidence
ranging from 19 per 100 000 women in Latvia to 79 per 100 000 women in Denmark. While Hungary,
Poland and Croatia have the highest lung cancer incidence among men, it is the Western European
countries of Denmark, the Netherlands and Ireland that have some of the highest rates among women.
Differences in lung cancer incidence are mainly driven by differences in historical rates of smoking
prevalence.
Gender gaps in colorectal cancer are also notable, with men in the EU having average incidence rates at
93 per 100 000, 60% higher than rates among women (58 per 100 000). Similarly, there are large
differences across countries. Hungary had the highest estimated incidence among men (at 138 per
100 000), double the rate of Austria, with the lowest incidence (63 per 100 000). Among women, estimated
colorectal cancer incidence varied even more – from 104 per 100 000 in Norway2 to 38 per 100 000 in
Austria. Differences in colorectal cancer incidence are largely accounted for by differences in prevalence
of obesity, consumption of alcohol and processed foods and cancer screening participation. Similar to
breast cancer, there are concerning trends indicating an increasing incidence of colorectal cancer among
younger birth cohorts in Europe and North America (Vuik et al., 2019[4]; Sung et al., 2025[5]).
According to ECIS, the number of new cancer cases in the EU is projected to grow by 18% from 2022 to
2040. Increases are expected to be greatest for Luxembourg (57%), Ireland (47%) and Malta (44%) and
smallest for Latvia (2%), Bulgaria (3%) and Croatia (4%).
Every minute, cancer kills more than two people in the EU
In EU countries in 2021, 1.15 million people died from cancer, which was the second-leading cause of
mortality on average after cardiovascular disease. The average age-standardised cancer mortality rate in
the EU was 235 per 100 000 population (Figure 1.2), with rates ranging from about 200 per 100 000 in
Malta and Luxembourg to about 310 per 100 000 in Hungary and Croatia. Mortality rates were generally
lower in wealthier countries: 235 per 100 000 in the top tercile compared to 257 in the bottom tercile.3
Age-standardised cancer mortality rates in the EU decreased by 12% on average from 2011 to 2021. All
countries saw decreased cancer mortality for both men and women, except Bulgaria and Cyprus, which
experienced increases for both genders. The largest decreases for men were in Luxembourg (25%),
Norway (23%) and Iceland (22%), while the largest decreases for women were in Luxembourg (24%),
Malta (23%) and Ireland (16%). Higher reductions were seen among the top and middle income terciles of
countries (13% each), as compared to a reduction of 10% in the bottom tercile.
In 2021, the cancer mortality rate was 67% higher among men (308 per 100 000) than women (184 per
100 000). From 2011 to 2021, the cancer mortality rate in men decreased by 16% on average in the EU
compared to an 8% decrease among women. The faster decline in cancer mortality rates among men
partly reflects the large decrease in lung cancer mortality rates among men, who have historically had
much higher smoking rates and lung cancer mortality than women.
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Figure 1.2. While decreasing over the last decade, cancer mortality rates are almost 70% higher among men than women
Age-standardised mortality rate per 100 000 population, 2021
Source: Eurostat Database.
From 2011 to 2021, avoidable mortality fell 16% for breast cancer and 17% for colorectal
cancer
Avoidable mortality refers to deaths among people aged under 75 and includes both preventable deaths
(such as lung cancer) that can be avoided through effective public health and prevention interventions,
and treatable deaths (such as colorectal and breast cancer) that can be avoided through timely and
effective healthcare interventions. On average in the EU from 2011 to 2021, avoidable mortality rates
decreased for breast cancer by 16% among women and for colorectal cancer by 17%, for both men and
women. These decreases suggest improvements in diagnosis and treatment for both cancers.
In contrast, while avoidable lung cancer mortality decreased by 27% among men, it increased by 4%
among females. Decreases among men were seen in all EU countries, ranging from 42% in Sweden to
2% in Cyprus. Among women however, avoidable lung cancer mortality increased in 16 EU countries, and
varied from a 45% increase in Malta to a 29% decrease in Iceland (Figure 1.3). These diverging trends
reflect the fact that although men have historically had higher smoking prevalence, increases in smoking
rates (followed by their subsequent decline) occurred in more recent birth cohorts of women as compared
to men. In addition to a reduction in smoking, improvements in diagnosis and treatment of lung cancer
(See Cancer care performance section) have contributed to improved outcomes in lung cancer for both
genders.
0
50
100
150
200
250
300
350
400
450
500
Total Men Women
-16%
-8%
Men Women
2011-21 change, EU average
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Figure 1.3. Avoidable lung cancer mortality among men decreased in all EU countries, but increased among women in 16 countries
Percentage change in avoidable lung cancer mortality, from 2011 to 2021
Note: Avoidable mortality is based on causes of deaths for those aged under 75. *In Iceland, the relative decline in mortality rates was greater
among women than among men.
Source: Eurostat Database.
Educational inequalities in cancer mortality are much larger among men than women,
and gaps vary greatly across EU countries
Large differences exist in overall cancer mortality by socio-economic status in EU countries, with higher
mortality rates reported among more vulnerable populations. Across 15 EU+2 countries4 with available
data, cancer mortality among men with low education levels was 84% higher (583 age-standardised cancer
mortality rates per 100 000), compared to men with high education levels (318 per 100 000) (European
Commission/IARC/Erasmus MC, 2024[6]). Mortality rates among lower-educated men were over twice
those of higher educated men in Czechia, Estonia, France, Hungary, Lithuania and Poland – while the
smallest gaps (below 45%) were in Sweden and Spain.
Socio-economic gaps in cancer mortality, albeit smaller, also appear among women. Cancer mortality
among women with low education levels was 37% higher (333 per 100 000), than among women with high
education levels (243 per 100 000). The largest gaps in cancer mortality in women were reported in Norway
(82%), Denmark (78%), Czechia (66%) and Estonia (59%), and the smallest gaps, at 10% or lower, were
in Spain, Italy and France. Slovenia was the notable exception that did not report any difference in cancer
mortality in women by education level.
Overall, the social gradient holds true when looking at other cancer outcomes such as cancer incidence
and cancer survival, as well as other markers of vulnerability such as income, geographical location,
migration status or ethnicity. In Ireland for instance, individuals in the most deprived areas faced, on
average, a 43% higher risk of mortality within five years following cancer diagnosis compared to their
counterparts in the least deprived regions. A 2024 study in the Netherlands found that 5-year cancer
survival rates were 10% lower among those from lower income groups compared to those from higher
income groups (Aarts et al., 2024[7]).
Educational inequalities in cancer mortality reflect higher prevalence of modifiable cancer risk factors
among lower socio-economic groups, along with differences in health literacy and knowledge of cancer
risk factors and symptoms. In addition, they reflect lower participation in screening programmes that
-50
-40
-30
-20
-10
0
10
20
30
40
50 %
Men Women
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support earlier detection and may also reflect differences in access to and quality of cancer diagnosis and
treatment (OECD, 2024[8]).
Cancer prevalence in the EU increased by a quarter in the last 10 years, as
improvements in early detection and treatment have increased cancer survival
In 2022, five-year cancer prevalence5 was estimated at 1 876 cases per 100 000 population in the EU
(Figure 1.4), or about two people out of every 100. This ranged from 1 268 cases per 100 000 population
in Bulgaria, which has relatively low incidence and lower survival rates among EU countries to 2 424 cases
per 100 000 in Denmark, which has high incidence but also higher survival.
From 2010 to 2020 the average age-standardised lifetime cancer prevalence in the EU increased by 24%.
The relative increase in cancer prevalence was highest in Latvia (45%), Lithuania (41%) and Estonia
(39%). Conversely, prevalence increases were lowest in Austria (13%), Iceland (16%) and France (17%).
Trends in prevalence are influenced by increased cancer incidence and survival, in addition to
demographic changes (De Angelis et al., 2024[9]). Looking forward, increased population ageing and
further improvements in cancer survival will lead to higher cancer prevalence and more people living with
a history of cancer, calling for investment in quality of life and survivorship programmes.
Figure 1.4. Cancer prevalence increased by over 20% in 24 EU+2 countries over the last ten years
Source: IARC Globocan Database 2024; De Angelis, R. et al. (2024), “Complete cancer prevalence in Europe in 2020 by disease duration and
country (EUROCARE 6): a population-based study”, https://doi.org/10.1016/s1470-2045(23)00646-0.
In virtually all EU countries, national cancer plans align with Europe’s Beating
Cancer Plan
Overall, national cancer plans in EU+2 countries are aligned with the four pillars of Europe’s Beating
Cancer Plan (EBCP): Prevention, Early detection, Diagnosis and treatment, and Quality of life (Table 1.1).
All countries reported having a section of their national cancer plan that is focused on the Prevention pillar,
with the exception of Cyprus, and all have a section dedicated to Diagnosis and treatment.
There is more variability with regards to alignment of national cancer plans with the transversal themes
established by the EBCP (Paediatrics, Inequalities and Research and innovation). France, Poland, Spain
and Sweden had a section specifically focused on each transversal theme of the EBCP in their national
cancer plans and the majority of countries had a national cancer plan with a section focused on Research
0
10
20
30
40
50
0
500
1 000
1 500
2 000
2 500 %Rate
Five-year crude prevalence rates per 100 000 population, 2022 (Globocan), left axis Change in age-standardised lifetime prevalence rates, 2010-20 (EUROCARE-6), right axis
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and innovation. However, only about half of countries had sections specifically focused on Paediatric
cancer and two countries did not address this topic in their plans. Furthermore, most countries lacked a
specific section in their national plans around cancer inequalities, with two countries not covering the topic
at all.
Table 1.1. While EU+2 countries closely align national cancer plans with the four pillars of the Europe’s Beating Cancer Plan, inequalities and paediatrics are not always fully addressed
Adoption of the topic in the National Cancer Plan (NCP), marked by blue (a dedicated section exists), orange (a
section partially covering the topic exists), or pink (not covered)
Pillars of Europe’s Beating Cancer Plan (EBCP) Transversal themes of EBCP Number of full
alignments Prevention Early
detection Diagnosis & treatment
Quality of life
Inequalities Paediatrics Research & innovation
France ● ● ● ● ● ● ● 7
Poland ● ● ● ● ● ● ● 7
Spain ● ● ● ● ● ● ● 7
Sweden ● ● ● ● ● ● ● 7
Croatia ● ● ● ● ● ● ● 6
Czechia ● ● ● ● ● ● ● 6
Germany ● ● ● ● ● ● ● 6
Ireland ● ● ● ● ● ● ● 6
Italy ● ● ● ● ● ● ● 6
Lithuania ● ● ● ● ● ● ● 6
Netherlands ● ● ● ● ● ● ● 6
Bulgaria ● ● ● ● ● ● ● 6
Estonia ● ● ● ● ● ● ● 5
Finland ● ● ● ● ● ● ● 5
Malta ● ● ● ● ● ● ● 5
Norway ● ● ● ● ● ● ● 5
Portugal ● ● ● ● ● ● ● 5
Romania ● ● ● ● ● ● ● 5
Slovenia ● ● ● ● ● ● ● 5
Iceland ● ● ● ● ● ● ● 5
Hungary ● ● ● ● ● ● ● 5
Cyprus ● ● ● ● ● ● ● 4
Latvia ● ● ● ● ● ● ● 4
Luxembourg ● ● ● ● ● ● ● 4
Slovak Republic ● ● ● ● ● ● ● 4
Austria ● ● ● ● ● ● ● 3
Denmark ● ● ● ● ● ● ● 3
Note: Countries are ordered first by the number of alignments and then alphabetical by name. Greece does not have a cancer-specific national
plan, although the National Action Plan for Public Health 2021-25 touches on cancer screening and palliative care for cancer patients. In Belgium,
the Cancer Centre of Sciensano is currently developing the Belgium Cancer Inventory in line with Europe’s Beating Cancer Plan.
Source: Adapted from “Study on mapping and evaluating the implementation of Europe’s Beating Cancer Plan” (forthcoming).
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The EU could prevent millions of new cancer cases in the coming decades through concerted efforts to
meet policy targets on cancer risk factors. In 2021, about 40% of cancer deaths in the EU were attributable
to known behavioural, metabolic and environmental risk factors (Global Burden of Disease Collaborative
Network, 2021[10]). This figure has remained relatively constant over the last decade (at 43% in 2011 and
42% in 2021), although there has been some improvement in the performance of EU countries on various
cancer risk factors. Tobacco use has fallen in almost all countries (although there is concern about a shift
towards e-cigarettes and other new tobacco and nicotine products), and on average, there has been a
small reduction in alcohol consumption. Similarly, progress has been made on reducing air pollution and
in expanding human papillomavirus (HPV) vaccination coverage. However, overweight and obesity and
the accompanying issues of poor diet and low physical activity are growing challenges. Over half of adults
are overweight in the EU and overweight rates among adolescents are increasing, while socio-economic
gaps in overweight rates remain substantial.
Tobacco smoking has decreased in all but three EU+2 countries between 2012
and 2022
Tobacco continues to be the leading driver of cancer cases in Europe, accounting for nearly 20% of all
cancer deaths in the EU in 2021 according to the Global Burden of Disease data tool. The share of daily
smokers among those aged 15+ varies widely across EU+2 countries, with Iceland having the lowest rate
(6%) and Bulgaria the highest rate (29%) (Figure 2.1). Countries in Central and Eastern Europe, along with
France, tend to have the highest smoking rates, while the Nordic countries (Iceland, Norway, Sweden,
Finland and Denmark), along with the Netherlands, have the lowest. Among adults, smoking rates are
higher among men in all EU+2 countries, with an EU average of 23% for men compared to 14% for women.
Intensified efforts to reduce tobacco consumption in recent years, including increases in taxation,
enactment of smoking bans in public places, restrictions on tobacco advertisement, use of visual health
warnings on tobacco products, and treatment to help people quit are paying off. Across the EU the share
of smokers has decreased from 22% in 2012 to 18% in 2022 on average, with all but three EU+2 countries
(Bulgaria, Luxembourg, Malta) seeing reductions. Decreases of more than 5 percentage points were seen
in Czechia, Denmark, Estonia, Finland, Germany, Iceland, the Netherlands, Norway and Poland. In
Czechia and Denmark, reductions in smoking rates reflect policies implemented over the last 5-8 years as
reported in the Country Cancer Profiles, including comprehensive tobacco control legislation, restrictions
on smoking in public places and increases in tobacco excise taxes. In 2024, both Slovenia and Spain
enacted tougher anti-smoking legislation, including further regulation of e-cigarettes (as well as heated
tobacco products in Slovenia), expansion of smoke-free areas, and new warning labels on nicotine
products (Slovenia) or standardised packaging (Spain).
2 Risk factors and prevention policies
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 2.1. Tobacco smoking rates among adults have decreased across almost all EU countries over the past decade
Share of adults (aged 15 and over) reporting smoking on a daily basis
Note: The EU average is unweighted.
Source: OECD Health Statistics 2024.
Alcohol consumption has decreased in two out of three EU countries between
2010 and 2022
Alcohol consumption averaged 10.0 litres per person aged 15 and over in the EU in 2022. Consumption is
highest in Austria, Czechia, Latvia, Romania and Spain (at 11.6 litres or above) and lowest in Finland,
Greece, Iceland, Italy, Norway and Sweden (at less than 7.7 litres). Between 2010 and 2022 there was a
small decrease of 0.3 litres in average alcohol consumption in the EU. Underlying this figure, however, are
major differences, with nine EU+2 countries reporting decreases of 10% or more (Belgium, Croatia,
Cyprus, Denmark, Finland, France, Greece, Ireland and Lithuania), while seven EU+2 countries showed
increases of 10% or more (Bulgaria, Italy, Latvia, Malta, Poland, Romania and Spain).
Trends in tobacco and alcohol consumption among adolescents reflect those
seen in adults
Behavioural patterns often emerge during childhood and become engrained over the life course; thus,
examining risk factors among adolescents provides insight into future cancer risk factors and calls for
greater investments in prevention. For example, adolescent smoking rates tend to be higher in countries
with higher rates of adult smoking, with a correlation coefficient of 0.61 reported among EU+2 countries
(Figure 2.2).
29
25 25 25 23 23 22
21 21
21 20
20 20 19 19 19 17 17 16 16 15 15 14 14
13 12 11
9 8 6
22
0
5
10
15
20
25
30
35
%
2022 (or nearest year) 2012 (or nearest year)
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Figure 2.2. Adolescent smoking is strongly associated with the prevalence of smoking among adults
Note: The EU averages are unweighted. Adults are those aged 15 and over, while adolescents are those aged 15. Data refer to 2022 or nearest year.
Source: OECD Health Statistics; Health Behaviour in School-Aged Children Survey.
Like the trend seen among adults, Figure 2.3 shows that the smoking rate among 15-year-olds in the EU
dropped from 22% in 2014 to 17% in 2022. This trend was seen in all countries except Bulgaria, Romania
and Spain. Among adolescents, girls have slightly higher rates of smoking (18%) compared to boys (16%).
In addition, there is concern that reductions in smoking are partly due to a shift towards e-cigarettes and
other new tobacco and nicotine products. In the EU on average, more than one in five 15-year-olds (21%)
reported using e-cigarettes at least once in the last 30 days in 2022, with rates above 30% in Bulgaria,
Hungary, Lithuania and Poland.
Figure 2.3. Tobacco smoking and drunkenness have decreased among adolescents in the EU
Percentage of 15-year-olds reporting various cancer risk factors
Note: The EU average is unweighted with 26 EU countries for smoking and drunkenness (excluding Cyprus) and 25 countries for overweight
and obesity (excluding Cyprus and Ireland).
Source: Health Behaviour in School-Aged Children Survey.
AT
BE
BG
HR
CY
CZ DK
EE
EU27 FI
FR
DE EL
HU
IS
IE
IT
LVLT
LU
MT
NL
NO
PL
PT
RO
SK
SI ES
SE
R² = 0.38
0
5
10
15
20
25
30
35
5 10 15 20 25 30 Adults - Population prevalence of daily smoking (%)
Adolescents - Self-reported smoking at least once over the last 30 days (%)
22
17
25
23
17
21
10
15
20
25
30
2014 2018 2022
%
Smoking at least once in the last 30 days Drunkenness more than once in a lifetime Overweight or obese
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Alcohol use among adolescents similarly reflects the mixed trend seen among adults. Overall, the rates of
15-year-olds reporting being drunk more than once in their life decreased slightly by 2 percentage points
between 2014-22. The largest decreases, of eight or more percentage points, were seen in Estonia,
Lithuania, Malta, Portugal and the Slovak Republic. In ten of the EU+2 countries, increased rates of
repeated drunkenness were reported between 2014-22 among adolescents. Increases by six or more
percentage points were seen in Austria, Denmark, Germany and Italy. Decreases were driven by boys,
among whom rates decreased from 27% in 2014 to 23% in 2022, while rates remained steady at 23%
among girls.
Countries showing large reductions in alcohol use among adults or adolescents have prioritised alcohol
control initiatives over the past years. In 2011, the Slovak Republic became the first EU country to introduce
minimum unit pricing, followed by Ireland in 2022. Lithuania implemented a 2018 ban on alcohol
advertising, including on social media.
More than half of the adult population is overweight in 23 EU+2 countries, while
overweight rates among adolescents have increased in all but three countries
Despite a slew of polices to address the high rates of overweight and associated issues of poor diet and
low physical activity, the share of overweight adults in the EU remained persistently high (at 51%) in 2022,
close to the 52% figure in 2017. In 2022, there were only six countries that had a self-reported overweight
prevalence of less than 50% of the adult population (Belgium, Cyprus, France, Italy, Luxembourg and the
Netherlands). In Iceland, Latvia and Malta, overweight rates were 60% or above. Men are more likely to
be overweight than women in all EU+2 countries, with overweight rates standing at 60% for men in the EU
compared to 44% of women.
High rates of overweight are driven by poor diets and lack of physical activity. In 2022, about four in ten
adults (40%) in the EU consumed vegetables less than once daily and a similar share (39%) consumed
fruit less than once a day. For both fruits and vegetables, men reported lower consumption than women,
and consumption was slightly lower in 2022 than in 2017. A total of 69% of adults reported engaging in
physical activity less than three times per week in 2022, with rates being fairly similar among men and
women.
Efforts to battle overweight and obesity among adolescents in the EU appear insufficient, with rates
increasing to 21% in 2022, up from 17% in 2014. During this period, overweight and obesity rates increased
in all but three (the Netherlands, Spain and Sweden) of the 25 EU+2 countries with available data. In 2022,
overweight rates among boys were much higher (26%) than among girls (16%). Only three in ten
adolescents reported daily fruit consumption in 2022 (similar to the rate in 2014) and slightly more than a
third (34%) reported daily vegetable consumption, an increase from the 30% rate in 2014. Few adolescents
reported engaging in daily physical activity of at least 60 minutes in 2022 – 15% – a rate similar to that in
2014.
Given the increasing challenge of overweight in EU countries, it is concerning to see the large socio-
economic gaps in overweight rates among women (Figure 2.4). In 2022, 53% of women with low education
reported being overweight, which is 20 percentage points higher than the 33% rate of overweight among
those with high education levels. Gaps of over 25 percentage points between low and high educated
groups were reported in Austria, Croatia, Cyprus, Portugal, the Slovak Republic and Spain. Socio-
economic gaps are large among children as well. In each of the 25 EU+2 countries with available data,
children aged 11-15 in the bottom quintile based on family affluence had higher rates of overweight than
those in the top quintile in 2022, with gaps of over 15 percentage points in Belgium, Bulgaria and
Luxembourg.
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Figure 2.4. While about a third of women with high education levels are overweight in the EU, that figure jumps to over half of women with low education
Percentage of women aged 18 and over with overweight (including obesity), 2022
Notes: Overweight (including obesity) includes those with a body mass index above 25. Low education refers to lower secondary education or
less (ISCED 0-2); high education refers to tertiary education (ISCED 5-8).
Source: Eurostat Database.
To address the overweight challenge, the German federal government’s food and nutrition strategy
introduced in 2024 aims to make healthy and sustainable diets more easily accessible, thereby also
supporting health and contributing to the prevention of obesity. Under this strategy, specific initiatives
supporting healthy diets in daycare centres and schools are being undertaken, among others.
Similarly, recent efforts in Malta and Italy aim to promote physical activity and reduce overweight and
obesity among school-age children, with Italy relying on educational campaigns and collaboration with
industry on food reformulation. Greece launched a National Action Plan for Childhood Obesity in 2023,
while Belgium also has new programmes that provide coverage to dieticians for overweight children and a
three-tier system including multidisciplinary care in recognised paediatric centres for obese children.
Finland, which has the third highest rate of overweight in the EU, is taking a comprehensive approach to
the issue – entailing excise taxes on sugar-sweetened beverages, front-of-package food labelling, school
food regulation and the Fit for Life cross-sectoral project to encourage physical activity among those ages
40+.
Although countries are investing in prevention, additional efforts are needed to
reduce the key cancer risk factors
In 2021, EU countries spent an average of 6.1% of their health spending on prevention policies, such as
informational and educational campaigns, healthy condition monitoring, and disease surveillance (4.6% in
2022). This reflects a substantial increase from spending levels of about 3% between 2014-19, prior to the
onset of the COVID-19 pandemic. However, much of the increase in recent years is attributed to spending
on vaccination and personal protective equipment, rather than wide-ranging public health initiatives aimed
at improving underlying population health.
0
10
20
30
40
50
60
70 %
Total women High education Low education
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HPV vaccination programmes have become gender-neutral in virtually all EU+2 countries
One of the areas that countries have invested in is vaccination against HPV to eliminate six types of HPV-
related cancers including cervical cancer. While many EU countries have been vaccinating girls for HPV
for over a decade, vaccination of boys is more recent. The addition of Estonia in 2024 to this list means
that all but one of the EU+2 countries already have gender-neutral vaccination programmes in place, with
Bulgaria’s updated national programme planning for inclusion of boys in 2025.
HPV vaccination uptake among 15-year-old girls averaged 64% in 2023 in the EU. Figures vary widely
across the 22 EU countries with available data, with rates below 50% in five countries and above 90% in
Iceland, Norway and Portugal. With its relatively low vaccination rate, France rolled out its first school-
based HPV vaccination campaign in 2023, seeing an increase in vaccination rates from 31% to 48% among
12-year-olds between the end of 2022 and the end of 2023. Via the RIVER-EU Project targeting
underserved groups, the Netherlands is developing interventions to increase HPV vaccine uptake among
adolescent girls of Turkish and Moroccan descent while the Slovak Republic is aiming to increase
vaccination among the Roma population. In Romania, which has cervical cancer incidence rates three
times the EU average, efforts include vaccination campaigns around January’s cervical cancer awareness
month and March’s HPV awareness day. A number of countries have implemented catch-up programmes
for those who were not adequately vaccinated at younger ages; for example, in Poland the vaccine is
reimbursed 50% for those older than 18 when purchased at pharmacies and in Sweden, a newer version
of the vaccine is temporarily being offered free of charge to women born 1994-99 in an effort to eliminate
HPV-related cancer by 2027.
Air pollution has decreased substantially over the decade between 2010-20
EU countries have similarly invested in reducing air pollution, with average particulate matter (PM)2.5 levels
decreasing to 11.7 µg/m³ in 2020, down over 30% from the 2010 figure of 16.9 µg/m³. Decreases were
seen in all countries. In Europe in particular, occupational exposure is a large driver of mortality, accounting
for 6% of cancer deaths in the EU in 2021. Reported rates of occupational exposure to chemical products
or substances among those aged 15+ ranged from 17% in the Netherlands to 37% in Poland. Rates were
higher among men than women in about two-thirds of EU countries. Regions in Belgium have different
policies against asbestos in both occupational and residential settings, with Flanders requiring an asbestos
inspection prior to building sales, which can only be undertaken by certified experts. In Poland, the National
Fund for Environmental Protection and Water Management carried out a national programme for safe
removal of asbestos and hosted an asbestos database for 2019-24.
Millions of cancer cases could be prevented in the EU over the coming decades via
concerted action on the key cancer risk factors
Much opportunity remains to reduce risk factors in EU countries in order to lower the cancer burden.
According to the OECD’s Strategic Public Health Planning (SPHeP) modelling work, the biggest potential
lies in meeting tobacco targets. Almost 1.9 million new cancer cases could be prevented in the EU between
2023 and 2050 if tobacco reduction targets were met (Figure 2.5), with over a million cases prevented in
Germany, France, Italy and Poland alone. If alcohol consumption targets were met, an additional 1 million
cancer cases could be prevented during this period. In Sweden and Norway, which already have relatively
low smoking rates, meeting alcohol targets holds the biggest potential for a reduction in cancer cases.
Meeting other risk factor targets would also reduce the number of new cancer cases substantially in the
EU: air pollution by about 430 000 cases and obesity by about 310 000 cases.
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Figure 2.5. Almost 2 million cancer cases could be prevented in the EU between 2023-50 by meeting tobacco reduction targets
Total number of cancer cases prevented between 2023-50 by meeting risk factor targets, by risk factor and country
Note: The target for tobacco is a 30% reduction in tobacco use between 2010 and 2025, and less than 5% of the population using tobacco by
2040. For alcohol, the target is a reduction of at least 20% in overall alcohol consumption and a 20% reduction in heavy drinking (six or more
alcoholic drinks on a single occasion for adults) between 2010 and 2030. For air pollution, it is an annual average PM2.5 level capped at 10 μg/m3
by 2030 and at 5 μg/m3 by 2050. For obesity, the target is a reduction to the 2010 obesity level by 2025.
Source: OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, https://doi.org/10.1787/85e7c3ba-en.
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Screening and early diagnosis increases the proportion of cancers detected at an early stage, improving
the likelihood of a successful response to treatment and contributing to better patient outcomes and more
sustainable health expenditures. Approximately 90% of EU+2 countries introduced population-based
breast cancer screening programmes as of 2022, and three-quarters of them have implemented cervical
and colorectal cancer screening programmes. While an increasing number of countries adopted a
population-based approach to boost participation and to systematically invite the relevant target
populations, uptake has recently stalled or even declined for breast and cervical cancer screening. As the
2022 Council Recommendation was adopted, countries are making efforts to reach out to
socio-economically disadvantaged communities and using outreach activities, self-sampling and digital
solutions to improve accessibility and participation. Moreover, additional cancer screening initiatives for
lung, prostate and gastric cancers are on the horizon, with pilot projects to establish the scientific rationale
for potential screening programmes implemented under the EU4Health Programme 2021-27.
Although cancer screening programmes are expanding and using new outreach
methods, participation rates are stagnating or even declining
Breast cancer screening participation rates have dropped in more than half of
EU+2 countries
The breast cancer screening participation rate reached 56% on average across 24 EU countries with
programme data available in 2022 (Figure 3.1). Participation rates were notably high (above 75% of eligible
women) in the Nordic countries (Denmark, Finland, Sweden and Norway) as well as in Slovenia. In
contrast, fewer than 40% of the target population underwent mammograms in Poland, Latvia, Hungary,
Cyprus and the Slovak Republic, according to programme data.6 Low participation was also observed in
Bulgaria (36%) and Romania (9%) according to 2019 survey data.
Uptake has been declining over the last decade, even prior to the additional challenges posed by the
COVID-19 pandemic. More than half of countries with programme data reported a drop in participation
from 2014 to 2022. During this period, the downward trend was most pronounced in Hungary
(-12 percentage points), Luxembourg (-10 percentage points), the Netherlands (-9 percentage points) and
Ireland (-6 percentage points). In these countries, participation rates were already lower in 2019 compared
to 2014.
3 Early detection
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Figure 3.1. Breast cancer screening coverage declined in more than half of EU+2 countries over the last decade
Breast cancer screening participation rates among the eligible population, by year and data source
Note: The EU average is based on the unweighted average among the 24 EU countries with programme data for 2022 and the 22 EU countries
with programme data for 2014. For the 2014 programme data, different years are referenced for Austria (2015), Poland (2017), Portugal (2017)
and Sweden (2017).
Source: OECD Health Statistics; Programa Nacional para as Doenças Oncológicas (Directorate General of Health, Portugal); Institute of
Oncology Ljubljana, National Institute of Public Health (Slovenia).
Cervical cancer screening rates declined in two-thirds of countries over the last decade
For cervical cancer screening programmes, cross-country variation in participation rates is substantial. In
the EU, based on programme or administrative data, 55% of eligible women were screened for cervical
cancer within the past 3 years in 2022 (Figure 3.2). However, while some Nordic countries (Sweden,
Finland and Norway), as well as Slovenia, Czechia and Ireland recorded high participation rates exceeding
70%, the uptake was poor in Poland (11%), Malta (16%) and Hungary (26%). A similar pattern can be
observed among countries with survey data, as the 2019 uptake ranged widely from a high of 85% in
Austria to a low of 39% in Romania. In Malta, the proportion of women aged 20-69 who were screened for
cervical cancer is much higher based on survey data (at 64%) than programme data (16%), reflecting the
important role of opportunistic screening for cervical cancer in the country.
Similar to breast cancer, falling participation is also evident in cervical cancer screening programmes, with
two-thirds of countries with programme or administrative data registering a decline in uptake during the
period of 2014 to 2022. The size of the decrease is particularly noticeable in the Netherlands
(-19 percentage points), Iceland (-11 percentage points), Hungary (-10 percentage points) and
Luxembourg (-7 percentage points), and these four countries all experienced a falling trend even in the
pre-pandemic years from 2014 to 2019. By contrast, Portugal and Latvia observed substantial
improvement: Portugal saw participation rates rapidly rising from 29% to 60% due to the programme’s
geographic expansion, whereas Latvia’s participation rates nearly doubled to 55%, a possible contributing
factor being that invitation letters became available electronically and eligible women were allowed to
participate without presenting a letter.
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Figure 3.2. Cervical cancer screening participation rates decreased in two-thirds of EU+2 countries
Cervical cancer screening participation rates among the eligible population, by year and data source
Note: The EU average is based on the unweighted average among the 20 EU countries with programme/administrative data for 2022 and the
18 EU countries with programme/administrative data for 2014. For the 2014 programme data, different years are referenced for Poland (2017)
and Portugal (2017).
Source: OECD Health Statistics; Programa Nacional para as Doenças Oncológicas (Directorate General of Health, Portugal); Institute of
Oncology Ljubljana, National Institute of Public Health (Slovenia).
Most EU+2 countries have introduced colorectal cancer screening programmes
A total of 22 EU+2 countries have implemented population-based colorectal screening programmes
(Figure 3.3). Finland, Norway and Sweden joined this list as recently as 2022, whereas Cyprus, Iceland
and Romania are in the process of launching population-based programmes. The 2022 Council
recommendation on screening noted that the faecal immunochemical test (FIT) is considered the preferred
colorectal cancer screening method, although colonoscopy may be used as well for a combined strategy.
In recent years, countries have intensified their efforts to improve accessibility by making self-sampling FIT
test kits more accessible, adopting new technologies and targeting socio-economically disadvantaged
groups.
Based on programme data, the share of the target population participating in colorectal cancer screening
programmes stood at 42% on average across EU countries in 2022. The uptake was highest in Finland
(77%), the Netherlands (68%) and Slovenia (65%). On the other hand, participation rates were less than
a third of the EU average in Portugal (14%) and Hungary (8%). Additionally, 2019 survey data shows a
high participation of 64% in Austria, but limited participation in Cyprus (22%) and Romania (3%).
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Figure 3.3. Colorectal cancer screening programmes have recently expanded in EU countries alongside initiatives to better reach target populations
Colorectal cancer screening programme, launch years and participation rates (colouring) in 2022 or the nearest year
Note: Only participation rates based on programme data are shown in figure. Twenty-two EU+2 countries implemented population-based
colorectal screening programmes as of 2022. Colorectal cancer screening programmes are not population-based in Austria, Iceland, Latvia,
Lithuania and Romania. Bulgaria and Greece do not have a national colorectal cancer screening programme.
Source: OECD Health Statistics; Programa Nacional para as Doenças Oncológicas (Directorate General of Health, Portugal); National Oncology
Institute (Slovak Republic); Institute of Oncology Ljubljana, National Institute of Public Health (Slovenia).
Countries are working to overcome screening inequalities and are making self-
sampling more accessible
Growing evidence reveals that screening participation is significantly lower among socio-economically
disadvantaged groups, including low-income earners, individuals with lower education, rural populations
and people with a migration background. In Iceland, for example, the 2023 uptake of cervical cancer
screening was 72% among Icelandic citizens and 27% among the foreign population. In Sweden in
2019-20, only 64% of women with lower education levels participated in the breast cancer screening
programme in contrast to 82% among women with higher education levels. National data from Germany,
Hungary, Ireland and Sweden also demonstrate that people with low income and people with a low level
of education have a lower likelihood to participate in cancer screening programmes. These countries have
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implemented targeted awareness campaigns to encourage their participation. In addition, the Country
Cancer Profiles note that countries such as Finland, Germany, Ireland, the Netherlands and Norway have
identified low uptake among migrant communities and made screening invitations and guidelines available
in different languages. Slovenia, which has among the highest screening participation rates in the EU, uses
a targeted approach to reach vulnerable populations for each screening programme as well as a general
public communications strategy.
To overcome socio-economic disparities, community outreach and mobile screening solutions are
increasingly adopted by EU+2 countries. France has hired 100 telephone operators to specifically connect
vulnerable groups with the colorectal cancer screening programme since 2024 (see also Figure 3.3). In
Estonia, Germany, Iceland, Ireland, Poland, Romania and Slovenia, mobile breast cancer screening
vehicles are authorised to perform mammography on the spot, often in remote areas. Hungary’s Mobile
Health Screening Programme mainly targets socio-economically disadvantaged communities including the
Roma population, for melanoma, cervical and oral cavity cancers, with records obtained during visits
feeding into the Hungarian e-Health Infrastructure platform.
Moreover, self-sampling kits are increasingly made available to address barriers to screening for
vulnerable populations and to improve the effective inclusiveness of programmes. For colorectal cancer
screening, the FIT kits have become a feasible self-sampling tool. Practical steps differ by country and
region. In France, Luxembourg and the Flemish, Walloon and Brussels regions of Belgium, self-sampling
is available, but individuals can get a test kit from general practitioners (Wallonia), order online (France,
Luxembourg, Wallonia, Flanders), or go to physical pick-up spots such as pharmacies (France,
Luxembourg, Brussels and Wallonia). On the other hand, countries such as Finland, the Netherlands and
Norway, as well as Brussels and the Flanders regions of Belgium, send an invitation with a FIT kit and a
paid return envelope included at the same time (see also Figure 3.3).
When it comes to cervical cancer screening, HPV self-sampling is already used in Denmark, Norway and
the Netherlands: it is optional in the Netherlands, while it is primarily limited to non-responders in the other
countries. In Norway, it is provided through general practitioners to women who face barriers to traditional
screening. Meanwhile, several EU+2 countries are in a pilot phase on HPV self-sampling and the
development has been promising. The Czech pilot has found that this approach supports better
participation from women at risk of poverty and social exclusion. In a Spanish study, HPV self-sampling
turned out to be more used among populations with migrant backgrounds. Belgium is exploring how to
scale up screening via a pilot comparing various HPV self-sampling kit delivery methods such as mail and
GPs.
Digital solutions are also being used to enhance screening awareness and support screening
implementation. Estonia’s digitalised health information system contributes to identifying the target
population, sending screening invitations and reminders, and reaching out to non-participants during their
interaction with healthcare workers. In Poland, the Ministry of Health launched a mobile phone application
in 2021 to inform the target population of screening opportunities. In the Netherlands, cancer screening
data are linked to other information systems to identify the socio-economic and migration status of
individuals in the target population, which then produce performance indicators to ensure quality and
coverage.
Lung, prostate and gastric cancer screening and expanded genetic testing are
under consideration
Consistent with the 2022 update of the Council Recommendation, which proposes to examine
evidence-based feasibility studies to introduce gastric, lung and prostate cancer screening programmes,
a number of EU+2 countries are already operating or about to launch additional screening programmes
for these three cancers. As part of the EU4Health Programme 2021-27, moreover, the TOGAS project (for
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gastric cancer), SOLACE project (for lung cancer) and PRAISE-U project (for prostate cancer) have been
launched to support these screening efforts.
Regarding lung cancer, the cost-effectiveness of the low-dose computed tomography (CT) screening is
recognised in Belgium under specific considerations for a high-risk population of current and recent ex-
smokers aged 50-75 years old (Desimpel F, 2024[11]), and in Sweden, while it is still under examination in
several EU countries. Although not population-based, in October 2020, Croatia became the first country in
Europe to introduce a lung cancer screening programme. It invites active smokers aged 50-70 and former
smokers who quit within the last 15 years to undergo a CT scan every year. Similar targeting is piloted in
Estonia, Germany, Hungary, Italy and Poland, for example.
For prostate cancer, Czechia transitioned to a population-based organised programme in January 2024.
The programme invites men aged 50 to 70 through their registered family doctors or urologists, who are
offered financial incentives to screen this target group. A prostate-specific antigen (PSA) test and a
urological test are performed and, if necessary, a magnetic resonance imaging (MRI) scan will also be
included. Similarly, Latvia and Lithuania introduced national, opportunistic prostate cancer screening in
May 2021 and January 2006, respectively. In Lithuania, guidelines call for men aged 50-69 as well as
those aged 45 and over with a family history of prostate cancer to be tested every 2 years. However, the
screening interval may be stretched to 5 years depending on the individual’s PSA level and age.
Meanwhile, in Latvia, men aged 50-75 as well as those aged 45 and over with a family history of prostate
cancer can be referred for screening every 2 years.
Furthermore, genetic counselling and testing are recommended and offered in a few countries to improve
early detection for individuals with a family history of cancer. Recent evidence suggests that targeted BRCA
genetic testing could be cost-effective for breast and ovarian cancers with an incremental cost-
effectiveness ratio (ICER) of USD 21 700 per quality-adjusted life years (QALYs) compared to no genetic
testing (Koldehoff et al., 2021[12]). Similarly, a meta-analysis of targeted genetic testing for colorectal cancer
finds that the estimated ICERs range from USD 32 322 to USD 76 750 per QALYs (Teppala et al.,
2023[13]). In Italy, all regions are expected to make genetic risk assessment available by the end of 2025.
In Austria, genetic testing is offered in six medical centres for individuals and recommended to those who
have a family history of cancer, have multiple tumours, or cancer occurring at a young age. Predictive
testing is free for patients suspected of hereditary breast and ovarian cancer syndromes.
In addition to screening, early diagnosis to enable the prompt detection of symptomatic people is key to
improving survival rates, patient quality of life and sustainability of health spending. Improving early
detection via fast-track pathways (See Cancer care performance section), raising awareness of cancer
symptoms among the general population, and engaging primary care physicians in early detection efforts
are vital to improving cancer outcomes (OECD, 2024[8]).
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Countries are undertaking different policies, ranging from increasing health professional training capacities,
using online tumour boards, investing in diagnostic and radiotherapy equipment, and implementing
managed entry agreements to improve access to the cancer care system. In parallel, improvements in
cancer survival have occurred in breast, prostate, colorectal and lung cancer, although cervical cancer
survival estimates are stagnant. To improve quality of cancer care, countries are centralising cancer care
at specialised centres supported by larger oncology networks, as well as incorporating use of patient-
reported outcomes and regular quality monitoring. Given that cancer is anticipated to take a large toll on
society in the coming decades, notably through a reduction of the workforce and its productivity and an
increase in mental health disorders, a number of countries are also investing in psychological, social and
occupational rehabilitation to improve the quality of life of people with cancer.
Growing cancer prevalence is driving efforts to improve accessibility and quality
of cancer care
There are shortages in the healthcare workforce involved in primary prevention, early
detection, and management of cancer care
Cancer care has increasingly become more specialised, requiring the collaboration of multidisciplinary
teams across all levels of care. With the growing number of cancer diagnoses, rising cancer prevalence
and efforts to shift health systems towards primary care, general practitioners and nurses play a vital and
expanding role in cancer-related prevention, early detection, rehabilitation, and follow-up. Consequently,
shortages in any links in the care process can create bottlenecks and affect patient outcomes, highlighting
the importance of an adequately staffed and skilled workforce.
Figure 4.1 illustrates the relationship between the number of physicians and nurses per 1 000 cancer cases
across EU+2 countries in 2022. In the EU on average, there are about twice as many nurses (1 376) per
1 000 new cancer cases as there are doctors (679). The Nordic countries (Iceland, Norway and Sweden),
along with Austria, Czechia, Germany, Ireland, Malta and Romania are characterised as having a higher-
than-average number of both doctors and nurses per cancer case. In contrast, many countries in Central
and Eastern Europe, as well as Southern Europe (Croatia, Estonia, Hungary, Italy, Latvia and Poland) are
characterised as having a lower-than-average number of doctors and nurses.
4 Cancer care performance
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Figure 4.1. The availability of nurses per cancer case varies more than 5-fold across EU+2 countries
Note: The data on nurses include all categories of nurses (not only those meeting the EU Directive on the Recognition of Professional
Qualifications). Data refer to practising nurses except in Portugal and the Slovak Republic, where they refer to professionally active nurses. In
Greece, the number of nurses is underestimated as it only includes those working in hospitals. In Portugal and Greece, data refer to all doctors
licensed to practise, resulting in a large overestimation of the number of practising doctors. The EU average is unweighted.
Source: OECD Health Statistics 2024. Data refer to 2022 (or latest available year) for all countries except Luxembourg (2017).
The shortage of general practitioners is particularly pronounced and was identified as an issue in
16 Country Cancer Profiles. Moreover, shortages of medical specialists essential to cancer care, such as
medical and radiation oncologists, radiologists, pathologists, and surgeons, are reported across the
Profiles. Among the 15 countries with available data, the density of medical, radiation or clinical oncologist
was the highest in Italy and Czechia (with more than 6 physicians per 100 000 population) and lowest in
Malta and Bulgaria (with 2 or fewer oncologists per 100 000 population).
In addition, there are significant geographical disparities in the distribution of oncologists within countries,
particularly between urban and rural areas. This is reported in countries such as Austria, Belgium, Czechia,
Greece and Latvia. In Greece, for example, the density of clinical oncologists ranges almost 10-fold from
53 per 1 000 000 population in urban Attica to 5.6 in remote Peloponnese. With nearly two-thirds of
oncology hospitals and clinics concentrated in Athens and Thessaloniki, rural patients face significant
challenges accessing diagnosis, treatment, and follow-up services.
Increasing training capacity, introducing digital solutions and re-envisioning the role of
oncology nurses can help address workforce shortages
Several countries have increased training capacity in cancer care to address shortages and uneven
distribution of the workforce, such as France, Ireland, Italy, Latvia and Norway. France implemented a
significant reform of its medical education programmes in 2017, particularly focusing on cancer specialists,
which led to a doubling of trained medical oncologists and a one-third increase in radiation oncologists by
AT
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2023. Increasing training capacity and recruitment efforts in Norway has led to a rise in the annual number
of newly recognised medical oncologists by almost 50% between 2013 and 2023.
To bridge gaps in underserved regions, some countries have also implemented innovative solutions such
as regional or online tumour boards and multidisciplinary meetings. Iceland extensively uses online tumour
boards to link its limited and geographically dispersed cancer specialists both among themselves and with
international experts. In Austria, the use of teleconsultations by oncologists and other specialists allows for
virtual consultations to discuss symptoms, treatment plans, and therapy progress, reducing travel
requirements and waiting times. Estonia also offers e-consultations with oncologists while Croatia is
expanding teleconsultation to promote multidisciplinary collaboration and enhance access to care in
isolated areas. The EU Joint Action “eCAN” is exploring the impact of teleconsultation and telemonitoring
on cancer care to reduce inequalities across the EU.
To better address the increasing health needs of people with cancer and tackle oncologist shortages,
several countries have started to implement more advanced roles for nurses in cancer care, such as
“oncology nurses” and “nurse co-ordinators”. Denmark and Sweden have well-developed advanced
practice nursing roles in cancer care that help mitigate physician shortages through task-sharing
opportunities. In 2018, France introduced a new two-year master’s degree for nurses, creating the role of
infirmiers en pratiques avancées [advanced practice nurses], with four specialisations: chronic pathologies
(primary care), oncology, kidney diseases and mental health. Specialisation for oncology nursing in Croatia
was initiated and a curriculum proposal submitted to the legislature. Slovenia has introduced nurse
co-ordinators to encourage substitution among healthcare workers at hospitals, while hospitals in
Luxembourg offer a continuous training programme for oncology nurses.
Addressing shortages of different categories of health workers requires a multi-pronged strategy targeting
both supply-side (e.g. expanding education, increasing retention) and demand-side policies (e.g. making
more effective use of the health workforce by changing skill-mix and supporting effective use of
technologies), with the optimal policy mix dependent on each country’s specific circumstances and guided
by a comprehensive workforce strategy (OECD/European Commission, 2024[14]).
Workforce shortages lead to increased waiting times for patients seeking diagnosis, treatment, and follow-
up care for cancer. Despite several countries reporting challenges in maintaining acceptable waiting times,
most struggle with effectively tracking and monitoring them. To address this issue, some countries have
set specific targets and actively monitor waiting times for various aspects of cancer care (Denmark,
Estonia, Finland, Ireland, Lithuania, Latvia, Luxembourg, the Netherlands, Norway, Poland, Portugal and
Slovenia). Additionally, fast-track pathways and referral mechanisms have also been introduced in
countries such as Croatia, Ireland, Lithuania, Latvia, Luxembourg, the Netherlands, Poland and Slovenia
to streamline the patient journey and reduce delays in accessing care. Lithuania, for instance introduced
the “Green Corridor” in 2023, connecting newly diagnosed patients with a dedicated care manager who
provides logistical and emotional support, as well as co-ordinates medical care.
Despite investments in diagnostic and treatment capacity, uneven geographical
distribution and skill gaps hinder access
Access to cancer diagnostic and treatment equipment is crucial for cancer care across EU+2 health
systems. Over 2012-22, EU countries registered substantial increases in the number of CT scans (28%),
MRIs (58%), and positron emission tomography (PET) scans (53%) per million inhabitants. Some of these
developments have been supported through joint efforts between countries and the EU. Portugal, for
example, is leveraging Recovery and Resilience Plan funds to increase and renew dated therapy and
imaging equipment and introduce new capabilities like robotic surgery across its national health service.
The density of radiotherapy equipment varies almost 3-fold among the 22 EU+2 countries with available
data, ranging from slightly less than 5 per million people in Portugal to 12 per million people in the
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Slovak Republic (Figure 4.2). Countries in the top economic tercile had an average radiotherapy
equipment supply of 8.8 per million people compared to 7.3 per million among countries in the bottom
economic tercile. Over the decade between 2013-23, most countries have also prioritised increasing
radiotherapy equipment. Bulgaria and Poland reported the highest increases (by 60% or more), while
Sweden, Iceland and Denmark experienced a decrease in the volume of radiotherapy equipment over the
same period.
Figure 4.2. Volume of radiotherapy equipment varies almost threefold across EU countries
Volume of equipment per 1 000 000 population
Note: The vast majority of radiotherapy equipment in EU countries is found in hospitals. Data for Portugal and France include equipment in
hospitals only while data for other countries refer to all equipment.
Source: OECD Health Statistics 2024.
Effective access to radiotherapy treatment can be restricted due to poor geographical distribution of
equipment, health workforce shortages and cost-sharing arrangements. Uneven geographic distribution of
diagnostic and treatment capacity is evident in countries such as Belgium, Cyprus, Czechia, Estonia,
Finland and Italy. To address this issue, several countries have pursued policies such as providing financial
support for travel or hotel costs (Ireland, Finland and Romania).
In addition, the low supply of a specialised health workforce and gaps in skills necessary to operate
equipment and provide treatment hinder effective access to medical equipment. Shortages of radiation
therapists and radiologists have, for example, been reported in Bulgaria, Czechia and the Slovak Republic.
In the Netherlands, a shortage of personnel in 2021 led to an increase from two to three years in the
invitation cycle for mammography screening, alongside campaigns and investments to boost the supply of
technicians. In Sweden, the decrease in available radiation therapy equipment over the last decade has
been attributed to the lack of specialised health personnel.
There is a three-fold difference in the reimbursement of cancer medicines with a high
clinical benefit across EU+2 countries
Alongside radiotherapy, traditional chemotherapy and novel medications are a mainstay of cancer
treatment. However, national coverage of cancer medications and the timelines for making coverage
decisions vary widely among EU countries. The proportion of indications among a sample of new cancer
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medicines for breast and lung cancers with high clinical benefit that are reimbursed stood at 100% in
Germany, 92% in the Netherlands, and 85% for both Bulgaria and Sweden (Hofmarcher, Berchet and
Dedet, 2024[15]). In contrast, Malta did not reimburse any indications, while Cyprus and Latvia reported that
only about a third of indications were covered (both 31%). Both Malta and Cyprus however had some
indications available through named-patient early access programmes. Time from European-wide
marketing authorisation of an indication until national reimbursement approval also ranged widely – from
around 100 days or less in Germany and Sweden to more than three years in Cyprus, Latvia and Lithuania.
Similarly, among 19 biosimilars of three cancer medicines, the share reimbursed also exhibits substantial
differences across countries. In Malta, only three biosimilars (16%) are available on the Government
Formulary while in Estonia, that figure stood at 100%. However, all countries had at least one biosimilar
reimbursed for each of the three medicines examined. Considering countries’ GDP per capita, there is a
positive correlation between higher-income countries and share of public reimbursement of new oncology
medicines. The reverse holds true for biosimilars, which are cost-saving alternatives to original biologics.
Performance- or financial-based managed entry agreements are available across most countries to help
patients gain faster access to new cancer medicines despite limited or immature evidence, while controlling
the budget impact on health spending. Other efforts aimed at addressing potential barriers to patient
access of new cancer medicines include population-based early access schemes (e.g. Cyprus), creating
specific budgets to finance pharmaceutical innovation (e.g. France), centralisation of price negotiations
and increases in reimbursement ceilings (e.g. the Slovak Republic), and joint health technology
assessments (HTA) to evaluate cost-effectiveness of new oncology medicines (such as the Beneluxa
initiative or the Joint Nordic HTA-bodies). The implementation of Regulation (EU) 2021/2 282 on HTA from
2025 is a step forward in this direction, mandating collaborative clinical assessments and scientific
consultations involving patients, clinical experts and relevant stakeholders.
Out-of-pocket costs can be an obstacle in accessing cancer care
In addition to national medication coverage decisions and supply of medical equipment, the degree of cost-
sharing can significantly impact access to cancer care, especially for less affluent populations. Although
out-of-pocket payments (based on EUR PPPs) have decreased by 11% in the EU in 2012-22, they still
account for 15% of all health spending in 2022. While a broad range of cancer care is publicly financed,
the Country Cancer Profiles show that financial barriers persist in accessing certain services.
For instance, in Bulgaria, a 2024 survey revealed average copayments of BGN 1 465 (EUR 733) for cancer
treatment, with surgery accounting for the largest share. Until November 2023, 44% of CT scans and 21%
of MRI scans in Belgian hospitals incurred fee supplements, while in Finland, patients face copayments
for sequential therapy in hospitals. Financial barriers also extend to other aspects of cancer care, such as
copayments for screening activities in Iceland and reliance on private financing for genetic testing to identify
optimal treatment and for palliative care services in the Slovak Republic.
Improvements in survival estimates and cancer care quality initiatives are
evident across EU countries
Estimated cancer survival has improved over the past years, although the pace of
progress varies substantially by cancer site
Cancer survival estimates are the best indicator of care quality, since they reflect the health system’s ability
to detect cancer at earlier stages and provide access to effective treatment. Based on the 17
EU+2 countries that had recently available survival estimates reported in the Country Cancer Profiles,
there has been an improvement in five-year survival. For example, in the Netherlands, the estimate of
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
overall five-year relative survival increased from 53% in 1995-2004 to 67% in 2015-22. In Estonia, five-year
relative survival estimates increased over the most recent ten-year window, from 54% in 2007-11 to 58%
in 2017-21, while estimates in Latvia increased to 48% in 2017-22 from 44% a decade prior. In Slovenia,
five-year survival estimates for patients diagnosed in 2012-16 improved for both genders compared to a
decade earlier, although improvements among men (46% to 56%) were larger than among women (58%
to 60%).
According to data presented in the Country Cancer Profiles, lung cancer (which has low survival rates),
has seen the largest increase in survival estimates among the main cancer types. Notable improvements
were seen in all 15 of the EU+2 countries with available trend data. In Ireland, the estimated five-year net
lung cancer survival stood at 24% in 2014-18 and in Denmark, the estimated lung cancer survival among
men stood at 25% and at 32% among women in 2017-21. In both Ireland and Denmark, 5-year survival for
lung cancer almost doubled or more compared to the previous decade.
Survival estimates tend to be highest for breast and prostate cancers. Five-year survival estimates have
moderately increased in all countries for breast cancer and in the majority of countries for prostate cancer
where data is available. In Austria, estimated prostate cancer survival improved from 84% to 94% during
the 20-year window leading up to 2014-18, while in Finland, it increased from 93% to 95% in the nine years
between 2011-13 and 2020-22.
Unlike breast cancer, there are concerning trends in survival for cervical cancer. Over the last 10-20 years,
there has been a stagnation in five-year survival estimates for cervical cancer in most of the 12
EU+2 countries with available data, even though cervical cancer survival estimates were already notably
lower than those of breast cancer. Some countries have even seen worsening survival estimates. Iceland
has seen particular improvement in breast cancer five-year survival estimates, increasing from 75% to
88% in the ten-year period between 1998-07 to 2008-17. In contrast, data from the Icelandic Cancer
Registry shows that estimated five-year survival rates for cervical cancer in the country have fallen from
69% to 67% during this period. Similarly, Croatia has seen breast cancer survival estimates increase to
84% in 2016-20 while cervical cancer survival estimates have decreased slightly to 61%, as compared to
figures in 2011-15. In Germany, breast cancer survival remained stable between 2009-10 (87%) and
2019-20 (88%) while cervical cancer survival decreased by 4 percentage points from 68% to 64% during
this period.
Screening programmes play a role in survival rates. Notable improvement in five-year survival estimates
for colorectal cancer for all countries with available data comes alongside the introduction of population-
based colorectal screening programmes in numerous EU countries over the past 15 years (see Section 3).
Given that breast cancer screening participation rates have fallen over time in many EU countries,
improved breast cancer survival estimates may relate to better treatment options that are compensating
for the challenges in uptake of breast cancer screening. For cervical cancer however, the decrease in
screening participation in the majority of EU countries may be contributing to stagnation in survival rates
for this cancer.
Between 2012 and 2022, premature mortality due to cancer has fallen by almost 20%
In addition to survival data, potential years of life lost (PYLL) is an interesting complementary measure of
the impact of different cancers on society, because it puts a higher weight on cancer deaths among
younger individuals. Examining the change in PYLL over time across various cancer sites can point to
improvements in cancer care systems (prevention, early detection and/or treatment) via reductions in
premature mortality. In 2022, cancer was responsible for 1 355 potential years of life lost per
100 000 population in the EU, which is a decrease of 19% compared to the 1 679 figure in 2012. Decreases
were seen in all EU countries, signifying improvements in cancer care across countries.
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Decreases in PYLL were seen on average in the EU across the main cancer types, with the largest
decrease (28%) seen in lung cancer (Figure 4.3). This decrease is likely due to reductions in smoking rates
over the years as well as the improvements seen in lung cancer survival. Similarly, reductions in colorectal
(13%) and breast cancer (14%) PYLL may be related to improvements in treatment, which have increased
survival rates and have come alongside introduction or expansion of population-based colorectal cancer
screening. In contrast, given the stagnant cervical cancer survival rates seen over time in EU countries,
the large reduction in PYLL from cervical cancer (21%) could point to effectiveness of the introduction and
expansion of HPV vaccination programmes over the years.
Figure 4.3. Over the last decade, there has been a reduction in potential years of life lost across all main cancer sites
Note: The rate of PYLL from breast, cervical and ovarian cancer is calculated in women only, while the rate of PYLL from prostate cancer refers
to men. The size of the bubbles is proportional to the PYLL rates in 2022 (or latest available year).
Source: OECD Health Statistics 2024.
Development of concentrated cancer care is a key priority for EU countries
Recognising the benefits of the concentration of cancer care in terms of patient outcomes, countries have
been moving towards organising cancer care around specialised care centres supported by broader cancer
networks.
Specialised cancer care has been centralised in Czechia since 2008, and as of 2022, such centres must
ensure co-ordination of the full spectrum of cancer care within their regional network. A similar centralised
care model with national and regional networks exists in Finland, while in Denmark, a comprehensive
cancer centre was established in 2017 to centralise national efforts on cancer research, prevention and
treatment.
Some countries are implementing important changes towards centralisation of cancer care. In Greece, it
was announced that Agios Savvas Hospital will become the country’s first comprehensive cancer centre.
In recent years, both Germany (2024) and the Slovak Republic (2021) have decided on or launched major
hospital reform efforts geared at centralising specialty care, including based on minimum volume
requirements. In addition to greater care concentration, the reforms also aim to improve cancer care via
allowing patients to compare hospitals on various criteria (Germany) and via the development of quality
indicators (the Slovak Republic). To leverage national efforts on a larger scale across borders, the Joint
Action CraNE laid the groundwork to establish the first Network of Comprehensive Cancer Centres in the
Lung
Colorectal
Pancreas
Stomach
Cervix uteri Breast
Ovary
-35%
-30%
-25%
-20%
-15%
-10%
-5%
0%
5%
0 50 100 150 200 250 300 350
Potential years of life lost per 100 000 population
Percentage change in potential years of life lost 2012-22 (or nearest available year)
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
EU. The work has been continued in the follow up Joint Action, EUnetCCC, started in October 2024. All
EU member states plus Norway, Ukraine, Moldova and Iceland are partners to this project.
Countries are upgrading data infrastructure and starting to collect patient-reported
outcomes to improve the quality of cancer care
EU countries are improving care quality via a range of methods such as enhancement of data infrastructure
for cancer control, implementation of multidisciplinary tumour boards, use of clinical guidelines, and
assessments and measurement of quality indicators. Italy has an observatory for monitoring the quality of
Regional Oncology Networks, including assessing their ability to meet cancer care pathways designed to
promote timely diagnosis and high-quality care across regions. In Lithuania, the existing health information
system was upgraded in 2023-24, and can now monitor the cancer patient’s diagnosis (for cervical, colon
and breast cancers) and treatment pathway over time. Romania is at an earlier stage in its cancer quality
processes but has made significant recent strides by developing patient pathways for major tumours and
undertaking efforts to establish a national cancer registry by 2025.
Countries are also increasingly recognising the importance of patient-reported outcome measures
(PROMs), although many have not yet implemented standardised, national processes to collect such
information. In Denmark, prostate and breast cancer-specific PROMs are reported at the regional level
while many of Sweden’s 30+ cancer quality registries also incorporate information on patient-reported
outcomes and experiences. Austria collected patient-reported measures for hospitalised patients, including
those with cancer, in 2022, and has various local initiatives underway, including a digital PROMs reporting
tool for young cancer patients at the Medical University of Innsbruck.
The increasing cancer burden has wide-ranging impact on the health system and
the economy
As populations age and the number of cancer diagnoses increases, per capita
healthcare spending on cancer is projected to increase by 59% in the EU
Cancer imposes a direct financial burden on societies through healthcare expenditures related to its
treatment. As populations age and the incidence of cancer increases, the prevalence of cancer is expected
to rise, leading to larger associated treatment costs. According to OECD SPHeP modelling work, per capita
health expenditure on cancer care is projected to grow by an average of 59% in the EU between 2023 and
2050 (OECD, 2024[16]). Assuming the current standard of care and cost per case of cancer remain the
same, the growth in per capita health expenditure on cancer is projected to be the lowest in Sweden,
Finland, Denmark and France – at less than 36% (Figure 4.4). By contrast in Cyprus, Spain and Poland,
the per capita health expenditure on cancer care is projected to grow by an average of more than 80%.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 4.4. On average in the EU, health expenditure on cancer is projected to increase by more than 50% in 2050 compared to 2023
Projected increase in per capita cancer health expenditure, in real terms, from 2023 to 2050
Note: The EU average is unweighted.
Source: OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, https://doi.org/10.1787/85e7c3ba-en.
The burden of cancer not only includes the cost associated with treating cancer, but also cancer’s broader
impact on other healthcare expenditures as it affects other conditions such as mental health or the need
for rehabilitative care. Looking at the burden of cancer on total health expenditure, the OECD SPHeP
modelling work shows that on average over the period 2023-50, health expenditure in 19 EU+2 countries
is estimated to be 7.0% higher due to the presence of cancer. Per person adjusted for purchasing power
parities (PPPs), this equates to EUR PPP 242 per year. Countries with higher average health expenditure,
like Norway, the Netherlands, Germany and Sweden also see higher per capita health spending due to
cancer, above EUR PPP 400 per year.
Cancer is projected to reduce workforce participation and productivity
Beyond its burden on health systems, cancer has a large impact on the economy via its effects on
workforce participation and productivity. People diagnosed with cancer often need to take leave from work
for treatment, recovery, and medical appointments, reducing employment. In addition, people with cancer
may experience fatigue, mental health impairments, and other side effects that can impact their ability to
work effectively, leading to absenteeism and presenteeism (OECD, 2024[16]). According to OECD SPHeP
modelling work, between 2023 and 2050, cancer is expected to lead to a loss of 178 full-time equivalent
(FTE) workers per 100 000 people on average in the EU, due to the need to reduce employment
(Figure 4.5). In addition, a loss of 38 and 43 FTE workers per 100 000 people is also anticipated due to
absenteeism and presenteeism, respectively.
Based on the countries’ average wages, this equates to a loss in workforce output of EUR PPP 49 billion
per year for EU countries. On a per capita basis, EU countries lose on average EUR PPP 161 per year
(OECD, 2024[16]).
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 4.5. Cancer is expected to have a large impact on workforce participation and productivity
Projected reduction in full-time equivalent workers due to cancer per 100 000 population, average over 2023-50
Note: The EU average is unweighted.
Source: OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, https://doi.org/10.1787/85e7c3ba-en.
Addressing the issue of well-being and workforce participation among people with cancer is key to
minimising income loss at both the micro and macro levels. There are various policies reported in the
Profiles, ranging from workplace adaptations, psycho-social support in the workplace or physical activity
interventions that have been shown to increase return-to-work rates among people with cancer. Return-
to-work programmes are reported in Belgium, Czechia, Finland, France, Germany, Hungary, Iceland,
Luxembourg, the Netherlands, Portugal and Slovenia. Return-to-work programmes are also key to promote
improved quality of life of people with cancer and social reintegration. Germany has invested in
occupational rehabilitation, including continuing education and training for people who need to change
their profession following a cancer diagnosis. The country also offers opportunities for gradual reintegration
into the workplace, including specifying different stages of workload during which people can continue to
receive sickness benefits. In Belgium, initiatives that support a return to work following cancer include the
Kankerenwerk website, financed by the non-governmental organisation Kom Op Tegen Kanker, which
provides information to assist employers and employees in the reintegration process. Hungary has adopted
policies guiding labour market reintegration of people who were previously ill.
Given increasing cancer prevalence, countries are developing follow-up and
rehabilitative care, and implementing policies to address quality of life
Cancer is expected to reduce life expectancy by 1.9 years in the EU and result in an
additional 85 000 more people with depression symptoms annually
Cancer is one of the main causes of death and disability in EU countries, and has a significant impact on
well-being through reducing life expectancy and increasing mental health disorders. According to OECD
SPHeP modelling work, between 2023 and 2050, cancer will reduce population life expectancy on average
by 1.9 years in the EU compared to a scenario without cancer. In some countries this figure is as high as
2.3 years (France, Denmark, Hungary and the Netherlands) (Figure 4.6).
-400
-300
-200
-100
0
Employment (combining unemployment and part-time) Absenteeism Presenteeism
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Recent evidence suggests that cancer-specific disability led to a decline in healthy life expectancy,
reducing the number of years that a person lives in full health (OECD, 2024[16]). On average in the EU,
cancer reduces healthy life expectancy by 1.6 years, related to activity limitations of cancer from symptoms
like fatigue, pain and nausea.
Figure 4.6. Cancer is projected to reduce life expectancy by between 1.4 and 2.5 years across EU countries
Projected reduction in years of life expectancy due to cancer, average over 2023-50
Note: The EU average is unweighted.
Source: OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, https://doi.org/10.1787/85e7c3ba-en.
In addition, cancer takes a substantial toll on the mental health of the population, through its associated
symptoms and treatment side effects, and impact on daily life, social roles and work. According to the
OECD’s SPHeP model, it is estimated that cancer leads to an additional 85 000 cases of depression
annually in the EU. This equates to an age-standardised rate of 17 cases per 100 000 people per year.
This rate varies significantly across countries, from roughly 5 per 100 000 people per year in Poland to
31 per 100 000 people in Portugal.
The impact of cancer on the mental health of the population is also reflected in national data. In Greece, a
2022 study showed that 80% of cancer patients receiving chemotherapy reported feeling of anxiety, fear
and fatigue, 30% reported depressive symptoms and more than 60% reported major challenges in
performing social activities.
Improving quality of life for people with cancer is a policy priority in many EU countries
A range of policies can contribute to increasing quality of life for people living with cancer, including greater
efforts to address psychological health needs, investments in expanded palliative care services in hospitals
and the community, and better management of cancer through rehabilitative care or improved health
literacy.
As reported in 25 Country Cancer Profiles, mental health support for people with cancer has been
extensively developed over the past years. Portugal ensures access to psychological evaluations and at
least five counselling sessions annually for cancer patients and their families. Norway and Sweden have
-2.5
-2
-1.5
-1
-0.5
0
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
mental health support networks, ensuring timely access to psychological care for cancer patients. Ireland
and Belgium have developed specialised psycho-oncology services, incorporating mental health care into
standard cancer treatment, enhancing patients’ overall well-being, with Ireland publishing a
psycho-oncology model of care in 2023 specifically designed to identify and provide for the comprehensive
needs of children, adolescents and young adults with cancer.
Palliative care, which focuses on alleviating suffering and enhancing the quality of life for patients with
life-threatening conditions, is a key lever to meet the physical, emotional, and spiritual needs of cancer
patients. Belgium, Germany, Ireland, Lithuania, Luxembourg, the Netherlands and Sweden have well-
developed palliative care systems, with services fully integrated into their national healthcare systems and
covered by public health insurance. These countries provide comprehensive care both in hospitals and
through community-based services, ensuring that palliative care is accessible and free of charge for those
in need. Estonia and Slovenia are also investing in training health professionals, increasing awareness of
palliative care, and developing a national palliative care services model, while Croatia has established
mobile palliative care teams operating across its 21 counties and practical palliative care learning
programmes in health centres. In 2020, Lithuania introduced a requirement that palliative care is available
24/7 and increased the number of reimbursable visits for outpatient palliative care services.
Development of supportive cancer care and health literacy programmes are also being integrated in the
care pathway of cancer patients. France for example provides supportive oncology care as part of the
cancer care pathway. The supportive care package is comprised of nine services, including four core
services (pain management, dietary support, psychological support and social, family and professional
support) and five supportive services (physical activity, fertility preservation, management of sexual
disorders, lifestyle advice, and psychological support for relatives and informal caregivers). Iceland focuses
on rehabilitation services for people with cancer based on a holistic assessment of the individual’s well-
being to provide counselling, lectures, and educational materials about regaining and maintaining the best
possible physical functioning, health and quality of life. Portugal has launched a patient resource guide
focusing on cancer literacy and informing patients of their rights and available resources.
In addition, protecting people from discrimination based on their medical history, and ensuring fair
treatment in areas such as employment, insurance and financial services can help promote social
inclusion, emotional well-being and financial security. In October 2023, the Directive (EU) 2023/37 was
introduced to reinforce the “right to be forgotten”, ensuring that health information after a certain period of
cancer survival cannot be used for assessing financial creditworthiness. Eight EU countries already had
such a “right to be forgotten” in place before this Directive (Belgium, France, Italy, Luxembourg, the
Netherlands, Portugal, Romania and Spain), with disclosure requirements ranging from limits of five to
ten years.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Over 50% of new cancer diagnoses among children stem from three main cancer
types: Leukaemia, brain and non-Hodgkin’s lymphoma
According to ECIS, it is estimated that 4 161 girls and 5 000 boys up to age 15 were diagnosed with cancer
in 2022 in the EU, for an age-standardised incidence rate of 13.7 per 100 000 (Figure 5.1).
Age-standardised incidence rates are slightly lower among girls (12.8 per 100 000) than boys (14.6 per
100 000). The most common cancer is leukaemia, representing a little under a third of childhood cancers
in the EU (31%), followed by brain and central nervous system cancers (15%) and non-Hodgkin’s
Lymphoma (8%). Eurostat data shows that 3-year average age-standardised mortality rates from cancer
among children stood at 2.1 per 100 000 in the EU as of 2021, with rates ranging from 0.5 (Iceland) to 3.4
(Malta).
Figure 5.1. The paediatric cancer mortality rate in the EU stood at 2.1 per 100 000 children
Age-standardised incidence (estimates) and 3-year average paediatric cancer mortality rates per 100 000 population
Note: 2022 incidence estimates are based on incidence trends from previous years, and may differ from observed rates in more recent years.
Incidence data includes all cancer sites except non-melanoma skin cancer. Incidence and mortality rates refer to children aged 0-14.
Source: European Cancer Information System (ECIS) for cancer incidence. From https://ecis.jrc.ec.europa.eu, accessed on 10 March 2024. ©
European Union, 2024. Eurostat Database for cancer mortality.
0
1
2
3
4
0
5
10
15
20
Mortality rateIncidence rate
Incidence per 100 000 population, 2022 (left axis) Mortality per 100 000 population, 3-year average, 2021 (right axis)
5 Spotlight on paediatric cancer care
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
In 12 EU+2 countries, paediatric cancer patients had access to less than 5% of
oncology clinical trials running in Europe
In Europe between 2010 to 2022, there were 436 oncology clinical trials that enrolled children and young
people, 76% of which involved novel agents. However, access to these trials varied widely by country. The
greatest access was in France, which had 226 paediatric oncology trials (or 52%) taking place in the
country, followed by Spain (43%) and Italy (41%). In contrast, 12 EU+2 countries had each less than 5%
of paediatric oncology clinical trials running in their country (SIOPE, 2024[17]). Access to trials is related to
the population size of a country and the number of paediatric cancers diagnosed, with larger countries
having more paediatric cancer cases and greater access in clinical oncology trials.
Assessing the availability of medicines that are most critical to paediatric oncology care in EU countries
also reveals substantial cross-country disparities. On average, 76% of essential medicines for treatment
of paediatric cancer were available across EU countries in 2018 (Vassal et al., 2021[18]). Access to less
than 60% of essential medicines for treatment of paediatric cancer was reported in five countries: Romania,
Estonia, Latvia, Lithuania and Bulgaria.
The European Society for Paediatric Oncology (SIOPE) evaluated the availability of 13 treatment
modalities and infrastructure for treating paediatric cancer (SIOPE, 2024[17]). Six countries in the top
income tercile (Austria, Belgium, Denmark, Germany, the Netherlands, and Sweden) have all 13 modalities
available, as do four countries in the middle income tercile (Czechia, France, Italy, and Spain). Only one
country (Poland) in the bottom income tercile had all treatments available within the country. However, the
fewest number of treatments available was in the low population countries of Malta and Luxembourg. In
the 27 EU+2 countries assessed, all provided both inpatient and outpatient chemotherapy as well as
surgery for both solid and central nervous system tumours within the country. Paediatric palliative care
was available in all but one country (Greece) and paediatric survivorship clinics were available in
21 countries. Proton radiation therapy was available in the least number of countries – only 11 – followed
by brachytherapy (17) and access to phase I/II treatments (19).
Through bilateral agreements, EU countries with a low number of paediatric cancer cases may arrange
referral of patients to larger treatment centres in neighbouring EU countries. Estonia relies on international
collaboration to ensure access to proton therapy and the Estonian Cancer Control Plan 2021-30 prioritises
improved international co-operation and expansion of access to treatments and clinical trials for paediatric
patients. Iceland funds travel and care costs in other Scandinavian countries for treatment of rare cancers
and in Malta, paediatric cancer patients are referred for care abroad via the Treatment Abroad Unit if the
recommended treatment is unavailable in the country. Such arrangements, which support countries that
have gaps in access to certain treatment modalities, could also be developed to help to address the
challenges of low access to paediatric clinical trials.
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Overview: This section includes a Cancer Performance Tracker (CaPTr) for each of the 27 EU countries,
Iceland and Norway that summarise performance on key indicators in the following domains: cancer
prevention, cancer early detection, cancer care capacity and cancer care outcomes. Each tracker (from
Figure 6.1 to Figure 6.29) shows the position of the country relative to the EU average, minimum and
maximum values on each indicator. If comparable national data is not available, the indicator is not shown
for that country. For most indicators, performance refers to 2021, 2022, or 2023, or nearest available year.
The tracker also shows the change in performance over time where trend data is available and relevant.
Moreover, Figure 6.30 shows the distribution of countries by indicator and Figure 6.31 shows the
definitions, time period assessed, number of countries in the EU average, and source for each indicator.
Colours are used to indicate performance compared to the EU and over time:
• Blue lines connect indicator dots when the country’s performance is better than the EU average;
blue text in “Trend over time” column refers to any improvement in performance;
• Pink lines connect indicator dots when the country’s performance is worse than the EU average;
pink text in “Trend over time” column refers to any deterioration in performance;
• Grey lines and grey text for “Trend over time” are used for cancer care capacity, as most indicators
cannot be classified as better or worse and thus no value judgement is made.
EU average: EU averages are weighted for overweight and obesity, air pollution, cancer mortality, and
educational inequalities but unweighted for all other indicators. EU averages do not include Iceland and
Norway.
Age-standardisation: Cancer mortality rates are reported as age-standardised to the revised European
standard population adopted by Eurostat in 2013.
Specific indicator comments:
Screening: The EU average shown in each tracker is based on programme data. For the following
screening sites and countries, the value and trend refer to 2019 survey data as programme data are not
available:
• Breast: Bulgaria, Greece and Romania;
• Cervical: Austria, Bulgaria, Croatia, Cyprus, Germany, Greece and Romania;
• Colorectal: Austria, Cyprus, Greece, Germany and Romania.
Workforce: Workforce data and definitions can be found in Figure 4.1.
Survival: To allow for cross-country comparison purposes, cancer survival estimates used in the trackers
come from the CONCORD-3 project, while the survival estimates used in the Country Cancer Profiles and
the Synthesis report are based on more recent national data.
6 Cancer performance trackers
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.1. Belgium’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on radiation therapy
equipment. *Please see Figure 6.31 for information on trend.
Min
EU
BE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.5 pp
Alcohol consumption Litres per capita, population aged 15+
-11 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-34 %
HPV vaccination % of girls aged 15
+11 pp
Breast cancer screening % of target population
-1.8 pp
Cervical cancer screening % of target population
-0.8 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+73 %
MRI units per 1 000 000 population
+9 %
Cancer mortality ASMR per 100 000 population
-18 %
Colorectal cancer mortality ASMR per 100 000 population
-29 %
Breast cancer mortality ASMR per 100 000 women
-25 %
Lung cancer mortality ASMR per 100 000 population
-25 %
Cancer PYLL years per 100 000 population
-24 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.6 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+1.6 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+2.8 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
15.4 6.2
10.0 11.9
9.2 6.3
51.3 62.5
48.9 41.9
11.7 17.8
11.1 4.9
6.1 10.4
3.1 1.2
679 1 094
571 499
3 462 1 8591 376
641
4911
2626
18 38
12 6
64 96
72 7
56 83
57 9
55
85
55
11
42
77
52 3
59 100
77 0
235 310
220 198
72 6860
49
1815 208
83 93
86 74
50 21 27
19
31 37
31 22
47 78
49 33
1 355 1 961
1 113 826
37 106
43 18
44
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.2. Bulgaria’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for colorectal cancer
screening. Breast and cervical cancer screening values for Bulgaria come from 2019 survey data while the EU averages are based on 2022
programme data. *Please see Figure 6.31 for information on trend.
Min
EU
BG
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
+0.9 pp
Alcohol consumption Litres per capita, population aged 15+
+13 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-5.8 pp
Air pollution Exposure to PM2.5 (µg/m³)
-25 %
HPV vaccination % of girls aged 15
-14 pp
Breast cancer screening % of target population
+3.7 pp
Cervical cancer screening % of target population
+4.6 pp
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+47 %
MRI units per 1 000 000 population
+61 %
Radiation therapy equipment per 1 000 000 population
+113 %
Cancer mortality ASMR per 100 000 population
+0 %
Colorectal cancer mortality ASMR per 100 000 population
+8 %
Breast cancer mortality ASMR per 100 000 women
-5 %
Lung cancer mortality ASMR per 100 000 population
-4 %
Cancer PYLL years per 100 000 population
-16 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+8.5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+7.4 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.9 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
29.1 6.2
10.0 11.9
11.1 6.3
51.3 62.5
53.7 41.9
17.8 17.211.7
4.9
6.1 10.4
3.9 1.2
679 1 094
967 499
3 462 943 1 376
641
8 12
11 5
49
4726
11
18 38
12 6
64 96
7 7
56 83
36 9
55 85
57 11
59 100
85 0
235 310
229 198
72 52 60
49
8 15 208
83 93
78 74
50 3527
19
31 37
30 22
47 78
42 33
1 355 1 961
1 695 826
37 106
86 18
45
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.3. Czechia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
CZ
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-6.7 pp
Alcohol consumption Litres per capita, population aged 15+
+2 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-5.8 pp
Air pollution Exposure to PM2.5 (µg/m³)
-32 %
HPV vaccination % of girls aged 15
-3 pp
Breast cancer screening % of target population
-0.4 pp
Cervical cancer screening % of target population
-0.3 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+9 %
MRI units per 1 000 000 population
+67 %
Radiation therapy equipment per 1 000 000 population
-1 %
Cancer mortality ASMR per 100 000 population
-15 %
Colorectal cancer mortality ASMR per 100 000 population
-23 %
Breast cancer mortality ASMR per 100 000 women
-9 %
Lung cancer mortality ASMR per 100 000 population
-24 %
Cancer PYLL years per 100 000 population
-19 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+8.1 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+5.7 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+2 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
16.2 6.2
10.0 11.9
11.6 6.3
51.3 62.5
56.5 41.9
17.8 14.111.7
4.9
6.1 10.4
8.1 1.2
679 1 094
737 499
3 462 1 5491 376
641
8 12
8 5
49 16 26
11
18 38
12 6
64 96
71 7
56 83
60 9
55 85
74 11
42 77
29 3
59 100
77 0
235 310
257 198
72 56 60
49
11 15 208
83 93
81 74
50 3227
19
31 37
30 22
47 78
45 33
1 355 1 961
1 367 826
37 106
106 18
46
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.4. Denmark’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
DK
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5.3 pp
Alcohol consumption Litres per capita, population aged 15+
-12 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31 %
HPV vaccination % of girls aged 15
+6 pp
Breast cancer screening % of target population
-1.3 pp
Cervical cancer screening % of target population
-5.5 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+31 %
MRI units per 1 000 000 population
%
Radiation therapy equipment per 1 000 000 population
-13 %
Cancer mortality ASMR per 100 000 population
-15 %
Colorectal cancer mortality ASMR per 100 000 population
-26 %
Breast cancer mortality ASMR per 100 000 women
-24 %
Lung cancer mortality ASMR per 100 000 population
-23 %
Cancer PYLL years per 100 000 population
-29 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+10.1 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+5.8 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+7.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6
29.1
11.7
6.2
10.0 11.9
9.5 6.3
51.3 62.5
54.6 41.9
17.8
8.9 11.7 4.9
6.1 10.4
8.8 1.2
679 1 094
601 499
3 462 1 376
641 1 384
8 12
12 5
49 4326
11
18 38
9 6
64 96
83 7
56 83
83 9
55
85
61
11
42
77
61 3
59 100
69 0
235 310
271 198
72 6260
49
1715 208
83 93
86 74
50 3027
19
31 37
33 22
47 78
57 33
1 355 1 961
1 092 826
37 106
70 18
47
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.5. Germany’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for radiation therapy
equipment. Cervical and colorectal cancer screening values for Germany come from 2019 survey data while the EU averages are based on
2022 programme data. *Please see Figure 6.31 for information on trend.
Min
EU
DE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-6.3 pp
Alcohol consumption Litres per capita, population aged 15+
-9 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-2.2 pp
Air pollution Exposure to PM2.5 (µg/m³)
-36 %
HPV vaccination % of girls aged 15
+25 pp
Breast cancer screening % of target population
-2.7 pp
Cervical cancer screening % of target population
-2.4 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+7 %
MRI units per 1 000 000 population
+22 %
Cancer mortality ASMR per 100 000 population
-10 %
Colorectal cancer mortality ASMR per 100 000 population
-24 %
Breast cancer mortality ASMR per 100 000 women
-9 %
Lung cancer mortality ASMR per 100 000 population
-9 %
Cancer PYLL years per 100 000 population
-13 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+2.8 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+2.1 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.4 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
14.6 6.2
10.0 11.9
10.6 6.3
51.3 62.5
46.5 41.9
17.8 10.3 11.7
4.9
6.1 10.4
6.6
1.2
679 1 094
715 499
3 462 1 8821 376
641
49
3626
11
18 38
35 6
64 96
54 7
56 83
52 9
55 85
78 11
42 77
55 3
59 100
100 0
235 310
236 198
72 6560
49
1815 208
83 93
86 74
50 24 27
19
31 37
34 22
47 78
47 33
1 355 1 961
1 243 826
37 106
33 18
48
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.6. Estonia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
EE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-10.1 pp
Alcohol consumption Litres per capita, population aged 15+
-2 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+1.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31 %
HPV vaccination % of girls aged 15
-5 pp
Breast cancer screening % of target population
+4.6 pp
Cervical cancer screening % of target population
+8.2 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+19 %
MRI units per 1 000 000 population
+73 %
Radiation therapy equipment per 1 000 000 population
+37 %
Cancer mortality ASMR per 100 000 population
-10 %
Colorectal cancer mortality ASMR per 100 000 population
-3 %
Breast cancer mortality ASMR per 100 000 women
-11 %
Lung cancer mortality ASMR per 100 000 population
-16 %
Cancer PYLL years per 100 000 population
-28 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+9.5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+7 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 29.1
15.9 6.2
10.0 11.9
11.2 6.3
51.3 62.5
57.4 41.9
17.8 6.1 11.7
4.9
6.1 10.4
8.8 1.2
679 1 094
591 499
3 462 1 121 1 376
641
8 12
5 5
49 21 26
11
18 38
17 6
64 96
43 7
56 83
63 9
55
85
58
11
42
77
55 3
59 100
46 0
235 310
266 198
72 58 60
49
1715 208
83 93
78 74
50 3427
19
31 37
29 22
47 78
44 33
1 355 1 961
1 283 826
37 106
80 18
49
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.7. Ireland’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
IE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5 pp
Alcohol consumption Litres per capita, population aged 15+
-12 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-4.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-21 %
HPV vaccination % of girls aged 15
+7 pp
Breast cancer screening % of target population
-6.2 pp
Cervical cancer screening % of target population
-3.9 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+17 %
MRI units per 1 000 000 population
+38 %
Radiation therapy equipment per 1 000 000 population
+1 %
Cancer mortality ASMR per 100 000 population
-17 %
Colorectal cancer mortality ASMR per 100 000 population
-28 %
Breast cancer mortality ASMR per 100 000 women
-22 %
Lung cancer mortality ASMR per 100 000 population
-23 %
Cancer PYLL years per 100 000 population
-18 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+7.2 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+4.8 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+7.4 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
14.0 18.6 6.2
10.0 11.9
10.2 6.3
51.3 62.5
53.0
41.9
17.8
8.0 11.7 4.9
6.1 10.4
5.9
1.2
1 094 728679
499
3 462 2 6261 376
641
8 12
10 5
49
20 26
11
18 38
17 6
64 96
75 7
56 83
70 9
55 85
73 11
42
77
34 3
59 100
38 0
235 310
248 198
6160 7249
1815 208
83 93
82 74
50 27 27
19
31 37
33 22
47 78
49 33
1 355 1 961
1 165 826
37 106
65 18
50
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.8. Greece’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on HPV vaccination
and cancer survival. Breast, cervical and colorectal cancer screening values for Greece come from 2019 survey data while the EU averages are
based on 2022 programme data. *Please see Figure 6.31 for information on trend.
Min
EU
EL
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2.4 pp
Alcohol consumption Litres per capita, population aged 15+
-24 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-29 %
Breast cancer screening % of target population
+6.1 pp
Cervical cancer screening % of target population
-2.6 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+47 %
MRI units per 1 000 000 population
+71 %
Radiation therapy equipment per 1 000 000 population
+25 %
Cancer mortality ASMR per 100 000 population
-2 %
Colorectal cancer mortality ASMR per 100 000 population
-1 %
Breast cancer mortality ASMR per 100 000 women
+6 %
Lung cancer mortality ASMR per 100 000 population
-4 %
Cancer PYLL years per 100 000 population
-9 %
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 24.918.6
6.2
10.0 11.9
6.3 6.3
51.3 62.5
54.9 41.9
17.8 14.211.7
4.9
6.1 10.4
4.0 1.2
1 094 1 094679
499
3 462 641 1 376
641
8 12
7 5
49 4926
11
18 38
38 6
56 83
66 9
55 85
73 11
42 77
28 3
59 100
54 0
235 310
239 198
50 22 27
19
31 37
32 22
47 78
57 33
1 355 1 961
1 361 826
37 106
33 18
51
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.9. Spain’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
ES
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.2 pp
Alcohol consumption Litres per capita, population aged 15+
+20 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-0.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-22 %
HPV vaccination % of girls aged 15
+19 pp
Breast cancer screening % of target population
-6 pp
Cervical cancer screening % of target population
-0.3 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+25 %
MRI units per 1 000 000 population
+39 %
Radiation therapy equipment per 1 000 000 population
+52 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-19 %
Breast cancer mortality ASMR per 100 000 women
-13 %
Lung cancer mortality ASMR per 100 000 population
-9 %
Cancer PYLL years per 100 000 population
-19 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.8 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+2.4 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+2.7 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 19.818.6
6.2
10.0 11.9
11.8 6.3
51.3 62.5
51.2 41.9
17.8 9.7 11.7
4.9
6.1 10.4
3.6 1.2
1 094 773679
499
3 462 1 106 1 376
641
8 12
7 5
49
21 26
11
18 38
21 6
64 96
85 7
56 83
74 9
55 85
68 11
42 77
32 3
59 100
62 0
235 310
213 198
72 6360
49
14 15 208
83 93
85 74
50 2927
19
31 37
22 22
47 78
45 33
1 355 1 961
1 166 826
37 106
18 18
52
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.10. France’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
FR
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.2 pp
Alcohol consumption Litres per capita, population aged 15+
-12 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-30 %
HPV vaccination % of girls aged 15
+29 pp
Breast cancer screening % of target population
-3.8 pp
Cervical cancer screening % of target population
-
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+50 %
MRI units per 1 000 000 population
+107 %
Radiation therapy equipment per 1 000 000 population
+7 %
Cancer mortality ASMR per 100 000 population
-12 %
Colorectal cancer mortality ASMR per 100 000 population
-19 %
Breast cancer mortality ASMR per 100 000 women
-8 %
Lung cancer mortality ASMR per 100 000 population
-14 %
Cancer PYLL years per 100 000 population
-18 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
-0.1 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.2 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
25.318.6 6.2
10.0 11.9
10.8 6.3
51.3 62.5
46.4 41.9
17.8
9.5 11.7 4.9
6.1 10.4
5.7
1.2
1 094 499 679
499
1 376 1 379 3 462641
8 12
11 5
49
20 26
11
18 38
18 6
64 96
45 7
56 83
48 9
55
85
60
11
42 77
34 3
59 100
54 0
235 310
223 198
72 6460
49
1715 208
83 93
87 74
50 23 27
19
31 37
30 22
47 78
43 33
1 355 1 961
1 269 826
37 106
51 18
53
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.11. Croatia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for HPV vaccination.
The cervical cancer screening value for Croatia comes from 2019 survey data while the EU average is based on 2022 programme data. *Please
see Figure 6.31 for information on trend.
Min
EU
HR
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2.9 pp
Alcohol consumption Litres per capita, population aged 15+
-16 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-2.8 pp
Air pollution Exposure to PM2.5 (µg/m³)
-25 %
Breast cancer screening % of target population
+2 pp
Cervical cancer screening % of target population
+1.1 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+42 %
MRI units per 1 000 000 population
+77 %
Radiation therapy equipment per 1 000 000 population
+18 %
Cancer mortality ASMR per 100 000 population
-10 %
Colorectal cancer mortality ASMR per 100 000 population
-4 %
Breast cancer mortality ASMR per 100 000 women
-24 %
Lung cancer mortality ASMR per 100 000 population
-6 %
Cancer PYLL years per 100 000 population
-14 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.8 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+5 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
-1.2 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 22.118.6
6.2
10.0 11.9
9.0 6.3
51.3 62.5
58.1 41.9
17.8 15.811.7
4.9
6.1 10.4
4.4 1.2
1 094 556 679
499
3 462 1 081 1 376
641
8 12
8 5
49
22 26
11
18 38
17 6
56 83
62 9
55 85
78 11
42 77
26 3
59 100
62 0
235 310
308 198
72 51 60
49
10 15 208
83 93
79 74
50 4927
19
31 37
30 22
47 78
63 33
1 355 1 961
1 761 826
37 106
86 18
54
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.12. Italy’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data on reimbursed medicines.
*Please see Figure 6.31 for information on trend.
Min
EU
IT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2.3 pp
Alcohol consumption Litres per capita, population aged 15+
+10 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+1.6 pp
Air pollution Exposure to PM2.5 (µg/m³)
-27 %
HPV vaccination % of girls aged 15
-3 pp
Breast cancer screening % of target population
-3.5 pp
Cervical cancer screening % of target population
-0.3 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
+23 %
MRI units per 1 000 000 population
+35 %
Radiation therapy equipment per 1 000 000 population
+9 %
Cancer mortality ASMR per 100 000 population
-15 %
Colorectal cancer mortality ASMR per 100 000 population
-17 %
Breast cancer mortality ASMR per 100 000 women
-7 %
Lung cancer mortality ASMR per 100 000 population
-18 %
Cancer PYLL years per 100 000 population
-17 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+5.2 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+1.8 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.9 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 19.818.6
6.2
10.0 11.9
7.7 6.3
51.3 62.5
41.9 41.9
17.8 14.311.7
4.9
6.1 10.4
6.7
1.2
1 094 615 679
499
3 462 947 1 376
641
8 12
7 5
49
4026
11
18 38
33 6
64 96
64 7
56 83
54 9
55 85
40 11
42 77
34 3
235 310
222 198
72 6460
49
1615 208
83 93
86 74
50 25 27
19
31 37
31 22
47 78
44 33
1 355 1 961
1 157 826
37 106
32 18
55
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.13. Cyprus’ Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for CT scanners,
MRI units, radiation equipment and cancer PYLL. Cervical and colorectal cancer screening values for Cyprus come from 2019 survey data while
the EU averages are based on 2022 programme data. In addition, 2019 survey data for breast cancer screening shows substantially higher
uptake (66%) than that of the programme data reported here. *Please see Figure 6.31 for information on trend.
Min
EU
CY
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.2 pp
Alcohol consumption Litres per capita, population aged 15+
-15 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-4.8 pp
Air pollution Exposure to PM2.5 (µg/m³)
-27 %
HPV vaccination % of girls aged 15
+13 pp
Breast cancer screening % of target population
-
Cervical cancer screening % of target population
+4.6 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
Cancer mortality ASMR per 100 000 population
+10 %
Colorectal cancer mortality ASMR per 100 000 population
+17 %
Breast cancer mortality ASMR per 100 000 women
+13 %
Lung cancer mortality ASMR per 100 000 population
+8 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.4 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+3.5 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+0.4 pp
Educational inequalities % difference in cancer mortality by education
-
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
ca p
ac it
y C
an ce
r ca
re o
u tc
o m
es
29.1
22.518.6 6.2
10.0 11.9
9.6 6.3
51.3 62.5
47.9 41.9
17.8
13.411.7 4.9
6.1
10.4 3.1
1.2
1 094 1 017679
499
3 462 1 040 1 376
641
64 96
67 7
56 83
29 9
55 85
69 11
42
77
22 3
59 100
31 0
235 310
213 198
72 7260
49
1915 208
83 93
93 74
50 19 27
19
31 37
37 22
47 78
42 33
37 106
33 18
56
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.14. Latvia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data on radiation therapy equipment.
*Please see Figure 6.31 for information on trend.
Min
EU
LV
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2 pp
Alcohol consumption Litres per capita, population aged 15+
+21 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+3.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-35 %
HPV vaccination % of girls aged 15
-15 pp
Breast cancer screening % of target population
+0.2 pp
Cervical cancer screening % of target population
+27.4 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+23 %
MRI units per 1 000 000 population
+100 %
Cancer mortality ASMR per 100 000 population
-6 %
Colorectal cancer mortality ASMR per 100 000 population
-12 %
Breast cancer mortality ASMR per 100 000 women
-5 %
Lung cancer mortality ASMR per 100 000 population
-8 %
Cancer PYLL years per 100 000 population
-12 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+8.3 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+7.6 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.7 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 22.618.6
6.2
10.0 11.9
11.9 6.3
51.3 62.5
60.4 41.9
11.7 11.8 17.84.9
6.1 10.4
5.1 1.2
1 094 575 679
499
3 462 706 1 376
641
49
4026
11
18 38
20 6
64 96
46 7
56 83
36 9
55
85
55
11
42 77
26 3
59 100
31 0
235 310
284 198
72 49 60
49
1815 208
83 93
77 74
50 3227
19
31 37
34 22
47 78
46 33
1 355 1 961
1 777 826
37 106
83 18
57
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.15. Lithuania’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
LT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-1.4 pp
Alcohol consumption Litres per capita, population aged 15+
-17 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+3.2 pp
Air pollution Exposure to PM2.5 (µg/m³)
-33 %
HPV vaccination % of girls aged 15
+43 pp
Breast cancer screening % of target population
+16.8 pp
Cervical cancer screening % of target population
+8 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+39 %
MRI units per 1 000 000 population
+69 %
Radiation therapy equipment per 1 000 000 population
-6 %
Cancer mortality ASMR per 100 000 population
-9 %
Colorectal cancer mortality ASMR per 100 000 population
-13 %
Breast cancer mortality ASMR per 100 000 women
-4 %
Lung cancer mortality ASMR per 100 000 population
-24 %
Cancer PYLL years per 100 000 population
-14 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+12.4 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+8.9 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 18.6
6.2 18.9
10.0 11.9
11.2 6.3
51.3 62.5
59.4 41.9
17.8 9.2 11.7
4.9
6.1 10.4
5.6
1.2
1 094 773679
499
3 462 1 376
641 1 304
8 12
7 5
49 3326
11
18 38
17 6
64 96
76 7
56 83
58 9
55
85
55
11
42 77
56 3
59 100
38 0
235 310
259 198
72 57 60
49
10 15 208
83 93
74 74
50 3027
19
31 37
30 22
47 78
37 33
1 355 1 961
1 699 826
37 106
94 18
58
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.16. Luxembourg’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. HPV vaccination coverage comes
from WHO data using estimates based on 2016. No data available for cancer medicine reimbursement and cancer survival. *Please see
Figure 6.31 for information on trend.
Min
EU
LU
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
+3.5 pp
Alcohol consumption Litres per capita, population aged 15+
-8 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-33 %
HPV vaccination % of girls aged 15
+1 pp
Breast cancer screening % of target population
-10.3 pp
Cervical cancer screening % of target population
-7.4 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
+4 %
MRI units per 1 000 000 population
+36 %
Radiation therapy equipment per 1 000 000 population
+22 %
Cancer mortality ASMR per 100 000 population
-24 %
Colorectal cancer mortality ASMR per 100 000 population
-28 %
Breast cancer mortality ASMR per 100 000 women
-17 %
Lung cancer mortality ASMR per 100 000 population
-24 %
Cancer PYLL years per 100 000 population
-37 %
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
20.318.6
6.2
10.0 11.9
11.0 6.3
51.3 62.5
49.7
41.9
17.8
8.7 11.7 4.9
6.1
10.4
6.4
1.2
1 094 647 679
499
3 462 2 5381 376
641
8 12
9 5
49 26
11 25
18 38
18 6
64 96
43 7
56 83
52 9
55
85
60
11
42 77
31 3
235 310
203 198
50 22 27
19
31 37
31 22
47 78
41 33
1 355 1 961
826 826
37 106
34 18
59
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.17. Hungary’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on radiation therapy
equipment and cancer survival. *Please see Figure 6.31 for information on trend.
Min
EU
HU
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-0.9 pp
Alcohol consumption Litres per capita, population aged 15+
-2 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+2.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31 %
HPV vaccination % of girls aged 15
+2 pp
Breast cancer screening % of target population
-12.3 pp
Cervical cancer screening % of target population
-9.6 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+39 %
MRI units per 1 000 000 population
+99 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-13 %
Breast cancer mortality ASMR per 100 000 women
-5 %
Lung cancer mortality ASMR per 100 000 population
-14 %
Cancer PYLL years per 100 000 population
-27 %
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
24.918.6 6.2
10.0 11.9
10.6 6.3
51.3 62.5
58.4 41.9
17.8
14.011.7 4.9
6.1
10.4 7.6
1.2
1 094 538 679
499
3 462 845 1 376
641
49
11 26
11
18 38
6 6
64 96
76 7
56 83
30 9
55 85
26 11
42
77
8 3
59 100
38 0
235 310
310 198
50 5027
19
31 37
37 22
47 78
78 33
1 355 1 961
1 961 826
37 106
78 18
60
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.18. Malta’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data for CT scanners, MRI units,
radiation therapy equipment and cancer PYLL. No data on cancer medicines reimbursement for Malta is shown as there were no indications
from the sample assessed that were included in the national coverage list, but the country provides other methods to help ensure access to
cancer medicines. In addition, 2019 survey data shows substantially higher screening uptake (breast: 61%; cervical: 64%; colorectal: 40%) than
that of the programme data reported here. *Please see Figure 6.31 for information on trend.
Min
EU
MT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
+0.5 pp
Alcohol consumption Litres per capita, population aged 15+
+15 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+0.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31 %
HPV vaccination % of girls aged 15
-6 pp
Breast cancer screening % of target population
-
Cervical cancer screening % of target population
-
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Cancer mortality ASMR per 100 000 population
-20 %
Colorectal cancer mortality ASMR per 100 000 population
-27 %
Breast cancer mortality ASMR per 100 000 women
-31 %
Lung cancer mortality ASMR per 100 000 population
-7 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+0.5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+7.2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+5.7 pp
Educational inequalities % difference in cancer mortality by education
-
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
ca p
ac it
y
C an
ce r
ca re
o u
tc o
m es
29.1
20.618.6
6.2
10.0 11.9
8.1 6.3
51.3 62.5
62.5 41.9
17.8
11.7
4.9
11.8
6.1
10.4 1.2
1.2
1 094 868679
499
3 462 1 5051 376
641
64 96
82 7
56 83
44 9
55 85
16 11
42
77
25 3
235 310
198 198
72 58 60
49
15 208
15
83 93
87 74
50 23 27
19
31 37
29 22
47 78
40 33
37 106
34 18
61
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.19. The Netherlands’ Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on radiation therapy
equipment. *Please see Figure 6.31 for information on trend.
Min
EU
NL
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5.7 pp
Alcohol consumption Litres per capita, population aged 15+
-7 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+1.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-33 %
HPV vaccination % of girls aged 15
+8 pp
Breast cancer screening % of target population
-9 pp
Cervical cancer screening % of target population
-18.9 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+45 %
MRI units per 1 000 000 population
+28 %
Cancer mortality ASMR per 100 000 population
-15 %
Colorectal cancer mortality ASMR per 100 000 population
-28 %
Breast cancer mortality ASMR per 100 000 women
-17 %
Lung cancer mortality ASMR per 100 000 population
-22 %
Cancer PYLL years per 100 000 population
-25 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+2.7 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.9 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 12.7 18.6
6.2
10.0 11.9
8.5 6.3
51.3 62.5
48.3 41.9
17.8 10.8 11.7
4.9
6.1 10.4
8.6 1.2
1 094 593 679
499
3 462 1 7451 376
641
49
16 26
11
18 38
15 6
64 96
65 7
56 83
70 9
55 85
46 11
42
77
68 3
59 100
92 0
235 310
256 198
72 6360
49
1715 208
83 93
87 74
50 26 27
19
31 37
33 22
47 78
56 33
1 355 1 961
1 180 826
37 106
34 18
62
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.20. Austria’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. Cervical and colorectal cancer
screening values for Austria come from 2019 survey data while the EU averages are based on 2022 programme data. *Please see Figure 6.31
for information on trend.
Min
EU
AT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.7 pp
Alcohol consumption Litres per capita, population aged 15+
-4 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+2.7 pp
Air pollution Exposure to PM2.5 (µg/m³)
-32 %
HPV vaccination % of girls aged 15
+48 pp
Breast cancer screening % of target population
+2.5 pp
Cervical cancer screening % of target population
-1.9 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
-5 %
MRI units per 1 000 000 population
+38 %
Radiation therapy equipment per 1 000 000 population
+18 %
Cancer mortality ASMR per 100 000 population
-12 %
Colorectal cancer mortality ASMR per 100 000 population
-22 %
Breast cancer mortality ASMR per 100 000 women
-4 %
Lung cancer mortality ASMR per 100 000 population
-3 %
Cancer PYLL years per 100 000 population
-24 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+3.1 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.3 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
20.618.6
6.2
10.0 11.9
11.6 6.3
51.3 62.5
52.7
41.9
17.8
10.9 11.7
4.9
6.1
10.4 10.4
1.2
1 094 1 091679
499
3 462 2 1701 376
641
8 12
6 5
49 2826
11
18 38
26 6
64 96
53 7
56 83
41 9
55 85
85 11
42
77
64 3
59 100
77 0
235 310
225 198
72 6460
49
2015 208
83 93
85 74
50 22 27
19
31 37
31 22
47 78
45 33
1 355 1 961
1 081 826
37 106
40 18
63
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.21. Poland’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on HPV vaccination
and colorectal cancer screening. *Please see Figure 6.31 for information on trend.
Min
EU
PL
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5.6 pp
Alcohol consumption Litres per capita, population aged 15+
+10 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+2.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-33 %
Breast cancer screening % of target population
+0.1 pp
Cervical cancer screening % of target population
-4.8 pp
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+52 %
MRI units per 1 000 000 population
+137 %
Radiation therapy equipment per 1 000 000 population
+60 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-8 %
Breast cancer mortality ASMR per 100 000 women
+4 %
Lung cancer mortality ASMR per 100 000 population
-19 %
Cancer PYLL years per 100 000 population
-23 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+7.6 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+5.2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+2.3 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
55 85
11 11
F r a
29.1 17.1 18.6
6.2
10.0 11.9
11.0 6.3
51.3 62.5
58.4 41.9
17.8 17.811.7
4.9
6.1 10.4
2.1 1.2
1 094 647 679
499
3 462 1 057 1 376
641
8 12
6 5
49 23 26
11
18 38
13 6
56 83
37 9
59 100
62 0
235 310
260 198
72 53 60
49
14 15 208
83 93
77 74
50 3327
19
31 37
30 22
47 78
56 33
1 355 1 961
1 508 826
37 106
71 18
64
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.22. Portugal’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
PT
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-2.6 pp
Alcohol consumption Litres per capita, population aged 15+
-8 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-0.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-21 %
HPV vaccination % of girls aged 15
-5 pp
Breast cancer screening % of target population
+9.2 pp
Cervical cancer screening % of target population
+31.3 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+15 %
MRI units per 1 000 000 population
+94 %
Radiation therapy equipment per 1 000 000 population
+17 %
Cancer mortality ASMR per 100 000 population
-8 %
Colorectal cancer mortality ASMR per 100 000 population
-22 %
Breast cancer mortality ASMR per 100 000 women
-5 %
Lung cancer mortality ASMR per 100 000 population
+3 %
Cancer PYLL years per 100 000 population
-6 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.4 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+6 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+5.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 14.2 18.6
6.2
10.0 11.9
10.4 6.3
51.3 62.5
53.0 41.9
17.8 8.3 11.7
4.9
6.1 10.4
3.2 1.2
1 094 889679
499
3 462 1 169 1 376
641
8 12
5 5
49
18 26
11
18 38
12 6
64 96
91 7
56 83
50 9
55
85
60
11
42 77
14 3
59 100
54 0
235 310
226 198
72 6160
49
1615 208
83 93
88 74
50 2927
19
31 37
26 22
47 78
37 33
1 355 1 961
1 494 826
37 106
33 18
65
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.23. Romania’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data on HPV vaccination and
cancer medicines reimbursement. Breast, cervical and colorectal cancer screening values for Romania come from 2019 survey data while the
EU averages are based on 2022 programme data. *Please see Figure 6.31 for information on trend.
Min
EU
RO
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-1.1 pp
Alcohol consumption Litres per capita, population aged 15+
+16 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-3.2 pp
Air pollution Exposure to PM2.5 (µg/m³)
-30 %
Breast cancer screening % of target population
+2.6 pp
Cervical cancer screening % of target population
-
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
+165 %
MRI units per 1 000 000 population
+288 %
Radiation therapy equipment per 1 000 000 population
+27 %
Cancer mortality ASMR per 100 000 population
-8 %
Colorectal cancer mortality ASMR per 100 000 population
+7 %
Breast cancer mortality ASMR per 100 000 women
+1 %
Lung cancer mortality ASMR per 100 000 population
-17 %
Cancer PYLL years per 100 000 population
-13 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
-
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
-
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
-
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
18.6 6.2
18.7 29.1
10.0 11.9
11.6 6.3
51.3 62.5
59.7 41.9
17.8 13.911.7
4.9
6.1 10.4
3.7 1.2
1 094 679
499 694
3 462 1 5481 376
641
8 12
5 5
49 24 26
11
18 38
15 6
56 83
9 9
55 85
39 11
42 77
3 3
235 310
243 198
72 52 60
49
11 15 208
83 93
75 74
50 3327
19
31 37
31 22
47 78
44 33
1 355 1 961
1 946 826
37 106
86 18
66
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.24. Slovenia’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
SI
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-1.5 pp
Alcohol consumption Litres per capita, population aged 15+
-3 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+1.2 pp
Air pollution Exposure to PM2.5 (µg/m³)
-25 %
HPV vaccination % of girls aged 15
+8 pp
Breast cancer screening % of target population
+1.1 pp
Cervical cancer screening % of target population
+2.8 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+38 %
MRI units per 1 000 000 population
+94 %
Radiation therapy equipment per 1 000 000 population
+13 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-31 %
Breast cancer mortality ASMR per 100 000 women
-12 %
Lung cancer mortality ASMR per 100 000 population
-12 %
Cancer PYLL years per 100 000 population
-19 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+8.3 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+4.8 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.9 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
17.4 18.6
6.2
10.0 11.96.3
10.0
51.3 62.5
55.7 41.9
17.8
14.011.7 4.9
6.1
10.4
5.4
1.2
1 094 519 679
499
3 462 1 6021 376
641
8 12
7 5
49
17 26
11
18 38
17 6
64 96
52 7
56 83
77 9
55 85
74 11
42
77
65 3
59 100
69 0
235 310
277 198
72 6260
49
15 208
15
83 9374
84
50 3027
19
31 37
32 22
47 78
51 33
1 355 1 961
1 388 826
37 106
31 18
67
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.25. Slovak Republic’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data on HPV vaccination and
cancer medicines reimbursement. *Please see Figure 6.31 for information on trend.
Min
EU
SK
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-1.9 pp
Alcohol consumption Litres per capita, population aged 15+
-6 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+3.9 pp
Air pollution Exposure to PM2.5 (µg/m³)
-28 %
Breast cancer screening % of target population
-1.6 pp
Cervical cancer screening % of target population
-0.5 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
+29 %
MRI units per 1 000 000 population
+67 %
Radiation therapy equipment per 1 000 000 population
-3 %
Cancer mortality ASMR per 100 000 population
-16 %
Colorectal cancer mortality ASMR per 100 000 population
-21 %
Breast cancer mortality ASMR per 100 000 women
-4 %
Lung cancer mortality ASMR per 100 000 population
-23 %
Cancer PYLL years per 100 000 population
-23 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.4 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+0.2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.7 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1 21.018.6
6.2
10.0 11.9
9.5 6.3
51.3 62.5
58.4 41.9
17.8 15.311.7
4.9
6.1 10.4
1.6 1.2
1 094 679
499 691
3 462 1 056 1 376
641
8 12
12 5
49 20 26
11
18 38
10 6
56 83
29 9
55 85
46 11
42 77
52 3
235 310
275 198
72 52 60
49
11 15 208
83 93
76 74
50 4127
19
31 37
37 22
47 78
41 33
1 355 1 961
1 516 826
37 106
69 18
68
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.26. Finland’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available for reimbursed
medicines. *Please see Figure 6.31 for information on trend.
Min
EU
FI
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-5.7 pp
Alcohol consumption Litres per capita, population aged 15+
-22 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-1.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-30 %
HPV vaccination % of girls aged 15
+15 pp
Breast cancer screening % of target population
-1.3 pp
Cervical cancer screening % of target population
+1.4 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
CT scanners per 1 000 000 population
-15 %
MRI units per 1 000 000 population
+55 %
Radiation therapy equipment per 1 000 000 population
+17 %
Cancer mortality ASMR per 100 000 population
-7 %
Colorectal cancer mortality ASMR per 100 000 population
-2 %
Breast cancer mortality ASMR per 100 000 women
-7 %
Lung cancer mortality ASMR per 100 000 population
-9 %
Cancer PYLL years per 100 000 population
-16 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+3.6 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+1.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
11.3 18.6 6.2
10.0 11.9
7.6 6.3
51.3 62.5
59.8 41.9
17.8
4.9 11.7 4.9
6.1
10.4 8.3
1.2
1 094 568 679
499
3 462 2 2231 376
641
8 12
11 5
49 19 26
11
18 38
33 6
64 96
76 7
56 83
82 9
55 85
72 11
42
77
77 3
235 310
210 198
72 6560
49
13 15 208
83 93
89 74
50 22 27
19
31 37
26 22
47 78
37 33
1 355 1 961
986 826
37 106
53 18
69
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.27. Sweden’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
SE
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-4.1 pp
Alcohol consumption Litres per capita, population aged 15+
+1 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-4.3 pp
Air pollution Exposure to PM2.5 (µg/m³)
-28 %
HPV vaccination % of girls aged 15
+7 pp
Breast cancer screening % of target population
+1 pp
Cervical cancer screening % of target population
-2.6 pp
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+17 %
MRI units per 1 000 000 population
+20 %
Radiation therapy equipment per 1 000 000 population
-22 %
Cancer mortality ASMR per 100 000 population
-13 %
Colorectal cancer mortality ASMR per 100 000 population
-14 %
Breast cancer mortality ASMR per 100 000 women
-18 %
Lung cancer mortality ASMR per 100 000 population
-19 %
Cancer PYLL years per 100 000 population
-25 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+4.7 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+3.2 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+5.6 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
8.7 18.6 6.2
10.0 11.9
7.5 6.3
51.3 62.5
53.2 41.9
17.8
5.6 11.7 4.9
6.1
10.4 4.3
1.2
1 094 746679
499
3 462 1 8441 376
641
8 12
6 5
49 24 26
11
18 38
17 6
64 96
85 7
56 83
81 9
55 85
79 11
42
77
64 3
59 100
85 0
235 310
207 198
72 6560
49
2015 208
83 93
89 74
50 26 27
19
31 37
23 22
47 78
33 33
1 355 1 961
840 826
37 106
54 18
70
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.28. Iceland’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information
on trend.
Min
EU
IS
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-7.6 pp
Alcohol consumption Litres per capita, population aged 15+
+9 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+10.1 pp
Air pollution Exposure to PM2.5 (µg/m³)
-22 %
HPV vaccination % of girls aged 15
+5 pp
Breast cancer screening % of target population
-2 pp
Cervical cancer screening % of target population
-11 pp
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+10 %
MRI units per 1 000 000 population
+8 %
Radiation therapy equipment per 1 000 000 population
-15 %
Cancer mortality ASMR per 100 000 population
-17 %
Colorectal cancer mortality ASMR per 100 000 population
-4 %
Breast cancer mortality ASMR per 100 000 women
+29 %
Lung cancer mortality ASMR per 100 000 population
-30 %
Cancer PYLL years per 100 000 population
-10 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.8 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+1.7 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.1 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
n
C an
ce r
ea rl
y
d et
ec ti
o n
C an
ce r
ca re
c ap
ac it
y
F r a
29.1
6.2 18.6 6.2
10.0 11.9
7.4 6.3
51.3 62.5
62.0 41.9
17.8
5.5 11.7 4.9
6.1
10.4 3.8
1.2
1 094 1 025679
499
3 462 3 4621 376
641
8
12
8
5
49
4426
11
18 38
24 6
64 96
96 7
56 83
57 9
55 85
62 11
59 100
69 0
235 310
217 198
72 6860
49
2015 208
83 93
89 74
50 21 27
19
31 37
33 22
47 78
44 33
1 355 1 961
1 040 826
37 106
65 18
71
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.29. Norway’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. No data available on colorectal cancer
screening available for 2022 as the programme was gradually rolled out, and no data available on cancer PYLL. *Please see Figure 6.31 for
information on trend.
Min
EU
NO
Max
Trend over
time*
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-8 pp
Alcohol consumption Litres per capita, population aged 15+
0 %
Overweight and obesity % of population aged 18+ with BMI ≥ 25
+4.4 pp
Air pollution Exposure to PM2.5 (µg/m³)
-23 %
HPV vaccination % of girls aged 15
+20 pp
Breast cancer screening % of target population
+5.3 pp
Cervical cancer screening % of target population
+3 pp
Physicians per 1 000 cancer cases
-
Nurses per 1 000 cancer cases
-
Reimbursed cancer medicines % of selected indications
-
CT scanners per 1 000 000 population
+82 %
MRI units per 1 000 000 population
+613 %
Radiation therapy equipment per 1 000 000 population
-8 %
Cancer mortality ASMR per 100 000 population
-17 %
Colorectal cancer mortality ASMR per 100 000 population
-15 %
Breast cancer mortality ASMR per 100 000 women
-17 %
Lung cancer mortality ASMR per 100 000 population
-19 %
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+3 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+6.3 pp
Educational inequalities % difference in cancer mortality by education
-
C an
ce r
ca re
o u
tc o
m es
Better than EU / improvement
Worse than EU / deterioration
No value judgement
C an
ce r
p re
ve n
ti o
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C an
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ea rl
y
d et
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C an
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ca re
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F r a
29.1 8.0 18.6
6.2
10.0 11.9
6.6 6.3
51.3 62.5
53.5 41.9
17.8 6.1 11.7
4.9
6.1 10.4
3.1 1.2
1 094 724679
499
3 462 2 2671 376
641
8 12
11 5
49 2826
11
18 38
31 6
64 96
93 7
56 83
76 9
55 85
71 11
59 100
69 0
235 310
220 198
72 6560
49
1815 208
83 93
87 74
50 3227
19
31 37
22 22
47 78
44 33
37 106
82 18
72
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.30. EU’s Cancer Performance Tracker (CaPTr)
Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. Grey circles represent EU+2 countries.
*Please see Figure 6.31 for information on trend.
EU Min Max
Trend
over time
Prevention expenditure % of health spending
-
Daily smoking % of population aged 15+
-3.1 pp
Alcohol consumption Litres per capita, population aged 15+
-3%
Overweight and obesity % of population aged 18+ with BMI ≥ 25
-0.5 pp
Air pollution Exposure to PM2.5 (µg/m³)
-31%
HPV vaccination % of girls aged 15
+9 pp
Breast cancer screening % of target population
-
Cervical cancer screening % of target population
-
Colorectal cancer screening % of target population
-
Physicians per 1 000 cancer cases -
Nurses per 1 000 cancer cases -
Reimbursed cancer medicines % of selected indications -
CT scanners per 1 000 000 population
29%
MRI units per 1 000 000 population
53%
Radiation therapy equipment per 1 000 000 population
9%
Cancer mortality ASMR per 100 000 population
-12%
Colorectal cancer mortality ASMR per 100 000 population
-18%
Breast cancer mortality ASMR per 100 000 women
-9%
Lung cancer mortality ASMR per 100 000 population
-14%
Cancer PYLL years per 100 000 population
-19%
Colon cancer 5-year survival % survival for patients diagnosed 2010-2014
+5 pp
Breast cancer 5-year survival % survival for women diagnosed 2010-2014
+4 pp
Lung cancer 5-year survival % survival for patients diagnosed 2010-2014
+3 pp
Educational inequalities % difference in cancer mortality by education
-
C an
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E ar
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C an
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an ce
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u tc
o m
es
Improvement ■ Deterioration ■ No value judgement ■
F r a
18.6 29.16.2
51.3 62.541.9
11.7 17.84.9
6.1 10.41.2
679 1 094499
1 376 3 462641
26 4911
18 386
64 967
56 839
55 8511
0 59 100
235 310198
15 208
83 9374
27 5019
31 3722
47 7833
1 355 1 961826
37 10618
42 773
10.0 11.96.3
60 7249
8 125
73
EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Figure 6.31. Cancer Performance Tracker (CaPTr) methods table
Note: EU-SILC = European Statistics on Income and Living Conditions; EHIS = European Health Interview Survey; IARC = International Agency
for Research on Cancer. Information from the EU-CanIneq study led by IARC is available at EU-CanIneq - European Commission.
Dimension Indicator Definition
Year/Perio
d of
change
EU average
(number of
countries) Source
Prevention expenditure Share of total current health expenditure allocated to preventive care 2021 27 Eurostat
Daily smoking Share of people aged 15 and over reporting smoking daily 2012-22 27 OECD Health Statistics and
Eurostat
Alcohol consumption Average litres of alcohol consumption per person aged 15 and over 2010-22 27 OECD Health Statistics and
Eurostat
Overweight and obesity Percentage of individuals aged 18 and over reporting body mass
index is >=25 2017-22 27 EU-SILC and EHIS
Air pollution Estimated mean population exposure to PM2.5 (µg/m³) 2010-20 27 OECD Environment Database
HPV vaccination % of 15-year-old girls who received their full dose of HPV vaccinations 2013-23 22 WHO
Breast cancer screening
Proportion of target population who have undergone breast cancer
screening based on the country’s breast cancer screening policy or
EHIS survey definition
2014-22 24 OECD Health Statistics and EHIS
Cervical cancer screening
Proportion of target population who have undergone cervical cancer
screening based on the country’s cervical cancer screening policy or
EHIS survey definition
2014-22 20 OECD Health Statistics and EHIS
Colorectal cancer screening
Proportion of target population who have undergone colorectal cancer
screening based on the country’s colorectal cancer screening policy
or EHIS survey definition
2022 20 OECD Health Statistics and EHIS
Physicians Number of practising physicians per 1 000 new cancer cases 2022 27 OECD Health Statistics and
European Cancer Information
Nurses Number of practising nurses per 1 000 new cancer cases 2022 27 OECD Health Statistics and
European Cancer Information
Reimbursed cancer medicines Proportion of reimbursed indications among a sample of new cancer
medicines for breast and lung cancers with high clinical benefit 2023 22
Hofmarcher, T., C. Berchet and
G. Dedet (2024)
CT scanners Number of CT scanners per 1 000 000 population 2013-23 25 OECD Health Statistics
MRI units Number of MRI units per 1 000 000 population 2013-23 25 OECD Health Statistics
Radiation therapy equipment Number of radiation therapy equipment per 1 000 000 population 2013-23 20 OECD Health Statistics
Cancer mortality Malignant neoplasms age-standardised mortality rate per 100 000
population 2011-21 27 Eurostat
Colorectal cancer mortality Colon, rectosigmoid junction, rectum, anus and anal canal cancer
age-standardised mortality rate per 100 000 population 2011-21 27 Eurostat
Breast cancer mortality Breast cancer age-standardised mortality rate per 100 000 women 2011-21 27 Eurostat
Lung cancer mortality Trachea, bronchus and lung cancer age-standardised mortality rate
per 100 000 population 2011-21 27 Eurostat
Cancer PYLL Potential Years of Life Lost due to cancer per 100 000 population 2012-22 25 OECD Health Statistics
Colon cancer 5-year survival Age-standardised 5-year net survival estimates (%) for patients
diagnosed with colon cancer, 2010-14
2000/04-
2010/14 24 CONCORD-3
Breast cancer 5-year survival Age-standardised 5-year net survival estimates (%) for women
diagnosed with breast cancer, 2010-14
2000/04-
2010/14 24 CONCORD-3
Lung cancer 5-year survival Age-standardised 5-year net survival estimates (%) for patients
diagnosed with lung cancer, 2010-14
2000/04-
2010/14 24 CONCORD-3
Educational inequalities Socio-economic inequality gap in cancer mortality between people
with higher and low education (%) 2015/19 27 IARC
C an
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C an
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an ce
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ap ac
it y
C an
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ca re
o u
tc o
m es
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EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025
Notes
1 According to data from the Cancer Registry Norway, ECIS estimations overestimate the country’s breast
cancer incidence rate (by around 6%).
2 According to data from the Cancer Registry Norway, ECIS estimations overestimate the country’s
colorectal cancer incidence rate (by around 19% among women and 15% among men).
3 Iceland, Norway and 27 EU countries are grouped into three distinct terciles based on 2022 GDP per
capita in purchasing power standard terms: the top tercile includes the highest-income countries (Austria,
Belgium, Denmark, Germany, Iceland, Ireland, Luxembourg, the Netherlands, Norway and Sweden); the
middle tercile includes the middle-income countries (Cyprus, Czechia, Finland, France, Italy, Lithuania,
Malta, Slovenia and Spain); the bottom tercile includes the lowest income-countries (Bulgaria, Croatia,
Estonia, Greece, Hungary, Latvia, Poland, Portugal, Romania and the Slovak Republic).
4 EU+2 countries include 27 EU Member States (EU27), plus Iceland and Norway. EU averages refer to
EU27 countries only.
5 Cancer prevalence refers to the proportion of the population who have been diagnosed with cancer and
are still alive, including those currently undergoing treatment for cancer and those who have completed
treatment. Five‑year cancer prevalence includes people who have been diagnosed within the previous
five years, while lifetime prevalence considers those who have ever received a cancer diagnosis.
6 While programme data are collected from administrative data or national/regional cancer registries,
survey data are obtained from international surveys, limiting the international comparability as responses
may be affected by recall bias.
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References
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Kankercentrum Nederland (IKNL).
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De Angelis, R. et al. (2024), “Complete cancer prevalence in Europe in 2020 by disease duration
and country (EUROCARE-6): a population-based study”, The Lancet Oncology, Vol. 25/3,
pp. 293-307, https://doi.org/10.1016/s1470-2045(23)00646-0.
[9]
Desimpel F, L. (2024), Lung cancer screening in a high risk population - Synthesis. Health
Technology Assessment (HTA), Federal Knowledge Centre for Health Care (KCE), Brussels.
[11]
European Commission/IARC/Erasmus MC (2024), Mapping Socio-economic Inequalities in
Cancer Mortality across European Countries.
[6]
Global Burden of Disease Collaborative Network (2021), Global burden of disease study 2021
(GBD 2021) results, https://vizhub.healthdata.org/gbd-results/ (accessed on
4 November 2024).
[10]
Hassaine, Y. et al. (2022), “Evolution of breast cancer incidence in young women in a French
registry from 1990 to 2018: Towards a change in screening strategy?”, Breast Cancer
Research, Vol. 24/1, https://doi.org/10.1186/s13058-022-01581-5.
[2]
Hofmarcher, T., C. Berchet and G. Dedet (2024), “Access to oncology medicines in EU and
OECD countries”, OECD Health Working Papers, No. 170, OECD Publishing, Paris,
https://doi.org/10.1787/c263c014-en.
[15]
Koldehoff, A. et al. (2021), “Cost-Effectiveness of Targeted Genetic Testing for Breast and
Ovarian Cancer: A Systematic Review”, Value in Health, Vol. 24/2, pp. 303-312,
https://doi.org/10.1016/j.jval.2020.09.016.
[12]
OECD (2024), Beating Cancer Inequalities in the EU: Spotlight on Cancer Prevention and Early
Detection, OECD Health Policy Studies, OECD Publishing, Paris,
https://doi.org/10.1787/14fdc89a-en.
[8]
OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, OECD
Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/85e7c3ba-en.
[16]
OECD/European Commission (2024), Health at a Glance: Europe 2024: State of Health in the
EU Cycle, OECD Publishing, Paris, https://doi.org/10.1787/b3704e14-en.
[14]
SIOPE (2024), Childhood cancer country profile, https://siope.eu/activities/joint-projects/OCEAN-
Country-Cancer-Profiles.
[17]
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Sung, H. et al. (2024), “Differences in cancer rates among adults born between 1920 and 1990
in the USA: an analysis of population-based cancer registry data”, The Lancet Public Health,
Vol. 9/8, pp. e583-e593, https://doi.org/10.1016/S2468-2667(24)00156-7.
[3]
Sung, H. et al. (2025), “Colorectal cancer incidence trends in younger versus older adults: an
analysis of population-based cancer registry data”, The Lancet Oncology, doi:
10.1016/S1470-2045(24)00600-4, pp. 51-63, https://doi.org/10.1016/S1470-2045(24)00600-
4.
[5]
Teppala, S. et al. (2023), “A review of the cost-effectiveness of genetic testing for germline
variants in familial cancer”, Journal of Medical Economics, Vol. 26/1, pp. 19-33,
https://doi.org/10.1080/13696998.2022.2152233.
[13]
Vaccarella, S. et al. (2024), “Prostate cancer incidence and mortality in Europe and implications
for screening activities: population based study”, BMJ, p. e077738,
https://doi.org/10.1136/bmj-2023-077738.
[1]
Vassal, G. et al. (2021), “Access to essential anticancer medicines for children and adolescents
in Europe”, Annals of Oncology, Vol. 32/4, pp. 560-568,
https://doi.org/10.1016/j.annonc.2020.12.015.
[18]
Vuik, F. et al. (2019), “Increasing incidence of colorectal cancer in young adults in Europe over
the last 25 years”, Gut, Vol. 68/10, pp. 1820-1826, https://doi.org/10.1136/gutjnl-2018-
317592.
[4]
E E S T I
European Cancer Inequalities Registry
Riigi vähiprofiil 2025
02 | EESTI | Riigi vähiprofiil 2025
A C (a) C (b)
B D
Inside cover
0 500 1000
Muu
Hingamisteede haigused
Tuvastatud COVID-19
Vähk
Vereringesüsteemi haigused
Eesti EL27
Vanusestandarditud suremus 100 000 elaniku kohta (2021)
76,7
78,8
80,2
81,5
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
Oodatav eluiga sünnihetkel (aastates)
17,7 %
20,2 %
18,0 %
21,3 %
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
65aastaste ja vanemate elanike osakaal (%)
7,0 %
10,4 %
0 %
5 %
10 %
15 %
Eesti EL27
Tervishoiukulud protsendina SKPst (2022 või lähim aasta)
EUR 2 014
EUR 3 533
0
1 250
2 500
3 750
Eesti EL27
Tervishoiukulud eurodes elaniku kohta ostujõu pariteedi alusel (jooksevhinnad, 2022)
# Restricted Use - À usage restreint
A C (a) C (b)
B D
Inside cover
0 500 1000
Muu
Hingamisteede haigused
Tuvastatud COVID-19
Vähk
Vereringesüsteemi haigused
Eesti EL27
Vanusestandarditud suremus 100 000 elaniku kohta (2021)
76,7
78,8
80,2
81,5
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
Oodatav eluiga sünnihetkel (aastates)
17,7 %
20,2 %
18,0 %
21,3 %
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
65aastaste ja vanemate elanike osakaal (%)
7,0 %
10,4 %
0 %
5 %
10 %
15 %
Eesti EL27
Tervishoiukulud protsendina SKPst (2022 või lähim aasta)
EUR 2 014
EUR 3 533
0
1 250
2 500
3 750
Eesti EL27
Tervishoiukulud eurodes elaniku kohta ostujõu pariteedi alusel (jooksevhinnad, 2022)
# Restricted Use - À usage restreint
A C (a) C (b)
B D
Inside cover
0 500 1000
Muu
Hingamisteede haigused
Tuvastatud COVID-19
Vähk
Vereringesüsteemi haigused
Eesti EL27
Vanusestandarditud suremus 100 000 elaniku kohta (2021)
76,7
78,8
80,2
81,5
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
Oodatav eluiga sünnihetkel (aastates)
17,7 %
20,2 %
18,0 %
21,3 %
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
65aastaste ja vanemate elanike osakaal (%)
7,0 %
10,4 %
0 %
5 %
10 %
15 %
Eesti EL27
Tervishoiukulud protsendina SKPst (2022 või lähim aasta)
EUR 2 014
EUR 3 533
0
1 250
2 500
3 750
Eesti EL27
Tervishoiukulud eurodes elaniku kohta ostujõu pariteedi alusel (jooksevhinnad, 2022)
# Restricted Use - À usage restreint
A C (a) C (b)
B D
Inside cover
0 500 1000
Muu
Hingamisteede haigused
Tuvastatud COVID-19
Vähk
Vereringesüsteemi haigused
Eesti EL27
Vanusestandarditud suremus 100 000 elaniku kohta (2021)
76,7
78,8
80,2
81,5
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
Oodatav eluiga sünnihetkel (aastates)
17,7 %
20,2 %
18,0 %
21,3 %
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27
65aastaste ja vanemate elanike osakaal (%)
7,0 %
10,4 %
0 %
5 %
10 %
15 %
Eesti EL27
Tervishoiukulud protsendina SKPst (2022 või lähim aasta)
EUR 2 014
EUR 3 533
0
1 250
2 500
3 750
Eesti EL27
Tervishoiukulud eurodes elaniku kohta ostujõu pariteedi alusel (jooksevhinnad, 2022)
# Restricted Use - À usage restreint
Riikide vähiprofiilide sari Vähktõve ebavõrdsuse register on Euroopa vähktõvevastase võitluse kava juhtalgatus. Sellest saab kindlat ja usaldusväärset teavet vähktõve ennetamise ja ravi kohta, et selgitada välja suundumused ning erinevused ja ebavõrdsus liikmesriikide, piirkondade ja elanikkon- narühmade vahel. Riikide vähiprofiilides tuuakse välja tugevad küljed, probleemid ja konkreetsed tegevusvaldkonnad kõigis 27 ELi liikmesriigis, Islandil ja Norras, et suunata Euroopa vähktõvevastase võitluse kava alusel investeeringuid ja sekkumisi ELi, riigi ja piirkonna tasandil. Lisaks toetab Euroopa vähktõve ebavõrdsuse register nullsaaste tegevuskava 1. juhtalgatust. Profiilid koostab Majanduskoostöö ja Arengu Organisatsioon (OECD) koostöös Euroopa Komisjoniga. Töörühm on tänulik riiklikele ekspertidele väärtusliku panuse ning OECD tervisekomiteele ja ELi vähktõve ebavõrdsuse registri eksperdirühmale märkuste eest.
Andme- ja teabeallikad Enamik riikide vähiprofiilides esitatud andmetest ja teabest põhineb riikide poolt Eurostatile ja OECD-le esitatud ametlikul statistikal, mis valideeriti, et tagada andmete võimalikult suur võrreldavus. Teave andmete algallikate ja alusmeetodite kohta on kättesaadav Eurostati andmebaasis ja OECD terviseandmebaasis.
Lisaks saadi andmeid ja teavet sellistest allikatest nagu Euroopa Komisjoni Teadusuuringute Ühiskeskus, sissetulekuid ja elamistingimusi käsitlev ELi statistika, Maailma Terviseor- ganisatsioon (WHO), Rahvusvaheline Vähiuurimiskeskus (IARC), Rahvusvaheline Aatomienergiaagentuur (IAEA), Euroopa pediaatrilise onkoloogia ühing, Euroopa Liidu Põhiõiguste Amet (LGBTIQ kogukonda käsitlev uuring), kooliealiste laste tervisekäitumist käsitlev uuring ja 2023. aasta riikide tervise- ja vähiprofiilid ning muudest riiklikest allikatest (mis on sõltumatud era- ja ärihuvidest). ELi kohta arvutatud keskmised on 27 liikmesriigi kaalutud keskmised, kui ei ole märgitud teisiti. ELi keskmised ei hõlma Islandit ja Norrat. Suremus- ja haigestumuskordajad on standarditud vanuse järgi 2013. aastal Eurostati poolt kinnitatud Euroopa standardrahvastiku põhjal.
Ostujõu pariteet on valuutavahetuskurss, mille abil võrdsustatakse eri vääringute ostujõud, kõrvaldades riikide hinnatasemete erinevused.
Vastutuse välistamine: Käesolev dokument avaldatakse OECD peasekretäri ja Euroopa Komisjoni presidendi vastutusel. Dokumendis e itatud arv mused ja väited ei pruugi tingimata kajastada OECD või Euroopa Liidu liikmesriikide ametlikke seisukohti. Käesoleva dokumendiga ega ka selles esitatud andmete ja diagrammidega ei piirata ühegi territooriumi staatust ega selle suveräänsust, rahvusvaheliste piiride ja riigipiiride piiristamist ega ühegi territooriumi, linna või piirkonna nime. Käesolevas ühisväljaandes kasutatud riikide ja territooriumide nimed ja kaardid on kooskõlas OECDs järgitava tavaga.
OECD vastutuse välistamine seoses konkreetsete territooriumidega:
Märkus Türgi Vabariigilt: käesolevas dokumendis sisalduv teave Küprose kohta puudutab saare lõunaosa. Ükski ametlik võim saarel ei esinda korraga nii türgi kui ka kreeka rahvusest küproslasi. Türgi tunnustab Põhja-Küprose Türgi Vabariiki. Türgi jääb Küprose küsimuses oma seisukohale seni, kuni ÜRO raames on leitud alaline ja erapooletu lahendus.
Märkus kõigilt OECDsse kuuluvatelt Euroopa Liidu liikmesriikidelt ja Euroopa Liidult: Küprose Vabariiki on tunnustanud kõik Ühinenud Rahvaste Organisatsiooni liikmed peale Türgi. Käesolevas dokumendis esitatud teave puudutab piirkonda, mis on Küprose Vabariigi tegeliku kontrolli all.
© OECD / Euroopa Liit, 2025 Käesoleva dokumendi originaali ja tõlke mis tahes vastuolu korral tuleks lugeda kehtivaks üksnes dokumendi originaal.
Peamised tervisesüsteemi ja demograafilised näitajad
Allikas: Eurostati andmebaas.
Sisukord 1. PÕHIPUNKTID 3
2. VÄHKTÕBI EESTIS 4
3. RISKITEGURID JA ENNETUSPOLIITIKA 8
4. VARAJANE AVASTAMINE 13
5. VÄHIRAVI TOIMIVUS 17
5.1. Kättesaadavus 17
5.2. Kvaliteet 20
5.3. Kulud ja kulutõhusus 23
5.4. Heaolu ja elukvaliteet 24
6. PILGUHEIT LASTE VÄHKTÕVELE 26
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Riigi vähiprofiil 2025 | EESTI | 03
1. Põhipunktid
Vähktõbi Eestis 2022. aastal oli hinnanguline vähihaigestumus Eestis meeste seas suurem, kuid naiste seas väiksem kui ELi keskmine. Sooline erinevus vähisuremuses oli üks ELi suurimaid: meeste suremus ületas naiste oma enam kui kaks korda. Tänu pidevatele edusammudele suurenes vähielulemus aastatel 2010–2020 peaaegu 40 %. 2025. aastal toimub Eesti vähitõrje tegevuskava 2021–2030 eesmärkide vahehindamine.
Riskitegurid ja ennetuspoliitika Kuigi igapäevane suitsetamine on märkimisväärselt vähenenud, on Eesti elanike tulemused mitme riskiteguri puhul, mille hulka kuuluvad ülekaalulisus ning puu- ja köögiviljade tarbimine, viletsamad kui ELi keskmine. Sotsiaal-majanduslikud erinevused naiste ülekaalulisuses on Eestis siiski väiksemad kui ELis keskmiselt ja need on viimastel aastatel vähenenud. Alkoholi- tarbimine on riigis tänu alkoholi taskukohasemaks muutumisele kasvanud ja on üks kõrgemaid ELis, ulatudes 2022. aastal 11,2 liitrini elaniku kohta. Lisaks võib osa suitsetajate osakaalu vähenemisest seostada suurenenud e-sigarettide kasutamisega, mis on eriti levinud noorte seas.
Varajane avastamine 2023. aastal oli Eesti rinna-, emakakaela- ja kolorektaalvähi sõeluuringu programmides osalusmäär läbi aegade kõrgeim. Seda tänu jõupingutustele parandada mitmesuguste vahendite abil, nagu HPV kodutestid ja maapiirkondi külastavad mammograafiabussid, programmide kättesaadavust ja teadlikkust neist programmidest. Ühes maakonnas on katsetatud ka kopsuvähi sõeluuringut ja samuti uuritakse eesnäärmevähi sõeluuringu teostatavust.
Vähiravi toimivus Viie aasta elulemus paranes 54 %-lt aastatel 2007–2011 diagnoositud vähijuhtude puhul 58 %-le vähijuhtude puhul, mis diagnoositi aastatel 2017–2021. Eestis toimub tsentral- iseeritud vähiravi ning arendatakse personaalmeditsiini ja inimesekeskseid lähenemisviise ravi kvaliteedi hindamiseks. Samas on oluline tagada ülevaade ooteaegadest, mis praegu puudub, ja piisav tööjõud. Esmatähtsaks peetakse ka vähiravimite ning diagnoosimis- ja raviviiside kättesaadavust. Palliatiivne ravi on Eestis killustunud ja teenustes esineb lünki, eriti hajuasustusega piirkondades. On oodata, et vähktõvest põhjustatud depressioonijuhtumite esinemissagedus on Eestis aastatel 2023–2050 suurem kui ELis keskmiselt, ehkki vähktõve mõju oodatavale elueale on sarnane.
A. Cancer in Eesti B (a). Adolescent risk factors and prevention policies
C. Early detection (ver. 1) D. (a) Cancer care performance (health expenditure)
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Eesti EL27 Mehed Naised
Vanusestandarditud kordajad 100 000 elaniku kohta
Vähihaigestu mus (2022)
Vähisuremus (2021)
3,6 %
6,8 %
0 %
3 %
5 %
8 %
Vähiga seotud kulude prognoositud osakaal tervishoiukuludes (2023.– 2050. aasta keskmine)
1,9 1,9
0,0
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1,0
1,5
2,0
2,5
Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
0 %
10 %
20 %
30 %
40 %
50 %
60 %
70 %
Eesti EL27 Eesti EL27
2017 2022 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
63 % 58 % 55 % 0 %
20 %
40 %
60 %
80 %
Rinnavähk Emakakaelavähk Kolorektaalvähk
2022 2019
% sihtrühma kuulunud elanikest, kes osales sõeluuringus (2022 või lähim aasta)
0 % 10 % 20 % 30 % 40 % 50 % 60 % 70 %
Eesti EL27 Eesti EL27
2017 2022 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
0 5 10 15 20 25
0 10 20 30
5 15 25 35 45
40,045,00,055,060,065,070,075,080,085,090,095,01 ,01 5,0110,015,020,0125,0130,0135,0140,0145,01 0,0155,0160,0165,0170,0175,0180,0185,0190,0195,0200,02 5,0210,0215,0220,025,030,0235,0240,0245,02 0,0255,0260,0265,0270,0275,0280,0
Eesti - Alumised 20% Eesti - Ülemised 20% EL27 - Alumised 20% EL27 - Ülemised 20%
Suitsetamine
% 11–15aastastest
Alkoholitarbimine % 11–15aastastest
Ülekaal (sh rasvumine) % 11–15aastastest
1,9 1,9
0,0
0,5
1,0
1,5
2,0
2,5
Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
23
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0
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Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
1,9 1,9
0,0
0,5
1,0
1,5
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Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
23
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Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
Use alternative below
# Restricted Use - À usage restreint
A. Cancer in Eesti B (a). Adolescent risk factors and prevention policies
C. Early detection (ver. 1) D. a) Cancer care performance (h alth expenditure)
Highlights pg1
B (b
). Ri
sk fa
ct or
s an
d so
ci oe
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m ic
in eq
ua lit
ie s
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Eesti EL27 Mehed Naised
Vanusestandarditud kordajad 100 000 elaniku kohta
Vähihaigestu mus (2022)
Vähisuremus (2021)
3,6 %
6,8 %
0 %
3 %
5 %
8 %
Vähiga seotud kulude prognoositud osakaal tervishoiukuludes (2023.– 2050. aasta keskmine)
1,9 1,9
0,0
0,5
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Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
0 %
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Eesti EL27 Eesti EL27
22027102 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
63 % 58 % 55 % 0 %
20 %
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60 %
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Rinnavähk Emakakaelavähk Kolorektaalvähk
2022 2019
% sihtrühma kuulunud elanikest, kes osales sõeluuringus (2019-2022 või lähim aasta)
0 % 10 % 20 % 30 % 40 % 50 % 60 % 70 %
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22027102 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
0 5 10 15 20 25
0 10 20 30
5 15 25 35 45
40,045,00,055,060,065,070,075,080,085,090,095,01 ,01 5,0110,015,020,0125,0130,0135,0140,0145,01 0,0155,0160,0165,0170,0175,0180,0185,0190,0195,02 0,02 5,0210,0215,0220,025,030,0235,0240,0245,02 0,0255,0260,0265,0270,0275,0280,0
Eesti - Alumised 20% Eesti - Ülemised 20% EL27 - Alumised 20% EL27 - Ülemised 20%
Suitsetamine
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1,9 1,9
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Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
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Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
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Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
Use alternative below
# Restricted Use - À usage restreint
A. Cancer in Eesti B (a). Adolescent risk factors and prevention policies
C. Early detection (ver. 1) D. (a) Cancer care performance (health expenditure)
Highlights pg1
B (b
). R
is k
fa ct
or s
an d
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eq ua
lit ie
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Eesti EL27 Mehed Naised
Vanusestandarditud kordajad 100 000 elaniku kohta
Vähihaigestu mus (2022)
Vähisuremus (2021)
3,6 %
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Vähiga seotud kulude prognoositud osakaal tervishoiukuludes (2023.– 2050. aasta keskmine)
1,9 1,9
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Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
0 %
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Eesti EL27 Eesti EL27
2017 2022 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
63 % 58 % 55 % 0 %
20 %
40 %
60 %
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Rinnavähk Emakakaelavähk Kolorektaalvähk
2022 2019
% sihtrühma kuulunud elanikest, kes osales sõeluuringus (2022 või lähim aasta)
0 % 10 % 20 % 30 % 40 % 50 % 60 % 70 %
Eesti EL27 Eesti EL27
2017 2022 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
0 5 10 15 20 25
0 10 20 30
5 15 25 35 45
40,045,00,055,060,065,070,075,080,085,090,095,01 ,01 5,0110,015,020,0125,0130,0135,0140,0145,01 0,0155,0160,0165,0170,0175,0180,0185,0190,0195,0200,02 5,0210,0215,0220,025,030,0235,0240,0245,02 0,0255,0260,0265,0270,0275,0280,0
Eesti - Alumised 20% Eesti - Ülemised 20% EL27 - Alumised 20% EL27 - Ülemised 20%
Suitsetamine
% 11–15aastastest
Alkoholitarbimine % 11–15aastastest
Ülekaal (sh rasvumine) % 11–15aastastest
1,9 1,9
0,0
0,5
1,0
1,5
2,0
2,5
Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
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Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
1,9 1,9
0,0
0,5
1,0
1,5
2,0
2,5
Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
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Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
Use alternative below
# Restricted Use - À usage restreint
A. Cancer in Eesti B (a). Adolescent risk factors and prevention policies
C. Early detection (ver. 1) D. (a) Cancer care performance (health expenditure)
Highlights pg1
B (b
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sk fa
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Eesti EL27 Mehed Naised
Vanusestandarditud kordajad 100 000 elaniku kohta
Vähihaigestu mus (2022)
Vähisuremus (2021)
3,6 %
6,8 %
0 %
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8 %
Vähiga seotud kulude prognoositud osakaal tervishoiukuludes (2023.– 2050. aasta keskmine)
1,9 1,9
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Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
0 %
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Eesti EL27 Eesti EL27
22027102 Madal haridustase Kõrge haridustase
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63 % 58 % 55 % 0 %
20 %
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Rinnavähk Emakakaelavähk Kolorektaalvähk
2022 2019
% sihtrühma kuulunud elanikest, kes osales sõeluuringus (2019-2022 või lähim aasta)
0 % 10 % 20 % 30 % 40 % 50 % 60 % 70 %
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22027102 Madal haridustase Kõrge haridustase
Ülekaaluliste (sh rasvunud) naiste osakaal
0 5 10 15 20 25
0 10 20 30
5 15 25 35 45
40,045,00,055,060,065,070,075,080,085,090,095,01 ,01 5,0110,015,020,0125,0130,0135,0140,0145,01 0,0155,0160,0165,0170,0175,0180,0185,0190,0195,02 0,02 5,0210,0215,0220,025,030,0235,0240,0245,02 0,0255,0260,0265,0270,0275,0280,0
Eesti - Alumised 20% Eesti - Ülemised 20% EL27 - Alumised 20% EL27 - Ülemised 20%
Suitsetamine
% 11–15aastastest
Alkoholitarbimine % 11–15aastastest
Ülekaal (sh rasvumine) % 11–15aastastest
1,9 1,9
0,0
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1,0
1,5
2,0
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Eesti EL27
Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
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Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
1,9 1,9
0,0
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1,0
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Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine)
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Depressioonijuhtumite arvu vähist tingitud prognoositud suurenemine aastas 100 000 elaniku kohta (vanusestandarditud) (2023.– 2050. aasta keskmine)
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# Restricted Use - À usage restreint
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1: Age-standardised incidence rate per 100 000 in 2022
Eesnäärmevähk 219 (28 %) Eesnäärmevähk 154 (23 %) Rinnavähk 110 (24 %) Rinnavähk 148 (30 %)
Kolorektaalvähk 107 (14 %)
Kolorektaalvähk 93 (14 %)
Kolorektaalvähk 62 (14 %) Kolorektaalvähk 58 (12 %)
Kopsuvähk 110 (14 %)
Kopsuvähk 95 (14 %)
Kopsuvähk 29 (6 %) Kopsuvähk 44 (9 %)
Põievähk 48 (6 %)
Põievähk 61 (9 %)
Emakakehavähk 32 (7 %) Emakakehavähk 27 (5 %)
Muu 297 (38 %)
Muu 282 (41 %)
Muu 220 (49 %) Muu 212 (43 %)
780
684
452 488
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Eesti EL27 Eesti EL27
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Hinnanguline vanusestandarditud haigestumus 100 000 elaniku kohta (2022)
Eesnäärmevähk 219 (28 %) Eesnäärmevähk 154 (23 %) Rinnavähk 110 (24 %) Rinnavähk 148 (30 %)
Kolorektaalvähk 107 (14 %)
Kolorektaalvähk 93 (14 %) Kolorektaalvähk 62 (14 %)
Kolorektaalvähk 58 (12 %)
Kopsuvähk 110 (14 %)
Kopsuvähk 95 (14 %)
Kopsuvähk 29 (6 %) Kopsuvähk 44 (9 %)
Põievähk 48 (6 %)
Põievähk 61 (9 %)
Emakakehavähk 32 (7 %) Emakakehavähk 27 (5 %)
Muu 297 (38 %)
Muu 282 (41 %)
Muu 220 (49 %) Muu 212 (43 %)
780
684
452 488
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Eesti EL27 Eesti EL27
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Hinnanguline vanusestandarditud haigestumus 100 000 elaniku kohta (2022)
# Restricted Use - À usage restreint
2. Vähktõbi Eestis
1 Kopsuvähk hõl ab ka hingetoru- ja bronhivähki.
Vähihaigestumus on Eestis meeste seas suurem, kuid naiste seas väiksem kui ELi keskmine Teadusuuringute Ühiskeskuse Euroopa vähiteabesüsteemi (ECIS) andmete kohaselt oli Eestis 2022. aastal – tuginedes pandeemi- aeelsete aastate haigestumussuundumustele – hinnanguliselt 7817 vähijuhtumit: 3726 naiste ja 4091 meeste seas. Vanusestandarditud hinnanguline haigestumus oli meeste puhul 780 juhtumit 100 000 elaniku kohta, mis oli suuruselt kuues ELis ja 14 % suurem kui ELi keskmine (Joonis 1). Naiste seas oli hinnanguline haigestumus 452 juhtumit 100 000 elaniku kohta, mis jääb 7 % alla ELi keskmise.
Eesti meeste vähijuhtumite seas oli suurim osakaal eesnäärmevähil (28 %), kusjuures selle esinemissagedus oli 42 % suurem kui ELi keskmine. Teine meeste seas kõige enam levinud vähivorm oli kolorektaalvähk (14 %), millele järgnes kopsuvähk1 (14 %). Naiste seas oli Eestis levinuim vähivorm rinnavähk, mis moodustas 24 % kõigist vähijuhtumitest, kuigi selle esinemissagedus oli 26 % väiksem kui ELi keskmine. Eesti maakondade lõikes oli vähihaigestumus 2021. aastal väga erinev. See oli mõlema soo puhul kõige suurem Lõuna- ja Ida-Eesti maakondades ning kõige väiksem Tallinna ja Tartu piirkonnas (Tervise Arengu Instituut, 2024a).
Joonis 1. Eestis on vähihaigestumus meeste seas suurem, kuid naiste seas väiksem kui ELi keskmine
Märkused. 2022. aasta näitajad on varasemate aastate haigestumussuundumustel põhinevad hinnangud ja võivad hilisematel aastatel täheldatud haigestumusest erineda. Kõik vähipaikmed, v.a. mittemelanoomne nahavähk. Emakakehavähk ei hõlma emakakaela ähki. Allikas: Euroopa vähiteabesüsteem (ECIS), https://ecis.jrc.ec.europa.eu (vaadatud 10. märtsil 2024), © Euroopa Liit, 2024. Haigestumuse protsentuaalne jaotus arvutati vanusestandarditud haigestumuse põhjal ümber ja seetõttu erineb see ECISe veebisaidil esitatud absoluutarvude protsentuaalsest jaotusest.
Võrreldes 2000. aastaga oli vanusestandardimata vähihaigestumus 2019. aastaks Eestis mõlema soo puhul suurenenud: 55 % meeste ja 44 % naiste seas (Tervise Arengu Instituut, 2024a). Pärast korrigeerimist elanikkonna vananemise mõju arvesse võtmiseks on siiski näha, et
vähihaigestumus on püsinud alates 2010. aastast nii meeste kui ka naiste puhul stabiilne. Meeste hulgas on alates 1990. aastate lõpust vähenenud vanusestandarditud haigestumus kopsuvähki (Zimmermann et al., 2024), samas kui rinnavähki haigestumus naiste seas on suurenenud (Tervise
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Eesti EL27 Sarnase ostujõuga riigid
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Eesti EL27 Sarnase ostujõuga riigid
Vanusestandarditud suremus vähi tõttu 100 000 elaniku kohta (2021)
# Restricted Use - À usage restreint
2: Cancer mortality by gender & change over 10-year period
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Vanusestandarditud suremus vähi tõttu 100 000 elaniku kohta (2021)
# Restricted Use - À usage restreint
Arengu Instituut, 2024b). 2021. aastal oli koguvähi- haigestumus mõlema soo puhul Eestis 8 % väiksem kui COVID-19 pandeemia eelne viie aasta keskmine (2015–2019), osaliselt viivituste tõttu mõne vähivormi diagnoosimisel, mida täheldati nii 2020. kui ka 2021. aasta puhul. Haigestumuse vähenemist saab osaliselt seostada riskitegurite pikaajalise vähenemisega (nt kopsu- ja maovähi puhul) ning emakakaelavähi sõeluuringu programmi mõjuga (Zimmermann et al., 2024). Tulevikku vaadates prognoosib ECIS siiski, et vähijuhtumite arv suureneb 2022.–2040. aastal 19 %.
Vähk põhjustab Eestis viiendiku kõigist surmadest 2021. aastal oli vähktõvest tingitud vanusestandarditud suremus Eestis 266 juhtumit
2 Riigid on jaotatud tertsiilidesse, võttes aluseks 2022. aasta SKP elaniku kohta ostujõu standardina. Eesti jaoks on sarnase ostujõuga riigid Bulgaaria, Horvaatia, Kreeka, Läti, Poola, Portugal, Rumeenia, Slovakkia ja Ungari.
100 000 elaniku kohta – vähk põhjustas 20 % kõigist surmadest ja suremus oli 13 % suurem kui ELis keskmiselt. Eesti meeste vähisuremus oli ELis suuruselt neljas (34 % üle ELi keskmise), naiste suremus oli keskmisele lähemal (4 % üle keskmise). Koguvähisuremus oli alates 2011. aastast siiski vähenenud 11 % nii meeste kui ka naiste puhul. Tuleb märkida, et meeste seas kahanes suremus vähem kui ELis ja sarnase ostujõuga riikides keskmiselt,2 ent naiste puhul rohkem kui teistes riikides keskmiselt (Joonis 2).
Ehkki suremus kopsuvähki on vähenenud Eestis alates 2011. aastast 16 %, oli kopsuvähk 2021. aastal endiselt kõige sagedasem surma kaasa toonud vähiliik, põhjustades 16 % kõigist vähisurmadest; sellele järgnes kolorektaalvähk 13 %ga.
Joonis 2. Eestis on ühed ELi suurimaid soolised erinevused vähisuremuses
Märkused. Riigid on jaotatud tertsiilidesse, võttes aluseks 2022. aasta SKP elaniku kohta ostujõu standardina. Eesti jaoks on sarnase ostujõuga riigid Bulgaaria, Horvaatia, Kreeka, Läti, Poola, Portugal, Rumeenia, Slovakkia ja Ungari. Allikas: Eurostati andmebaas.
Soolised erinevused vähisuremuses on Eestis ühed ELi suurimad Eesti on Läti ja Leedu kõrval üks kolmest ELi riigist, kus vähisuremus on meeste seas enam kui kaks korda suurem kui naiste seas, mis kujutab endast ühte suurimaid soolisi erinevusi ELis. Kõige suurem erinevus võrreldes ELi keskmisega oli vanemate meeste hulgas: üle 65aastaste suremus ületas ELi keskmist 37 %, olles Horvaatia ja Läti näitaja järel ELis suuruselt kolmas. Nagu mujalgi ELis, vähenes suremus aastatel 2011–2022 märksa enam
nooremate inimeste hulgas. Langus oli suurem alla 65aastaste meeste seas (25 %) kui üle 65aastastel meeste seas (7 %) ja alla 65aastaste naiste seas (26 %) kui üle 65aastastel naiste seas (5 %).
Eestis on eriti suured haridustasemest tingitud sotsiaalsed erinevused vähisuremuses. Meeste seas on erinevus madalama ja kõrgema haridustasemega inimeste vahel peaaegu 130 % (võrreldes 84 %ga ELis), naiste seas peaaegu 60 % (võrreldes 36 %ga ELis) (Joonis 3).
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3: Avoidable mortality by cancer type and year
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Joonis 3. Eestis on madalama haridustasemega meeste suremus üle kahe korra suurem kui kõrgema haridustasemega meeste suremus
Märkused. Andmed tulevad ELi CanIneqi uuringust ja on aastate 2015–2019 kohta. EL 15 keskmine on 14 ELi riigi ja Norra kaalumata keskmine. Allikas: Euroopa Komisjon / IARC / Erasmus MC (2024), „Mapping Social-economic Enequalities in Cancer Mortality in European Countries“, vähktõve ebavõrdsuse registri teabeleht vähktõvega seotud erinevuste kohta.
3 Välditav suremus hõlmab ennetatavaid surmajuhtumeid, mida on võimalik ära hoida tõhusate rahvatervise ja ennetusmeetmetega, kui ka raviga välditavaid surmajuhtumeid, mida saab ära hoida õigeaegse ja tõhusa raviga.
Ehkki ennetatav suremus kopsuvähki väheneb, on probleemiks raviga välditav suremus kolorektaalvähki 2021. aastal oli ennetatavaks suremuseks liigituv välditav suremus3 kopsuvähki naiste seas 12 juhtumit 100 000 elaniku kohta (41 % väiksem kui ELi keskmine) ja meeste seas 51 juhtumit 100 000 elaniku kohta (17 % suurem kui ELi keskmine). Võrreldes 2011. aastaga on see näitaja kahanenud naiste puhul 9 % ja meeste puhul 27 % (Joonis 4), mis on kooskõlas suitsetamise vähenemisega (vt punkt 3).
Raviga välditav suremus rinnavähki oli Eestis 2021. aastal 18 juhtumit 100 000 naise kohta, mis on 4 % väiksem kui ELi keskmine. Seda on 23 % vähem kui 2011. aastal, mis tähendab suuremat kahanemist kui ELi keskmine. Raviga välditav suremus kolorektaalvähki oli Eestis märkimisväärselt suurem – naiste seas 37 % ja meeste seas 24 % üle ELi keskmise. Võrreldes 2011. aastaga oli standarditud suremus 2021. aastal naiste puhul 23 % suurem, kuid raviga välditavate surmajuhtumite arv vähenes nii 2022. kui ka 2023. aastal mõlema soo puhul. Siinkohal tuleks arvesse võtta seda, et kolorektaalvähi sõeluuring hõlmab Eestis kitsast vanusevahemikku (vt punkt 4), mis võib kaasa tuua hilisema diagnoosimise ja keerukama ravi.
Joonis 4. Hoolimata vähenemisest meeste seas, on suremus kolorektaalvähki Eesti naiste seas suurenenud
Märkus. Välditava suremuse näitajad hõlmavad alla 75aastaseid inimesi. Allikas: Eurostati andmebaas. Andmed on 2021. aasta kohta.
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Vähilevimus on suurenenud Eestis alates 2010. aastast rohkem kui kolmandiku võrra 2022. aastal oli viie aasta levimus4 Eestis 1780 vähijuhtumit 100 000 elaniku kohta, mis on 5 % väiksem kui ELi keskmine. Tänu muutustele mõne vähivormi esinemissageduses ja elulemuse paranemisele (vt punkt 5.2) suurenes vanusestandarditud vähilevimus riigis 2010.–2020. aastal 39 % (Joonis 5). Kuigi
4 Vähi levimus osutab sellele osale elanikkonnast, kellel on diagnoositud vähk ja kes on endiselt elus, hõlmates nii neid, kes saavad praegu vähiravi, kui ka neid, kelle ravi on lõppenud. Viie aasta levimus hõlmab inimesi, kellel on diagnoositud vähk viimase viie aasta jooksul.
see on üks suuremaid suhtelisi kasve kogu ELis, tuleb märkida, et 2010. aastal oli Eesti vähilevimus poolest ELis tagantpoolt kuuendal kohal. Muutused levimuses kajastavad varajase avastamise ning vähiravi kättesaadavuse ja kvaliteedi paranemist ning neil on ulatuslik mõju vajadusele tagada vähktõvega elavatele inimestele ja vähktõvest jagusaanutele pikaajaline hooldus ja psühhosotsiaalne tugi.
Joonis 5. Vähilevimus suureneb Eestis kiiresti
Allikad: Rahvusvahelise Vähiuurimiskeskuse (IARC) Globocani andmebaas, 2024; uuring EUROCARE-6 (De Angelis et al., 2024).
2025. aastal toimub Eesti vähitõrje tegevuskava 2021–2030 vahehindamine Eestis on tehtud alates 2021. aastast ulatuslikke jõupingutusi, et parandada vähktõve tõrjet, rakendades vähitõrje tegevuskava 2021–2030 (sotsiaalministeerium ja Tervise Arengu Instituut, 2021) (Tekstikast 1). Kasutusel on jooksev rakenduskava, et vaadata regulaarselt läbi eri sidusrühmade tegevus. Hoolimata COVID-19 põhjustatud viivitustest vähitõrje tegevuskava elluviimisel hinnatakse 2025. aastal tegevuskava eesmärkide saavutamisel tehtud edusamme kooskõlas Eesti riikliku tervisekava 2020–2030 vahehindamisega.
Eesti vähiregister sisaldab enam kui 50 aasta andmeid, mis hõlmavad kõiki pahaloomulisi kasvajaid, sealhulgas in situ kasvajaid ja mõningaid piirpahaloomulisi kasvajaid. Register jälgib vähidiagnoosi saanud isikuid kogu nende elu jooksul, kogudes eri allikatest andmeid haigestumuse, suremuse, elulemuse, vähi staadiumide, diagnoosimise ja ravi kohta. Tervise Arengu Instituut juhib ennetustegevust ja sõeluuringute korraldamist, mida rahastab Tervisekassa. Andmete kogumine ja protsessinäitajad on valdkond, mis vajab parandamist, kuna oluline teave, näiteks vähikahtl se ning diagnoosi ja ravi vahele jäävate ooteaegade kohta, puudub. Jälgimise parandamiseks tehakse tööd vähikeskuste andmestruktuuride ühtlustamiseks.
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Tekstikast 1. Eesti vähitõrje tegevuskava 2020–2030 on üldjoontes kooskõlas Euroopa vähktõvevastase võitluse kava põhisammastega Eesti avaldas uuendatud vähitõrje tegevuskava aastateks 2021–2030, viies oma prioriteedid kooskõlla Euroopa vähktõvevastase võitluse kavaga selle mitme samba ja valdkonnaülese teema puhul (Tabel 1). Tegevuskava eesmärk on vähendada kõige sagedasemate riskitegurite levimust, lahendada kvaliteedinäitajate abil probleeme sõeluuringuprogrammide koordineerimisel ja hindamisel, rakendada diagnoosimisel patsiendikeskset, personaalset ja süstemaatilist lähenemisviisi ning parandada vähipatsientide juurdepääsu psühholoogilisele ja sotsiaalsele toele ning rehabilitatsiooniteenustele. Tegevuskavas on seatud tähtsale kohale ka lastele pakutavad teenused (vt punkt 6). Kuigi tegevuskava erinevates jagudes käsitletakse ebavõrdsust ja teadusuuringuid, ei ole neile eraldi keskendutud.
Tabel 1. Eesti vähitõrje tegevuskava on osaliselt kooskõlas Euroopa vähktõvevastase võitluse kavaga
Euroopa kava sambad Euroopa kava valdkonnaülesed
teemad
Ennetus Varajane
avastamine Diagnoosimine
ja ravi Elukvaliteet Ebavõrdsus Pediaatria
Teadusuuringud ja innovatsioon
Märkused. Sinine tähendab, et vähitõrje tegevuskava sisaldab eraldi jagu sel teemal; oranž tähendab, et teemat käsitletakse mõnes tegevuskava jaos, kuid sellele ei ole eraldi keskendutud, ning roosa tähendab, et seda teemat tegevuskavas ei käsitleta. Allikas: Euroopa vähktõvevastase võitluse kava rakendamise kaardistamist ja hindamist käsitleva veel avaldamata uuringu põhjal.
3. Riskitegurid ja ennetuspoliitika
5 Tervishoiu arvepidamissüsteemis kajastatavad ennetuskulutused peaksid hõlmama riiklike programmide väliseid tegevusi (nt oportunistlikud vähi sõeluuringud või suitsetamisest loobumise alane nõustamine tavalise arstivisiidi ajal), kuid tegelikkuses võib riikidel olla keeruline eristada kulutusi, mis tehakse ennetusele väljaspool riiklikke programme.
Eesti peab esmatähtsaks vähendada vähi riskitegurite levimust elanikkonna seas 2019. aastal oli ennetuse eesmärgil tehtud tervishoiukulutuste osakaal Eestis 4 %5. Järgmistel aastatel kulus kuni 9 % tervishoiuku- lutustest COVID-19ga seotud tegevusele, mille järel oli ennetusele kulutatud vahendite osakaal 2022. aastal 6 %. Oluline on märkida, et Eesti kulutab tervishoiule ELi keskmisega võrreldes vähe ning kuigi ennetusele kulutatud osa tervishoiuku- lutustest oli suurem kui ELi keskmine, olid Eesti ennetuskulutused elaniku kohta (mida on kohandatud ostujõu erinevuste alusel) 2019. aastal ELi keskmisest 31 % väiksemad.
Eesti vähitõrje tegevuskava 2021–2030 üks põhieesmärke on vähendada riskitegurite levimust elanikkonnas. Iga riskiteguriga tegelemiseks on algatatud mitmeid meetmeid, sealhulgas pandud rõhku noorukite kaitsmisele riskide eest
terviklikuma koolitervishoiu kaudu. 1995. aastal vastu võetud määruse alusel on kogu riigis tööle võetud riigi palgal olevad kooliõed, kes tegelevad peamiselt tervise edendamise ja haiguste ennetamisega. Lisaks, et rakendada koordineeritud strateegiaid ja parimaid tavasid, osaleb Tervise Arengu Instituut ELi ühisprojektis (Joint Action PreventNCD), mille eesmärk on ennetada mitmesuguste riskiteguritega seotud meetmete abil vähktõbe ja muid mittenakkuslikke haigusi.
Joonisel 6 on näidatud Eesti paiknemine valitud riskitegurite osas võrreldes teiste ELi riikide, Islandi ja Norraga. Teiste riikidega võrreldes läheb Eestil hästi õhusaastega kokkupuutumise vaatenurgast. Samas on kõrge levimuse tõttu jätkuvalt olulisteks riskideks alkoholitarbimine, ülekaalulisus ja viletsad toitumisharjumused ning inimeste papilloomiviiruse (HPV) vastu vaktsineerituse tase Eestis oli 2023. aastal üks madalamaid ELis. Kuigi sissetulekuid ja elamistingimusi käsitleva
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6a: Prevalence of behavioral cancer risk factors among adults & environmental risk factors
Igapäevane suitsetamine
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ELi uuringu (EU-SILC) andmetest on näha, et Eesti tulemused igapäevase suitsetamise ja vähese kehalise aktiivsuse osas on teiste ELi riikidega
võrreldes suhteliselt head, osutavad riiklikud uuringud, et need riskitegurid on jätkuvalt probleemiks.
Joonis 6. Eestis on võrreldes ELi keskmisega laialt levinud sellised olulised vähi riskitegurid nagu alkoholitarbimine ning ülekaalulisus ja rasvumine
Märkused. Mida lähemal on punkt keskpunktile, seda paremad on riigi tulemused võrreldes teiste ELi riikidega. Valgel n-ö sihtalal ei ole ükski riik, kuna kõigil riikidel on kõigis valdkondades arenguruumi. Õhusaastet mõõdetakse tahkete osakestena, mille läbimõõt jääb alla 2,5 mikromeetri (PM2,5). Allikad: sissetulekuid ja elamistingimusi käsitleval 2022. aasta ELi uuringul (EU-SILC) põhinevad OECD arvutused (ülekaalulisuse, rasvumise, kehalise aktiivsuse ning puu- ja köögiviljade tarbimise puhul (täiskasvanud)); Eurofoundi uuring töökeskkonnas esinevate ohutegurite kohta; OECD tervisestatistika (suitsetamise ja alkoholitarbimise (täiskasvanud) ning õhusaaste puhul) ning WHO (HPV vastu vaktsineerimise puhul (15aastased tüdrukud)).
Suitsetamise levimuse vähenemist varjutavad uued riskid – noored on hakanud üha rohkem veipima Igapäevane suitsetamine on Eestis alates 2010. aastast märkimisväärselt vähenenud, olles kahanenud 2022. aastaks rohkem kui 10 protsendipunkti võrra 16 %-le. Kahanemine on olnud eriti järsk meeste seas – 37 %-lt 2010. aastal 21 %-le 2022. aastal –, mis on kooskõlas kopsuvähki haigestumuse ja suremuse vähenemisega. Viimase
30 päeva jooksul vähemalt korra suitsetanute osakaal 15aastaste seas vähenes Eestis aastatel 2014–2022 mõlema soo puhul, ehkki poiste seas rohkem (vähenes 49 %) kui tüdrukute seas (36 %) (Joonis 7). Seda saab osaliselt seostada viimati 2019. aastal muudetud tõhusa tubakatoodete tarbimise piiramise poliitikaga, millega reguleeritakse tubakatoodete ja nendega seotud toodete reklaami ja väljapanekut.
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Joonis 7. Eesti 15aastased tüdrukud suitsetavad ja teatavad, et nad on olnud purjus, suurema tõenäosusega kui samas vanuses poisid
Märkus. ELi keskmine on kaalumata keskmine. Andmed on 2022. aasta kohta. Allikas: kooliealiste laste tervisekäitumist käsitlev uuring.
Paraku on osa suitsetamise vähenemisest tingitud ka sellest, et alternatiivsed nikotiinitooted on muutunud laialdasest kättesaadavaks – 2022. aastal kasutas neid 10 % Eesti elanikest. Kogunäitajast ei ole näha, kui ulatuslik on see probleem noorte hulgas: 15–24aastastest teatas regulaarsest veipimisest peaaegu 30 % (35 % naistest ja 24 % meestest); 15aastastest oli viimase 30 päeva jooksul suitsetanud vähemalt üks kord e-sigaretti 20 % poistest ja 30 % tüdrukutest. Alates 2019. aastast on olnud tubakaseadusega keelatud kasutada e-sigarettide vedelikes muid maitse- ja lõhnaained peale tubaka ning samuti on keelatud tubakatoodete kaugmüük. Samas on endiselt võimalik teha internetioste välismaalt.
Pärast alkoholiaktsiisi vähendamist 2019. aastal suurenes Eestis alkoholitarbimine Kuigi alkoholitarbimine inimese kohta vähenes tänu alkoholipoliitika rohelises raamatus ette nähtud meetmete süstemaatilisele rakendamisele 12 liitrilt 2012. aastal 10 liitrile 2018. aastal, suurenes see 2022. aastal 11 liitrile, kuna alkohol muutus 2019. aasta aktsiisivähenduse tulemusel taskukohasemaks. Alkoholitarbimise reguleerimist riigis raskendab tava osta alkoholi üle piiri Lätist, mis nõuab ühtlustatud poliitikameetmeid. Kuigi Eesti on piiranud kellaaegu, mil alkohol on kauplustes kättesaadav, ei ole kehtestatud piiranguid müügikohtade tihedusele, maksustamist ei kohandata vastavalt inflatsioonile ning alkoholi puhul ei ole kasutusel spetsiaalseid terviseohust hoiatavaid etikette (OECD, 2024a).
2021. aastal oli Eestis 4 % kõigist vähijuhtumitest seostatavad alkoholiga. Samas selgus 2022. aastal
alkoholitarbijate seas korraldatud uuringust, et vaid 11 % naistest pidas alkoholi rinnavähi riskiteguriks ja üksnes 27 % inimestest pidas seda riskiteguriks kolorektaalvähi puhul, mis näitab, et üldsuse teadlikkus on suhteliselt madal. Teadlikkuse suurendamiseks on korraldatud avalikke kampaaniaid, et juhtida tähelepanu alkoholi rollile vähktõve puhul, nagu kampaania „Septembris ei joo“, veebipõhine eneseabialgatus „Selge“ ning Euroopa Sotsiaalfondi programm „Kainem ja tervem Eesti“. Vaid 9 % neist inimestest, kelle iganädalane alkoholitarbimine kujutab endast suurt riski (7 standardühikut naiste ja 14 meeste puhul), teatasid, et nad on saanud tervishoiutöötajalt soovituse tarbimist vähendada, mis osutab vajadusele tervishoiutöötajaid täiendavalt koolitada ära tundma probleeme ja vajaduse korral sekkuma (Tervise Arengu Instituut, 2023).
Tarbimisharjumused on mõnevõrra muutunud: aastatel 2012–2022 vähenes rohkem kui üks kord nädalas alkoholi tarbivate meeste osakaal (33 %-lt 27 %-le), samal ajal kui naiste seas see osakaal suurenes (11 %-lt 12 %-le). Naiste hulgas on suurenenud korrapärane veinijoomine (Tervise Arengu Instituut, 2023). Alkoholitarbimine Eesti noorukite seas on vähenenud: purjus olnute osakaal 15aastaste noorukite hulgas kahanes 2014.–2022. aastal 9 protsendipunkti, kuigi see on endiselt suurem kui ELi keskmine. Vastupidiselt varasematele suundumustele oli neid 15aastaseid, kes olid viimase 30 päeva jooksul purjus olnud, 2022. aastal tüdrukute seas rohkem kui poiste seas (vt Joonis 7).
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Ülekaalulisus ja rasvumine sageneb Eestis mõlema soo puhul Peaaegu kolm täiskasvanut viiest (57 %) on Eestis ülekaalulised (sh rasvunud) ja 22 % täiskasvanutest on rasvunud. Ülekaalulisus ja rasvumine on rohkem levinud Eesti meeste seas (62 %) kui naiste hulgas (53 %), kuigi rasvumine üksi on naiste
seas sagedasem (23 %) kui meeste hulgas (21 %). Ülekaaluliste osakaal on võrreldes 2017. aastaga suurenenud mõlema soo puhul. Naiste puhul on ülekaalul seos haridustasemega (Joonis 8), kuid mitte meeste puhul, kuigi rasvumisest teatavad nii madalama haridustasemega mehed kui ka naised suurema tõenäosusega kui kõrgema haridustasemega mehed ja naised.
Joonis 8. Eesti on ülekaaluliste (sh rasvunud) naiste osakaalu poolest ELis viiendal kohal
Märkus. Ülekaalulised (sh rasvunud) inimesed on inimesed, kelle kehamassiindeks on üle 25. Allikas: Eurostati andmebaas.
Eestis suurenes 15aastaste seas ülekaalulisus 2014.–2022. aastal 5 protsendipunkti võrra (vt Joonis 7). Olulised soolised erinevused ilmnevad juba selles vanuses, kuna 2022. aastal teatas ülekaalulisusest 29 % poistest võrreldes 13 %ga tüdrukutest.
Jätkuvalt on probleemiks kehalise aktiivsuse ja toitumisega seotud riskitegurid Enam kui pool Eesti elanikest teatas, et nad tarbivad puu- (51 %) ja köögivilju (50 %) harvem kui kord päevas, mida on üle 10 protsendipunkti rohkem kui ELi keskmine (39 % puuviljade ja 40 % köögiviljade puhul). Väiksema tõenäosusega teatasid vähesest tarbimisest naised ja kõrgharidusega inimesed. 15aastastest teatas üle kahe kolmandiku, et nad ei söö vähemalt kord päevas puuvilju (tüdrukud veidi vähem (67 %) kui poisid (74 %)), samal ajal kui peaaegu kolm neljandikku (73 %) teatas, et nad ei söö iga päev köögivilju.
Toitumise parandamiseks on koostatud toidu koostise muutmise kava, mille üle hakatakse pidama 2023. aasta septembris läbirääkimisi toidutööstusega. 2023. aastal võeti vastu käitumiskoodeks, mis käsitleb ebatervisliku toidu ja joogi vastutustundlikku telereklaami
lastesaadete ajal, kuigi seda juhendit kohaldatakse ainult alla 12aastaste laste puhul. Lisaks on juhend vabatahtlik ja see ei hõlma digiturundust, otseturundust ega avalikus ruumis korraldatavaid kampaaniaid. 2024. aastal arutati suhkrumaksu kehtestamist suhkruga magustatud jookidele ja 1995. aasta rahvatervise seaduse läbivaatamist lisapiirangute osas reklaamidele, kuid neist loobuti.
Ehkki sissetulekuid ja elamistingimusi käsitleva ELi uuringu (EU-SILC) andmed osutavad sellele, et Eesti elanike seas on vähene kehaline aktiivsus (treenimine vähem kui kolm korda nädalas) suhteliselt harv (Joonis 6), on 2021. aasta riiklike andmete kohaselt peaaegu kolm neljandikku Eesti täiskasvanutest mitteaktiivsed (vähem kui 120 minutit treenimist nädalas) (Tervise Arengu Instituut, 2024b). Eesti 15aastased tüdrukud teatasid vähem igapäevasest kehalisest aktiivsusest (9 %) kui poisid (15 %) ja mõlema tulemus jääb alla ELi keskmise. Eesti on rakendanud noorte kehalise aktiivsuse suurendamiseks programme, nagu 2016. aastal käivitatud programm „Liikuma kutsuv kool“, mille eesmärk on tuua liikumine ja kehaline aktiivsus kõigi Eesti õpilasteni.
Share of overweight (including obese) adult women, by educational attainment, 2022
8: Share of overweight (including obese) adult women, by educational attainment, 2022
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9: Avoided cancer cases over 2023-2050, by achieving risk factors taget reduction
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Eesti on teinud edusamme õhusaaste valdkonnas, kuid töökeskkonnast tulenevad riskid on endiselt laialt levinud Pärast mitut õhukvaliteedi parandamiseks võetud poliitikameedet oli Eesti 2023. aastal üks seitsmest maailma riigist, kus õhukvaliteet vastas WHO kehtestatud PM2,5 kontsentratsiooni standardile (alla 5 μg/m³). See kajastub nii elanikkonna keskmises kokkupuutes PM2,5-osakestega kui ka sellest kokkupuutest tingitud enneaegsete surmade hinnangulises määras, mis on langenud varasemate aastakümnete märksa kõrgematelt tasemetelt ELi madalaimate hulka.
Samas tekitavad muret riskitegurid töökeskkonnas, kuna ligikaudu 26 % nii meestest kui ka naistest on teatanud, et nad puutuvad tööl kokku selliste keemiliste toodete või ainetega, mis võivad põhjustada vähktõbe. Eestis puudub tööst tingitud vähisurm de registreerimise süstee , kuid hinnangute kohaselt võib kuni 11 % aastatel 2016–2020 diagnoositud vähijuhtudest, millest suurima osa moodustasid kopsuvähk ja mittemelanoomne nahavähk, seostada tööalase kokkupuutega. 2020. aast l täiend ti Eesti töökeskkonnas esinevate keemiliste ohtude loetelu, lisades sellesse vähki tekitavad ained.
Eesmärkide saavutamiseks tuleb suurendada inimeste papilloomiviiruse ja B-hepatiidi vastu vaktsineerituse taset Selleks et kaotada kooskõlas WHO ülemaailmse strateegiaga 2040. aastaks emakakaelavähk,
algatas Eesti 2018. aastal 12–14aastaste tüdrukute HPV vastu vaktsineerimise programmi; 2024. aasta veebruaris laiendati programmi ka poistele ja programm võimaldab järelvaktsineerimist. 2023. aastal oli saanud 15. eluaastaks kõik HPV vaktsiini doosid 43 % tüdrukutest, mida on vähem kui 60 % aastal 2022 ning oluliselt vähem kui WHO eesmärk 90 % ja ELi keskmine 64 %. Murettekitavalt on viimastel aastatel vähenenud üheaastaste laste kolme doosiga vaktsineerimine B-hepatiidi vastu – 2023. aastal kahanes see 72 %-le, võrreldes 90 %ga 2020. aastal ja 95 %ga 2007. aastal. Reageerides madalale üldisele vaktsineerituse tasemele, eraldas Tervisekassa aastatel 2024–2028 sihtotstarbeliselt rahalisi vahendeid teadlikkuse suurendamise kampaaniate korraldamiseks.
Eesti saaks ära hoida suure hulga vähijuhtumeid, võttes otsustavaid meetmeid riskide vähendamiseks OECD rahvatervise strateegilise planeerimise modelleerimise (SPHeP) andmed, võttes arvesse praegust vähihaigestumust, osutavad sellele, et Eesti igal saaks igal aastal ära hoida hulga vähijuhtumeid, kui oleksid täidetud riskitegurite levimusega seotud eesmärgid. Näiteks tubakaga seotud eesmärkide saavutamisega oleks võimalik hoida aastatel 2023–2050 ära peaaegu 4000 vähijuhtumit ning alkoholitarbimise vähendamisega rohkem kui 2000 vähijuhtumit (Joonis 9).
Joonis 9. Aastatel 2023–2050 oleks võimalik ära hoida tuhandeid vähijuhtumeid, võttes otsustavaid meetmeid tubaka ja alkoholiga seotud eesmärkide saavutamiseks
Märkused. Tubaka puhul on seatud eesmärk vähendada aastatel 2010–2025 tubakatarbimist 30 % ja saavutada 2040. aastaks olukord, kus tubakat tarbib alla 5 % elanikkonnast. Alkoholi puhul on eesmärk vähendada aastatel 2010–2030 vähemalt 20 % üldist alkoholitarbimist ja 20 % alkoholi liigtarbimist (korraga kuus või rohkem alkohoolset jooki (täiskasvanud)). Õhusaaste valdkonnas on eesmärk tagada, et aasta keskmine PM2,5 tase on 2030. aastaks maksimaalselt 10 μg/m³ ja 2050. aastaks maksimaalselt 5 μg/m³. Rasvumise puhul on eesmärk alandada rasvumise taset 2025. aastaks 2010. aasta tasemele. Allikas: OECD (2024b), „Tackling the Impact of Cancer on Health, the Economy and Society“, OECD Health Policy Studies, OECD Publishing, Pariis, DOI: https://doi.org/10.1787/85e7c3ba-en
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% sihtrühma kuulunud elanikest, kes osales sõeluuringus
COVID-19
2021: 1) emakakaelavähi sõeluuringu sihtrühma vanusepiiri tõstmine 30.– 65. eluaastale, 2) PAP-testi asendamine HPV-testiga
2021: kindlustamata inimeste tasuta kaasamine kõikidesse sõeluuringu- programmidesse
2003: rinnavähi sõeluuringu programm 50–62aastastele naistele
2006: emakakaelavähi sõeluuringu programm 30– 55aastastele naistele
2009: mobiilsete üksuste (mammograafiabusside) kasutuselevõtt
2016: kolorektaalvähi sõeluuringu programm 60– 68aastastele elanikele
2024: peaaegu kõik rinnavähi sõeluuringu korraldajad võimaldavad broneerida aja veebis
2024–25: 1) rinnavähi sõeluuringu sihtrühma vanusepiiri tõstmine 50.– 74. eluaastale, 2) personaalsel riskihinnangul põhineva rinnavähi sõeluuringu programmi katsetamine
2022–2024: HPV kodutesti katsetamine ja kasutuselevõtt emakakaela sõeluuringu puhul
2024: peaaegu kõik rinnavähi sõeluuringu korraldajad võimaldavad broneerida aja veebis
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Sellel on ka mitmesugune positiivne kõrvalmõju: vähenevad muud kroonilised haigused ja koormus tervishoiusüsteemile, sealhulgas tööjõupuudus (vt punkt 5.1). Kõikide riskitegurite lõikes saab terviseseisundit parandada ka terviseteadlikkuse
edendamisega, mis suurendab kontrolli oma tervise üle. Eestil puudub riiklik strateegia terviseteadlikkuse suurendamiseks elanike seas või organisatsioonides.
4. Varajane avastamine
Eesti vähi sõeluuringu programmides osalusmäär oli 2023. aastal kõigi aegade kõrgeim Eesti on otsinud viise vähi sõeluuringu programmides osalemise suurendamiseks, töötades selle nimel, et parandada nende programmide kättesaadavust ja teadlikkust neist programmidest. Joonisel 10 on näidatud sõeluuringutes osalusmäära muutumine Eestis ning toimunud või kavandatud olulised muudatused. 2023. aasta paistis silma sellega, et kõigis kolmes rahvasti- kupõhises sõeluuringuprogrammis osalusmäär oli läbi aegade kõrgeim (üle 60 %). Sellele oli eelnenud COVID-19 pandeemia, mille ajal riiklikud sõeluuringuprogrammid ajutiselt peatati ja paljud
tervishoiuteenused olid piiratud. Selle tõttu olid vähenenud sõeluuringute käigus avastatud juhtumite arv ja tervisekontrolli käigus juhuslikult avastatud kergete sümptomitega juhtumite arv (Zimmermann et al., 2024). Oluline areng toimus 2021. aastal, kui programmiga hõlmati kindlustamata inimesed, kelle sõeluuringut hakkas rahastama Eesti Haigekassa (Tervisekassa varasem nimi); varem oli neil tulnud tasuda sõeluuringu eest ise. Aastatel 2022–2023 suurenes põgenike ja pagulaste seas 20 % rinna- ja kolorektaalvähi sõeluuringu eesmärgil tehtud arstivisiitide arv ning 12 % emakakaelavähi sõeluuringu eesmärgil tehtud arstivisiitide arv, mille peamine põhjus oli põgenike suur sissevool Ukrainast (Tervisekassa, 2023).
Joonis 10. Osalusmäär rinna, emakakaela ja kolorektaalvähi sõeluuringuprogrammides on oluliselt suurenenud alates 2020. aastast
Märkus. Kõigi vähivormide ja aastate puhul on esitatud riiklikest andmebaasidest saadud programmiandmed, mis hõlmavad asjaomasel aastal sõeluuringule kutsutud elanikke. Allikas: OECD Tervisestatistika 2024. (aastad 2000–2022); Tervise Arengu Instituut, 2024a (aasta 2023).
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Vähi sõeluuringute register areneb, võimaldades paremini toetada sõeluuringute korraldamist Vähi sõeluuringute juhtrühm, mida juhib sotsiaalministeerium, hõlmab peamisi sidusrühmi ja patsientide organisatsioone ning hindab olemasolevaid ja algatab uusi sõeluurin- guprogramme. Tervisekassa korraldab ulatuslikke teadlikkuse suurendamise kampaaniaid ning Tervise Arengu Instituut haldab vähi sõeluuringute registrit, mis hõlmab nii rahvastikupõhiseid kui ka oportunistlikke sõeluuringuid, ning rakendab juurdepääsu- ja kvaliteedimõõtmeid kvaliteedi parandamiseks. Tervisekassa avaldab kindlustusnõuete andmetele tuginedes interaktiivse platvormi kaudu reaalajas kolme programmi andmed, sealhulgas tuvastatud juhtumid ning osalusmäärad tervishoiuasutuste, asukohtade ja vanuserühmade kaupa.
Vähi sõeluuringute register saab rahvasti- kuregistrist esialgse sihtrühma kohordi, mis põhineb konkreetsetel sünniaastatel ja sool. Register sisaldab elanike kontaktandmeid ja on seotud elektrooniliste terviselugudega (Terviseportaal). Eesti digitaliseeritud tervise infosüsteem võimaldab kõrvale jätta need inimesed, kellel on teatava aja jooksul diagnoositud pahaloomuline kasvaja või kes on hiljuti asjaomases sõeluuringus osalenud. Vähi sõeluuringute register saadab sihtrühma kuuluvatele elanikele posti ja e-posti teel ning tervise infosüsteemi kaudu osalemiskutsed koos meeldetuletuste ja tekstisõnumitega. Samuti teavitab register tervishoiutöötajaid ja proviisoreid tuletama tervishoiuasutusse või apteeki pöörduvatele inimestele, kes ei ole sõeluuringus osalenud, meelde, et nad laseksid end kontrollida.
Alates 2024. aastast tõstetakse rinnavähi sõeluuringu sihtrühma vanusepiiri Rinnavähk on Eesti naiste seas kõige enam levinud vähivorm ja umbes veerandil juhtudel on vähk diagnoosimise hetkel juba kaugele arenenud staadiumis. Eesti rinnavähi sõeluuringu programmi raames kutsutakse 50–68aastaseid naisi üles tegema iga kahe aasta tagant mammogramm, kui nad ei ole seda teinud viimase 12 kuu jooksul ja kui neil ei ole olnud viimase viie aasta jooksul rinnavähki. Alates 2024. aastast tõstetakse sihtrühma vanuse ülempiir järk-järgult 74. eluaastale, millega sihtrühma vanusevahemik viiakse lähemale vahemikule 45–74, mida soovitatakse nõukogu 2022. aasta ajakohastatud soovituses (joonis 10). 2023. aastal kontrolliti 65 % sihtrühma kuulunud elanikkonnast, mis tähendab märkimisväärset kasvu võrreldes 2003. aastaga,
mil see määr oli 37 %. Vähitõrje tegevuskava 2021–2030 üks põhieesmärke on siiski saavutada kõigis rühmades 70 % osalusmäär (sotsiaalmin- isteerium ja Tervise Arengu Instituut, 2021). 2023. aastal saavutati see eesmärk rinnavähi puhul 15 Eesti maakonnast neljas, kusjuures kahes maakonnas jäi puudu vähem kui 1 protsendipunkt. Kõik kuus maakonda asuvad eemal suurematest linnadest, mis näitab, et rinnavähi sõeluuring on maaelanikele kättesaadav. Ida-Viru maakonnas oli osalusmäär siiski oluliselt väiksem, jäädes alla 60 % (Joonis 11), mis võib olla tingitud väiksemast teadlikkusest, keelebarjäärist või kättesaadavusest (ERR, 2024). Ilmselt jääb eesmärk saavutamata ka madalama haridustasemega inimeste puhul, kes teatavad pidevalt väiksema tõenäosusega, et nad on teinud mammogrammi.
Eestis rakendatakse mitmeid meetmeid, et parandada juurdepääsu sõeluuringule. 2024. aastast alates on kõik rinnavähi sõeluuringu korraldajad pakkunud võimalust broneerida aeg veebis, 2023. aastal oli see võimalik vaid ühes haiglas. Juurdepääsu parandamiseks maapiirkondades sõidavad kogu aasta mööda Eestit ringi kolm mammograafiabussi, et muuta sõeluuring kättesaadavamaks kohtades, kuis naised elavad ja töötavad. See algatus on hästi vastu võetud ja elanike nõudmisel külastavad bussid samu paiku rohkem kui kord aastas, mis aitab saavutada maapiirkondades kõrgemaid osalusmäärasid (ERR, 2024).
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Osalusmäär
74.1 %
58.0 % 68.8 %
67.1 %
67.4 % 69.7 %
62.6 %
71.2 %
58.0 % 68.0 %
72.5 %
70.5 %
68.3 % 65.3 %
64.2 %
69.3 %
74.1 %
Joonis 11. Kättesaadavuse parandamine Eestis on võimaldanud mitmel suurematest linnadest eemal asuval maakonnal saavutada rinnavähi sõeluuringu osalusmääraks 70 %
Märkus. Jämeda oranži joonega tähistatud maakondades ulatub osalusmäär 70 %ni, peenema rohelise joonega tähistatud maakondades jääb sellest puudu vähem kui üks protsendipunkt. Allikas: Kohandatud allikast Tervise Arengu Instituut (2024a).
Sõeluuringute tõhususe suurendamiseks töötab Eesti välja täiustatud programmi, kus kasutatakse geneetilistel andmetel põhinevaid personaalseid riskiskoore, mis on olemas viiendiku Eesti elanikkonna kohta. Programm on suunatud neile 40aastastele naistele, kes annavad oma nõusoleku personaalse rinnavähiriski hinnangu koostamiseks geneetilise teabe põhjal. Naised, kelle risk leitakse olevat suurem, kutsutakse iga kahe aasta tagant sõeluuringule alates 40. eluaastast, ülejäänud lisatakse tavapärasesse sõeluuringuprogrammi alates 50. eluaastast.
Eesti on võtnud eesmärgi kaotada 2040. aastaks emakakaelavähk, kasutades osalusmäära suurendamiseks inimeste papiloomviiruse koduteste Emakakaelavähi sõeluuringu programmi raames kutsutakse 30–65aastaseid naisi osalema uuringus iga viie aasta tagant. 2021. aastal võeti PAP-testi asemel kasutusele HPV-test (vt joonis 10). 2023. aastal oli sõeluuringus osalusmäär riigis 64 %, võrreldes 45 %ga 2020. aastal ja 30 %ga 2006. aastal, mil selle programmiga alustati. See märkimisväärne edasiminek ei kajasta erinevusi riigi sees: osalusmäärad ulatusid 49 %st Ida-Viru maakonnas 71 %ni Saare maakonnas. Tuleb siiski märkida, et pärast mitut sihipärast sekkumist on osalusmäär Ida-Viru maakonnas alates 2021. aastast kasvanud rohkem kui
10 protsendipunkti (Tervise Arengu Instituut, 2024a).
Osalusmäära suurendamiseks katsetati 2022. aastal HPV kodutesti ning 2023. aasta teises pooles võeti see kasutusele naiste puhul, kes ei olnud end veel kontrollida lasknud, millega kaasnes oluline ajakokkuhoid ja suurenes privaatsus kasutajate vaatenurgast. 2023. aastal otsustas kodutesti kasuks enam kui 10 % sõeluuringus osalejatest, sealhulgas – mis on oluline – 14 % osalejatest Ida-Viru maakonnas. 2023. aastal pakkusid koduteste täiendavad 89 apteeki väiksema osalusmääraga maakondades. 2022. aastal tehtud analüüs näitas, et haigestumus emakakaelavähki on Eestis alates 2014. aastast vähenenud ning et märkimisväärset vähenemist mõnes vanuserühmas võib seostada sõeluurin- guprogrammi positiivse mõjuga (Zimmermann et al., 2024).
Uuenduslike sõeluuringulahenduste rakendamiseks osaleb Tartu Ülikool ühisprojektis, mille eesmärk on integreerida teaduslikud teadmised rahvastikupõhiste terviseregistrite, tervishoiuteenuste, uuringute ja Eesti geenipanga andmetega, et töötada välja ja valideerida tehisintellekti tehnoloogia, mis modelleerib emakakaelavähi sõeluuringu raames patsientide tulemusi ja hindab vähiriske riskipõhiseks lähenemiseks sõeluuringule.
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jooksul
Emakakaela proov viimase 5 aasta jooksul
Eesti EL27
% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
18 %
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% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
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40-54 aastad 25-39 aastad 40-55 aastad
Mammogramm viimase 12 kuu
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% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
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Eesti EL27
% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
18 %
70 %
28 %
64 %
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40-54 aastad 25-39 aastad
Mammogramm viimase 12 kuu jooksul
Emakakaela proov viimase 5 aasta jooksul
Eesti EL27
% LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus
LGBTIQ-inimesed osalevad Eestis rinnavähi sõeluuringus vähem kui ELis ELi kolmanda LGBTIQ kogukonda käsitleva uuringu andmete kohaselt teatas Eestis 18 % sellesse kogukonda kuuluvatest cis-soolistest naistest, transsoolistest naistest ja intersoolistest inimestest vanuses 40–54, et neile on viimase 12 kuu jooksul tehtud mammogramm, mis on vähem kui ELi keskmine 28 % (Joonis 12). Mis puudutab emakakaelavähi sõeluuringut, siis sellest, et nad on andnud viimase viie aasta jooksul emakakaela proovi, teatas Eestis 70 % LGBTIQ-inimestest vanuses 25–39 (rohkem kui ELi 64 %) ja 83 % LGBTIQ-inimestest vanuses 40–55 (rohkem kui ELi 74 %).
Joonis 12. LGBTIQ kogukonnas on emakakaela prooviga hõlmatus Eestis kõrgem kui ELis
Märkus. LGBTIQ kogukonda käsitleva uuringu tulemused viitavad vanuserühmadele ja/või sõeluuringute intervallidele, mis ei ole kooskõlas ELi riikides rahvastikupõhiste sõeluuringute tegemisel rakendatava lähenemisviisiga, mistõttu ei tohiks neid võrrelda. Allikas: Euroopa Liidu Põhiõiguste Amet (ELi kolmas LGBTIQ kogukonda käsitlev uuring).
Kolorektaalvähi sõeluuringu programmi laiendamisel on probleemiks diagnostiliste uuringute kättesaadavus Kolorektaalvähi sõeluuringu programm loodi 2016. aastal ja see on suunatud 60–68aastastele elanikele, keda kutsutakse iga kahe aasta tagant tegema esmatasandi tervishoius immunokeemilist peitveretesti. Programmist jäetakse välja need inimesed, kellele on tehtud varasema sõeluuringu käigus kolonoskoopia või kellel on kunagi diagnoositud kolorektaalvähk (OECD, 2024a). 2023. aastal oli kolorektaalvähi sõeluuringu osalusmäär 60 % (55 % meeste puhul ja 65 % naiste puhul), mis on suurem kui 2021. aasta 49 %.
Osalusmäär ulatus 51 %st Ida-Viru maakonnas 74 %ni Võru maakonnas (Tervise Arengu Instituut, 2024a). Programmi üks suur puudus on sihtrühma kitsas vanusevahemik – hõlmatud on vaid osa 50–74aastaste vanuserühmast, mida on soovitatud kolorektaalvähi sõeluuringu programmide puhul nõukogu 2022. aasta ajakohastatud soovituses vähi sõeluuringute kohta. Ehkki vähi sõeluuringute juhtrühmas on arutatud selle vanusevahemiku laiendamise üle, on kahtlusi, kas Eesti suudab täita nõuet, et kõigile, kes saavad positiivse tulemuse, peavad olema kiiresti kättesaadavad endoskoopilised või radioloogilised uuringud.
Töötatakse välja sõeluuringuprogramme kopsuvähi ja eesnäärmevähi jaoks 2021. aastal tehtud teostatavusuuringu järel laiendati 2022. ja 2023. aastal kopsuvähi sõeluuringu katseprogrammi, et hõlmata enamik Tartu maakonna perearstikabinette. Tartu maakonna perearstid ja -õed esitasid 55–74aastastele inimestele küsimusi suitsetamise ja kopsuvähi esinemise kohta perekonnas ning suunasid suure riskiga patsiendid väikesedoosilise kompuutertomograafia uuringule, et teha kindlaks võimalik kopsuvähk. Tänu esmatasandil toimunud süstemaatilisele osalejate otsimisele oli sihtrühma kuulunud inimeste osalusmäär 87 %, mis näitab, et see lähenemisviis võib olla tõhus (OECD, 2024a). 2024. aastal jätkus programm Tartu maakonnas, kuid arutatakse ka laienemist Ida-Viru maakonda. Eesmärk on käivitada 2027. aastaks riiklik rahvasti- kupõhine sõeluuringuprogramm, mida rahastab Tervisekassa.
Käimas on eesnäärmevähi sõeluuringu teostata- vusuuring. 2024. aasta aprillis alustas Tervise Arengu Instituut kutsete saatmist enam kui 13 000-le Tallinnas või Tartus elavale 50–69aastasele mehele, kes ei ole teinud viimase 12 kuu jooksul prostataspetsiifilise antigeeni (PSA) testi ja kellel ei ole kunagi olnud eesnäärmevähki. Kõrge PSA tasemega mehed suunatakse uroloogi juurde, kes küsitleb patsienti, hindab riske ja saadab kõrge riskiga isikud magnetresonant- stomograafia (MRI) uuringule. See programm on oluline areng, kuna eesnäärmevähk on Eesti meestel enim diagnoositud vähivorm ja Eesti on eesnäärmevähi suremuse poolest ELi riikide seas kolmandal kohal.
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5. Vähiravi toimivus
5.1. Kättesaadavus
Eesti tervishoiusüsteemis on probleemiks pikad ooteajad; vähitõrje tegevuskavas on kavandatud eesmärkide süstemaatiline jälgimine Eesti oli 2023. aastal ELis riik, kus rahuldamata vajadusest arstiabi järele teatas suurim osa elanikkonnast – 13 % võrreldes ELi keskmise 2 %ga –, ehkki see osakaal on viimastel aastatel kahanenud. Linnapiirkondades elavad inimesed teatasid pidevalt suuremast rahuldamata vajadusest eriarstiabi järele kui maapiirkondades elavad inimesed. Kui kuludel ja arstiabi kaugusel oli väike roll, siis enam kui 90 % rahuldamata vajadusest teatanud inimestest nimetas peamise põhjusena ooteaegu (Riigikontroll, 2022).
Kuigi 2011. aastal seati vähiravi ooteajaga seoses eesmärk alustada kiiritusravi 28 päeva jooksul alates vähi diagnoosimisest, ei ole ooteaegu veel süstemaatiliselt analüüsitud. Vähitõrje tegevuskavas 2021–2030 on kindlaks määratud maksimaalsed ooteajad raviprotsessi eri osades alates esma- ja teise tasandi arstiabist kuni vähikeskuseni ja ravi alustamiseni (sotsiaalmin- isteerium ja Tervise Arengu Instituut, 2021). Andmetaristus esinevate lünkade tõttu ei ole keskmist ooteaega võimalik arvutada, kuid selle võimaldamiseks on käimas tervise infosüsteemi läbivaatamine.
Eesti otsib digitaalseid lahendusi, et kiirendada diagnoosi- ja raviotsuste tegemist. Nende hulka kuuluvad perearstide ja spetsialistide vahelised e-konsultatsioonid diagnoosimisel ning veebikonsultatsioonid patsientidele, mis moodustasid 2021. aastal üle 40 % arstide ja õdede töökoormusest (Tervise Arengu Instituut, 2023a). Lisaks aitaks riiklik veebipõhine broneerimisteenus valitsusel jälgida, millistel tervishoiuteenustel on pikemad ootenimekirjad, ja analüüsida selle põhjuseid.
Hoolimata sellest, et rahalised takistused vähiravi pakkumisel on väikesed, võivad erinevused tööealiste inimeste kindlustuskattes põhjustada viivitusi diagnoosimisel Rahaliste vahendite piiratus ei tekita Eestis olulisi takistusi juurdepääsul vähiravile. Kohaldatakse omaosalust, kuid seda hoitakse nii ravi kui ka
ravimite puhul väiksena. Ravimite puhul, millega ravitakse raskeid, eluohtlikke või valutekitavaid haigusi, nagu vähktõbi, tasuvad patsiendid 2,5 euro suuruse fikseeritud omaosaluse, mitte teatud protsendi ravimi hinnast. Kui aasta jooksul makstud omaosaluse kogusumma ületab 100 eurot, on võimalik saada lisahüvitist. Omaosaluse arvutamine ja arvestamine toimub ostu hetkel automaatselt, kasutades ulatuslikku tervisesüsteemi digitaristut. Sotsiaalkindlustus on seotud Eestis tööalase staatusega (kuid hõlmab lapsi ja pensionäre). Sellega seoses oli 2022. aastal 5 % Eesti elanikest kindlustamata (Tervise Arengu Instituut, 2023a). Kuigi patsiendid on pärast vähidiagnoosi saamist kindlustatud invaliidsu- shüvitiste kaudu, võib muret tekitavate sümptomite esinemise korral arstivisiit kindlustuskatte puudumise tõttu viibida.
Eesti on suurendanud vastuvõttu meditsiiniõppesse, et tegeleda olulise tööjõupuuduse probleemiga Eesti tervishoiusüsteemi murekohana on pidevalt esile tõstetud tervishoiutöötajate nappust. 2021. aastal oli Eestis 100 000 elaniku kohta 347 arsti, mis jääb 17 % alla ELi keskmise. Võttes arvesse vähktõve esinemissagedust, on Eestis arste 1000 uue vähijuhtumi kohta 13 % vähem kui ELis keskmiselt (Joonis 13). Peale selle arstkond vananeb ning peremeditsiini ja psühhiaatria valdkonnas, eriti väljaspool suuremaid linnu, valitseb arstide nappus, mis võib põhjustada lünki ravi integreerimisel ning vähipatsientidele ja vähktõvest jagusaanutele pakutava toe kättesaadavuses.
2023. aastal oli riigis 56 onkoloogi ehk neli onkoloogi 100 000 elaniku kohta, kuigi täistööajale taandatud töötajate arv oli väiksem. Radiolooge oli 100 000 elaniku kohta 15 ja see arv ei ole vaatamata suurenenud nõudlusele 2013. aastaga võrreldes eriti muutunud. Radioloogide nappust on nimetatud ka takistusena kopsuvähi sõeluuringu programmi laiendamisel (vt punkt 4), eriti kuna uuenduslikke lahendusi, nagu tehisintellekti kasutamine analüüsimisel, peetakse täiendavateks lahendusteks, mis ei asenda spetsialiste (Alloja et al., 2023).
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11: Supply of nurses and physicians per new cancer cases
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Arste palju Õdesid palju
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Arste palju Õdesid väheELi keskmine: 679
ELi keskmine: 1 376
Arstide arv 1 000 uue vähijuhtumi kohta
Õdede arv 1 000 uue vähijuhtumi kohta
# Restricted Use - À usage restreint
Joonis 13. Eestis on uute vähijuhtumite arvu arvesse võttes vähem õdesid ja arste kui ELis keskmiselt
Märkused. Andmed õdede kohta hõlmavad kõiki õdede kategooriaid (mitte üksnes neid, mis vastavad ELi kutsekvalifikatsioonide tunnust mise direktiivile). Andmed on praktis erivate õdede kohta, välja arvatud Portugal ja Slovakkia, kelle andmed osutavad ametialaselt aktiivsetele õdedele. Kreeka puhul on õdede arv hinnatud tegelikust väiksemaks, kuna arvesse on võetud üksnes haiglates töötavaid õdesid. Portugali ja Kreeka puhul hõlmavad andmed kõiki tegevusloaga arste, mis tähendab, et praktiseerivate arstide arv on hinnatud tegelikust palju suuremaks. ELi keskmine on kaalumata keskmine. Allikas: OECD 2024. aasta tervisestatistika. Andmed on 2022. aasta kohta või viimase aasta kohta, mille andmed on kättesaadavad.
2022. aastal oli Eestis 100 000 elaniku kohta 658 õde , mida on 22 % vähem kui ELis keskmiselt. See teeb 1121 õde 1000 vähijuhtumi kohta, mis jääb 19 % alla ELi keskmise. Õdede arv 100 000 elaniku kohta on suurenenud alates 2013. aastast peaaegu 100 võrra. 2023. aastal töötas onkoloogiakliinikutes kokku 177 õde (12,9 õde 100 000 elaniku kohta) (Tervise Arengu Instituut, 2024a).
Kõnealuse nappuse leevendamiseks suurendas Eesti 2023. aastal kuuendiku võrra (700ni) õenduse õppekohtade miinimumarvu, kuigi kulub aastaid, et see kajastuks suuremas tööjõus (Tervise Arengu Instituut, 2023a). Eestis on kasutatud mõningal määral ka võimalust jagada ümber tööülesanded, et laiendada õdede rolli, kuna pereõed on sageli esimene kontaktpunkt esmatasandi tervishoius, ning eriõdede (magistrikraadile vastava kvalifikatsiooniga) teenust on hakatud rahastama eraldi teenusena kõigil ravitasanditel. Õdede onkoloogiaalane eriväljaõpe toimub siiski peamiselt töökohal, mis tähendab võimalikku lünka koolituskavas võrreldes mõne teise Euroopa riigiga. Eesti Onkoloogiaõdede Ühing, mis on Eesti Õdede Liidu allorganisatsioon, määrab kindlaks koolitusprogrammide eesmärgid ja sisu ning annab soovitusi õdede heaolu ning patsientide ja nende hooldajate ohutuse parandamiseks (sotsiaalmin- isteerium ja Tervise Arengu Instituut, 2021).
Varasema diagnoosimise saavutamiseks on vaja pöörata suuremat tähelepanu tervisetead- likkusele ja diagnostiliste uuringute kättesaa- davusele 2021. aastal diagnoositi Eestis üle poole vähijuhtudest 70aastastel ja vanematel inimestel, kusjuures peaaegu veerand rinnavähi juhtudest diagnoositi 75aastastel ja vanematel, mis osutab vajadusele teha vanuseliselt piiratud sõeluurin- guprogrammidele lisaks jõupingutusi varajase diagnoosimise vallas (Tervise Arengu Instituut, 2024a). Vähitõrje tegevuskavas 2021–2030 on seatud eesmärk suurendada elanikkonna teadlikkust vähisümptomitest, parandades seeläbi õigeaegset jõudmist perearsti juurde, kes suunab ligipääsu tervishoiusüsteemile, ning seejärel õigeaegset vähktõve diagnoosimist ja staadiumi määramist. Selleks töötatakse välja standardsed patsienditeekonnad alates esmasest pöördumisest kuni ravi alustamiseni (sotsiaalministeerium ja Tervise Arengu Instituut, 2021).
2021. aastal diagnoositi umbes pooltel vähipatsientidel lokaalne kasvaja enne selle levimist külgnevatesse kudedesse; viiendikul meestest ja enam kui kuuendikul naistest olid siiski diagnoosimise ajal juba kaugmetastaasid. Eriti valmistab muret kõhunäärmevähk, mille puhul olid metastaasid ligikaudu pooltel
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13: Access to new oncology medicines & biosimilars
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Eesti EL22 Sarnase ostujõuga riigid
# Restricted Use - À usage restreint
patsientidel. Sapipõievähi, söögitoruvähi või maksavähiga naiste ning kopsuvähiga meeste seas oli kaugemetastaasidega juhtumite osakaal üle 40 % (Zimmermann et al., 2024).
2022. aastal oli Eestis pildidiagnostikaseadmeid elaniku kohta vähem kui ELis keskmiselt ning 100 000 elaniku kohta tehti vähem kompuuter- tomograafia (3 % vähem), magnetresonantsto- mograafia (33 % vähem) ja positronemissioon- tomograafia uuringuid (58 % vähem). Selleks et parandada juurdepääsu diagnoosimisele, eelkõige piirkondades, mis asuvad suurematest haiglatest kaugemal, ostab Eesti Vähiliit mobiilse kompuuter- tomograafia skänneri, kasutades heategevu- sorganisatsioonidelt saadud rahalisi vahendeid (Heinsalu, 2024). See toetab ka kopsuvähi sõeluuringu programmi laiendamist, tagades juurdepääsu diagnostilistele uuringutele, eelkõige maapiirkondades (vt punkt 4).
Pikk aeg, mis kulub ravimi hüvitatavate ravimite loetellu kandmiseks, võib takistada juurdepääsu uutele ravimitele Eestis on nimetatud probleemina juurdepääsu uutele ravimitele, kuna paljudest uuetest ravimitest, mis on mujal Euroopas kättesaadavad, saavad Eestis riiklikult hüvitatavad ravimid alles palju hiljem. Seda seostatakse sellega, et väikeses riigis kulub taotluste läbivaatamiseks ja hinnaläbirääkimisteks rohkem aega. Uute ravimite heakskiitmisest Euroopa Ravimiametis (EMA) kuni hüvitamiseni Eestis kulus 559 päeva, mida on rohkem kui ELi keskmine 516 päeva. Riik hüvitab või katab valitud kliiniliselt tõhusatest uuematest vähiravimitest 46 %, mida on vähem kui keskmiselt ELis (59 %) ja sarnase ostujõuga riikides (54 %) (Joonis 14). Mõnel juhul kasutatakse Eestis müügiloata ravimite ja ettenähtust erinevalt kasutatavate ravimite / hüvitamisele mittekuuluvate näidustuste puhul patsiendipõhist hüvitamist, et tagada varajane juurdepääs. Lisaks kohaldatakse Eestis umbes poolte uuemate ravimite puhul seoses patsiendi õigusega ravimi hüvitamisele rohkem piiranguid kui on näinud ette Euroopa Ravimiamet ravimi heakskiitmisel (OECD, 2024a).
Joonis 14. Kuigi tõendid näitavad, et Eesti tagab juurdepääsu biosimilaridele, jääb uuemate ravimite hüvitamine maha keskmisest ELis ja sarnase ostujõuga riikides
Märkused. Analüüs hõlmab valimit, kuhu kuuluvad kümme uut kliiniliselt tõhusat rinnavähi ja kopsuvähi ravimit, mida kasutatakse kolmeteistkümne näidustuse puhul, ning kolme vähiravimi (bevatsisumaab, rituksimab, trastusumaab) üheksateist biosimilari, millel on 26. märtsi 2023. aasta seisuga kehtiv Euroopa Ravimiameti müügiluba. Andmed kajastavad nende ravimite ja biosimilaride osakaalu, mis olid kantud 1. aprilli 2023. aasta seisuga riiklikku hüvitatavate ravimite loetellu. Riigid on jaotatud tertsiilidesse, võttes aluseks 2022. aasta SKP elaniku kohta ostujõu standardina. Eesti jaoks on sarnase ostujõuga riigid Bulgaaria, Horvaatia, Kreeka, Läti, Poola, Portugal ja Ungari. ELi keskmine on kaalumata keskmine. Allikas: Hofmarcher, Berchet ja Dedet (2024), „Access to oncology medicines in EU and OECD countries“, OECD Health Working Papers, nr 170, OECD Publishing, Pariis, https://doi.org/10.1787/c263c014-en.
Samal ajal hüvitati Eestis kõik valimisse valitud kolme vähiravimi 19 biosimilari, millel oli kehtiv Euroopa Ravimiameti müügiluba, võrreldes keskmiselt 67 %ga sarnase ostujõuga riikides. Selle põhjuseks on asjaolu, et biosimilare ei hüvitata mitte kaubamärgi, vaid toimeaine alusel; kaubamärgi valik sõltub hanke tulemustest.
Juurdepääs kliinilistele uuringutele on Eestis keskmiselt väiksem kui teistes riikides, mis võib olla tingitud sellest, et paberimajanduse, eetiliste aspektide hindamise ja kohalikku keelde tõlkimise kulud on väikestes riikides suuremad. Olukorra parandamiseks luuakse riiklik vähikeskus, mis tõhustab teadus- ja arendustegevust, hõlbustab kõigi sidusrühmade koostööd ning hakkab tegutsema rahvusvaheliste kliiniliste ja
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12: Volume of radiation therapy equipment
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teadusuuringute keskusena, et saada Euroopa Liidu kõikehõlmava vähikeskuse akrediteering (sotsiaalministeerium, 2023).
Eesti hindab kiiritusravi optimaalseks kasutamiseks vajadusi, et tagada piisavate seadmete kättesaadavus 2023. aastal oli Eestis seitse kiiritusraviseadet, mis tähendab, et varustatus inimese kohta on 35 % väiksem kui ELi keskmine (Joonis 15). 2024. aastaks oli Eesti ostnud seadmeid juurde, lähenedes sellega ELi keskmisele. Kõik seadmed on suhteliselt uued, vaid kaks on vanemad kui 15 aastat. Probleemiks võib olla geograafiline ligipääsetavus, sest kiiritusravi pakutakse ainult Tallinna ja Tartu vähikeskuses ning sageli peab patsient viibima seal kaua, et saada mitu päeva järjest väikeseid annuseid.
Rinnavähi diagnoosiga naiste seas korraldatud uuring näitas, et kiiritusravi saamine 12 kuu jooksul pärast esmast operatsiooni oli sagedasem kõrgema haridustasemega naiste ja abielus naiste seas, kuid ei sõltunud geograafilisest elukohast. Uuring näitas ka seda, et kiiritusravi kasutamine on aja jooksul märkimisväärselt kasvanud: 39 %-lt aastatel 2007–2009 diagnoosi saanud patsientidest 58 %-le aastatel 2016–2018 diagnoosi saanutest, mis on kooskõlas kättesaadavate seadmete arvu suurenemisega (Shahrabi Farahani, Paapsi & Innos, 2021). Käimas on analüüs, et hinnata kiiritusravi praegust kasutamist eri vähipaikmete puhul, võttes arvesse rahvusvahelisi soovitusi optimaalse kasutamise kohta. Selle raames hinnatakse vajadust kiiritusravi järele kuni aastani 2040 ning praegust ja tulevast vajadust seadmete ja tööjõu järele.
Joonis 15. Eestis on vähem kiiritusraviseadmeid kui ELis keskmiselt
Märkused. Suur enamus kiiritusraviseadmetest ELi liikmesriikides asub haiglates. Portugali ja Prantsusmaa andmed hõlmavad ainult haiglates asuvaid seadmeid, teiste riikide andmed on kõigi seadmete kohta. Riigid on jaotatud tertsiilidesse, võttes aluseks 2022. aasta SKP elaniku kohta ostujõu standardina. Eesti jaoks on sarnase ostujõuga riigid Bulgaaria, Horvaatia, Kreeka, Poola, Portugal, Rumeenia ja Slovakkia. ELi keskmine on kaalumata keskmine. Allikas: OECD 2024. aasta tervisestatistika.
5.2. Kvaliteet
Elulemus on mitme vähivormi puhul Eestis paranenud Vähipatsientide elulemus on üks peamisi Eesti vähitõrje tegevuskava 2021–2030 tulemusnäitajaid, kuna see võimaldab terviklikult hinnata vähitõrjemeetmeid, hõlmates nii varajast diagnoosimist kui ka vähiravi tõhusust. Aastatel 2017–2021 oli kõigi Eestis diagnoositud vähijuhtude (v.a mittemelanoomne nahavähk) puhul ühe aasta suhteline elulemus 74 %, viie aasta suhteline elulemus 58 % ja kümne aasta suhteline elulemus 53 %. Võrreldes 2007.–2011. aastal diagnoositud vähijuhtudega oli viie aasta elulemus paranenud kõige rohkem nahamelanoomi, pärasoolevähi ja leukeemia puhul (8 protsendipunkti) (Joonis 16).
Eesti eesmärk on jõuda elulemuse näitajateni, mis on lähedal Põhjamaade näitajatele. Mõne vähipaikme puhul on see juba saavutatud, kuid teiste, sealhulgas mitte-Hodgkini lümfoomi ning pea- ja kaelavähi puhul, on veel puudujääke. Ehkki enamiku vähipaikmete puhul oli elulemus naiste seas suurem kui meeste seas, on mõne puhul (kõhunäärme-, mao-, käärsoole- ja neeruvähk) erinevus vähenenud, mis on üks vähitõrje tegevuskava 2021–2030 eesmärke (Zimmermann et al., 2024).
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14: Potential Years of Life Lost per 100 000 population
Kopsuvähk
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Kaotatud potentsiaalsete eluaastate arv 100 000 elaniku kohta
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Viie aasta elulemus (%)
Joonis 16. Viie aasta elulemus paranes 2017.–2021. aastal diagnoositud vähijuhtude puhul 2007.–2011. aastal diagnoositud vähijuhtudega võrreldes 4 protsendipunkti
Allikas: Zimmermann et al. (2024).
Kõige rohkem potentsiaalseid eluaastaid kaotati Eestis kopsuvähi tõttu Lisaks elulemusandmetele on näitaja, mis võimaldab mõõta erinevate vähivormide mõju ühiskonnale, kaotatud potentsiaalsed eluaastad, sest see suurendab nooremate inimeste seas esinevate vähisurmade kaalu. Aja jooksul eri vähipaikmete puhul toimunud muutused kaotatud potentsiaalsete eluaastate arvus võivad osutada sellele, et vähiravisüsteem on tänu enneaegse suremuse vähendamisele paranenud. Eesti elanikud kaotasid 2022. aastal vähktõve tõttu 1283 potentsiaalset eluaastat 100 000 elaniku kohta, mida on 5 % vähem kui ELi keskmine ja 28 % vähem kui 2012. aastal. See näitaja oli meeste seas 58 % suurem kui naiste seas. 2022. aastal langes kõige enam aastaid – 186 eluaastat 100 000 elaniku kohta – kopsuvähi arvele, kuigi see näitaja oli vähenenud 2012. aastaga võrreldes 46 % (Joonis 17). Naiste seas kaotati rinnavähi tõttu 203 eluaastat 100 000 naise kohta. Kuigi enamiku vähivormide puhul täheldati kahanemistrendi, suurenes kõhunäärmevähi tõttu kaotatud eluaastate arv samal ajavahemikul 12 %.
Joonis 17. Kaotatud potentsiaalsete eluaastate arv on enamiku peamiste vähipaikmete puhul vähenemas
Märkused. Rinna-, emakakaela- ja munasarjavähi puhul hõlmab kaotatud potentsiaalsete eluaastate arv vaid naisi ja eesnäärmevähi puhul üksnes mehi. Roosa ring tähendab kaotatud potentsiaalsete eluaastate arvu suurenemist aastatel 2012–2022 (või viimasel aastal, mille kohta andmed on kättesaadavad), sinised ringid tähendavad vähenemist. Ringide suurus on võrdeline kaotatud potentsiaalsete eluaastate arvu suurusega 2022. aastal. Allikas: OECD 2024. aasta tervisestatistika.
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Kuigi inimesekesksust peetakse oluliseks, on vaja jõupingutusi suurendada Eestis minnakse vähiravis üle personali- seeritud, väärtuspõhisele ja patsiendikesksele lähenemisviisile, mille kohaselt peaksid olema ravi ja selle talutavuse hindamise lahutamatu osa patsiendi poolt teatatud ravitulemused. Eestis on vähikeskustes ellu viidud mitu asjakohast katseprojekti ning selle lähenemisviisi rakendamist rinna- ja kopsuvähki põdevate patsientide puhul peetakse teostatavaks. Sellest hoolimata ei koguta patsientide teatatud ravitulemusi ja ravikogemusi tsentraalselt riigi tasandil ning puudub üldine mudel nende ravitulemuste jälgimiseks – see on vajakajäämine, mis püütakse vähitõrje tegevuskavaga 2021–2030 kaotada.
Käivitatud on mitu inimesekesksust edendavat algatust, nagu e-platvorm KAIKO, mille eesmärk on toetada patsienti kodus ning hõlbustada pidevat suhtlemist ja sümptomitest teatamist patsiendi
ja tervishoiuteenuse osutaja vahel. Tervikliku patsienditeekonna tagamiseks on vähikeskustes loodud õe-koordinaatori teenus, et patsiendil oleks üks kontaktisik, kellele ta saab helistada kogu ravi vältel. Patsiendikesksust on kavas veelgi arendada, parandades patsienditeekonda alates vähikahtlusest kuni ravijärgsesse perioodi, sealhulgas patsientide rahulolu mõõtmist eri etappides. Mõningaid edusamme on juba tehtud: kopsuvähi diagnoosiga patsientide jaoks on välja töötatud spetsiifiline raviteekond ja patsientide organisatsioonid on kaasatud juhtorganite tegevusse, näiteks ravijuhiste väljatöötamisse. Nähes võimalusi kasutada oma digitaliseeritud tervishoiusüsteemi ja parandada geneetilise teabe kättesaadavust, et teha paremaid raviotsuseid, on Eesti alustanud jõupingutusi teatavate ravi aspektide personaliseerimiseks, et suurendada tõhusust konkreetse patsiendi vaatenurgast (tekstikast 2).
Tekstikast 2. Eesti digitaalne tervise infosüsteem võimaldab arendada personaalmeditsiini, et paremini suunata vähktõve sõeluuringuid ja ravi Inimesekesksus ja personaalmeditsiin on üks viiest Eesti e-tervise strateegia fookusvaldkonnast. Eesti ühtne tervise infosüsteem sisaldab kõiki terviseandmeid, sealhulgas 20 % täiskasvanud elanikkonna genoomiandmeid, mis annab võimaluse teha paremaid ennetus- ja raviotsuseid. Tervise Arengu Instituut juhtis Euroopa Regionaalarengu Fondi toel aastatel 2019–2023 projekti, et suurendada valmisolekut personaalmeditsiini rakendamiseks. Tähelepanu keskmes olid infotehnoloogiasüsteemi ja õigusraamistiku väljaarendamine, tervishoiu- töötajate koolitamine ja üldsuse teadlikkus. Esimesed teenused, mida kavatsetakse arendada, on rinnavähi ennetamine ja varajane avastamine ning personaalsed ravimisoovitused (Tervise Arengu Instituut, 2024d).
Eesti vaatab vähiravi kvaliteedi parandamiseks läbi ravikorralduse Rakendades ulatuslikke tsentraliseerimis- meetmeid ja -kavu, korraldas Eesti ümber oma vähiravivõrgustiku – nüüd toimub täiskasvanute vähiravi enamjaolt riigi põhja- ja lõunaosas asuvais kolmes vähikeskuses. Väiksemad haiglad pakuvad peamiselt süsteemset ravi vähikeskuste järelevalve all. Kavas on edasine tsentraliseerimine ning arutatakse ideed jagada operatsioonid vähipaikmete kaupa haiglate vahel ära, et tagada piisava oskusteabe kättesaadavus.
2021. aastal viibisid vähipatsiendid Eestis haiglas keskmiselt 7,4 päeva, mida on rohkem kui ELi keskmine 6,9 päeva. Kuna pikemat haiglaravi seostatakse suuremate riskidega, on mitu Euroopa riiki, kus on olemas suutlikkus pakkuda operatsiooni läbinud patsientidele terviklikku järelravi, hakanud rakendama vähiravis rohkem päevakirurgiat, kui see on ohutu. 2022. aastal ei tehtud Eestis päevakirurgia osakonnas siiski ühtki täielikku mastektoomiat ja rinnanäärme ekstsisioonidest tehti seal üksnes 13 %.
Eesti parandab vähiravi seiret täiustatud digitaalse tervishoiutaristu kaudu Eestis on tehtud viimastel aastatel süstemaatiliselt vähiravi tulemuslikkuse seiret ja auditeid. Tervisekassal on kvaliteedinäitajate nõuandekogu, et töötada välja tulemustele suunatud tervishoiu- teenused, kuid seire- ja infosüsteemides on mitmeid vajakajäämisi. Vähitõrje tegevuskavas 2021–2030 tunnistatakse lünka juhiste järgimise süstemaatilises järelevalves. Tänu digitaalsele tervise infosüsteemile saavad Eesti arstid otsuste tegemisel tõenduspõhist tuge, omades ligipääsu patsiendi terviseteabele, sealhulgas diagnoosidele ning teabele ravimite, analüüside ja protseduuride kohta. Raviotsuste tegemises osalevad Eestis tavaliselt multidistsiplinaarses onkoloogilises konsiiliumis, keda rahastab Tervisekassa, kuigi praktika on konkreetsete juhiste puudumise tõttu erinev.
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5.3. Kulud ja kulutõhusus
Vähktõve põhjustatud koormus tervishoiuku- lutustele on Eestis eeldatavasti väiksem kui ELis Eesti tervishoiusüsteemi rahastab suures osas Tervisekassa, mis korraldab tervishoiu- teenuste ostmist. Tegemist on poolautonoomse avalik-õigusliku organisatsiooniga, mis hangib enamiku rahalistest vahenditest palgafondimaksu kaudu, kuigi üha suurem roll on ka riigi tehtavatel ülekannetel. Eesti tervishoiukulutused osana SKPst on ühed ELi väiksemad (2022. aastal 7 %). 2022. aastal hüvitas Tervisekassa 51 000 inimese vähiravi, eraldades operatsioonide, ravi ja ravimite jaoks üle 171 miljoni euro (sotsiaalministeerium, 2023). Tervisekassa 2023. aasta finantsaruande kohaselt oli 15 % eriarstiabiga seotud tervishoiukuludest seotud vähktõvega, mida on rohkem kui 2022. aasta 14 % (Tervisekassa, 2023). 2023. aastal moodustasid kallite vähiravijuhtude (maksumusega üle 104 000 euro) kulud 12 % kõigist kallite ravijuhtude kuludest.
OECD rahvatervise strateegilise planeerimise modelleerimise andmete kohaselt on kogukulutused tervishoiule aastatel 2023–2050 vähktõvest tingitud koormuse tõttu Eestis hinnanguliselt 3,6 % suuremad. See teeb aastas keskmiselt 37 eurot inimese kohta, mida on tunduvalt vähem kui EL 19 keskmine (242 eurot). Tuleb siiski märkida, et Eesti praegust rahastamismudelit ei peeta jätkusuutlikuks ning Eesti tervishoiusüsteemi peamised kapitaliinvest- eeringud on tuginenud ELi struktuurifondidele.
Arvestades suurenevat vähihaigestumust ja -elulemust, on oodata, et rohkem inimesi vajab tugiteenuseid pikemat aega, mis toob kaasa kulude kasvu. Prognooside kohaselt suurenevad vähiraviga seotud tervishoiukulutused elaniku kohta Eestis 2023.–2050. aastal 61 %, võrreldes 59 %ga ELis.
Käivitatud on kulutõhususe algatused, keskendudes sõeluuringute ja ravimite rahastamisele Eestis on kasutatud seni vähem meetmeid vähiravi kulude piiramiseks, kuna pidevalt on rõhutatud vajadust parandada ravi kättesaadavust. Kulude piiramiseks varasema diagnoosimisega, mille järel ravi on odavam, eraldati 2023. aastal lisavahendeid sõeluuringuprogrammide jaoks, et laiendada vanusevahemikke, katsetada uuenduslikke lahendusi ja töötada välja uued programmid (vt punkt 4). Võrreldes 2022. aastaga
6 Persentism viitab tootlikkuse vähenemisele, mis leiab aset siis, kui tööl viibiv töötaja ei ole haiguse, vigastuse või muu seisundi tõttu täielikult töövõimeline.
kasvasid sõeluuringuprogrammide jaoks eraldatud eelarvevahendid 2023. aastal rinnavähi puhul 5 %, emakakaelavähi puhul 13 % ja kolorektaalvähi puhul 19 % (Tervisekassa, 2023).
Ravimihindade tõusu tõttu on suurenenud ravimihindade mõju eelarvele. Uuemate vähiravimitega seotud kulude piiramiseks kohaldatakse umbes poolte ravimite hüvitamisel piiranguid – ravim hüvitatakse väiksema arvu näidustuste puhul, kui on heaks kiitnud Euroopa Ravimiamet (OECD, 2024a). Ravimite hüvitamine on toimainepõhine, mis võimaldab haiglatel teha eelarvet mõjutavaid otsuseid ja osutab sellele, et rõhku pannakse eelarve jätkusuut- likkusele. Hüvitamisotsustes järgib Tervisekassa üldpõhimõtteid – näiteks peaks geneeriline ravim olema vähemalt 30 % ja biosimilar vähemalt 15 % odavam kui riiklikku retseptiravimite loetellu kantud originaalravim.
Vähktõbi mõjutab laialdaselt Eesti tööturgu ja majandust Lisaks otsesele kahjule inimese tervisele, nagu haigestumise tagajärjed ja surm, ning vaimsele ja psühholoogilisele kahjule, mida vähktõbi põhjustab patsiendile ja tema lähedastele, tekitab vähktõbi märkimisväärset kaudset koormust ühiskonnale laiemalt. See tuleneb töölt kõrvalejäämise, absentismi ja presentismi6 suurenemisest, mille tulemuseks on mõju SKP-le ja sissetulekute vähenemine, mis mõjutab inimeste heaolu ja tervishoiuteenustesse investeerimiseks kättesaadava raha kogust. OECD rahvatervise strateegilise planeerimise modelleerimise andmete kohaselt on tööjõu kadu Eestis hinnanguliselt üks suuremaid ELis (Joonis 18). Aastatel 2023–2050 on kadu, mis on tingitud vajadusest vähendada vähi tõttu töötamist, Eestis eeldatavasti keskmiselt 213 täistööajale taandatud töötajat 100 000 elaniku kohta, mida on rohkem kui ELi keskmine 178 täistööajale taandatud töötajat 100 000 elaniku kohta. Samuti on oodata, et absentismist ja presentismist tingitud kadu on Eestis 89 täistööajale taandatud töötajat 100 000 elaniku kohta, mida on rohkem kui ELi keskmine 81 täistööajale taandatud töötajat 100 000 elaniku kohta.
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16: Impact of cancer on the average population life expectancy in years, average over 2023-2050
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# Restricted Use - À usage restreint
15b: Impact of cancer on workforce through employment (combining unemployment and part-time work), absenteeism and presenteeism in FTEs, average over 2023-2050 per 100 000 people
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Tööhõive (töölt kõrvale jäämine ja osaline tööaeg) Absentism Presentism
Vähist tingitud prognoositud kadu täistööajale taandatud töötajate arvuna 100 000 elaniku kohta (2023.–2050. aasta)
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Tööhõive (töölt kõrvale jäämine ja osaline tööaeg) Absentism Presentism
Vähist tingitud prognoositud kadu täistööajale taandatud töötajate arvuna 100 000 elaniku kohta (2023.–2050. aasta)
Joonis 18. Vähktõbi avaldab aastatel 2023–2050 suurt mõju Eesti tööjõule, mille tulemuseks on keskmine aastane kadu suurusega enam kui 300 täistööajale taandatud töötajat 100 000 elaniku kohta
Märkus: ELi keskmine on kaalumata keskmine. Allikas: OECD (2024b), „Tackling the Impact of Cancer on Health, the Economy and Society“, OECD Health Policy Studies, OECD Publishing, Pariis, DOI: https://doi.org/10.1787/85e7c3ba-en.
5.4. Heaolu ja elukvaliteet
2020. aasta seisuga oli diagnoositud kunagi elu jooksul vähk enam kui 5 %-l Eesti elanikest OECD rahvatervise strateegilise planeerimise modelleerimise andmete põhjal prognoositakse, et vähktõbi vähendab aasatel 2023–2050 Eestis oodatavat eluiga võrreldes vähivaba stsenaariumiga 1,9 aasta võrra, mis sarnaneb ELi
keskmisega (Joonis 19). Peale selle seostatakse vähktõbe oluliste vaimse ja füüsilise tervise probleemidega, mis mõjutavad nii patsienti kui ka tema lähedasi. Riiklike andmete põhjal oli 2020. aasta seisuga saanud oma elus vähidiagnoosi üle 67 000 inimese (5 % Eesti elanikkonnast), mis tõstab esile tugiteenuste kättesaadavuse tähtsuse, et parandada elukvaliteeti ja aidata inimestel toime tulla vähktõve mõjuga.
Joonis 19. Vähktõve mõju elanike keskmisele oodatavale elueale aastatel 2023–2050 on Eestis lähedal ELi keskmisele
Märkus: ELi keskmine on kaalumata keskmine. Allikas: OECD (2024b), „Tackling the Impact of Cancer on Health, the Economy and Society“, OECD Health Policy Studies, OECD Publishing, Pariis, DOI: https://doi.org/10.1787/85e7c3ba-en.
Tugi- ja rehabilitatsiooniteenused kannatavad struktuuri puudumise tõttu Avaldatud on kaks palliatiivse ravi juhendit, mis hõlmavad sümptomaatilist ravi, soovitusi konkreetsete juhtude käsitlemiseks ning interdistsiplinaarse ravi korraldamist, kaasates vaimse tervise keskused ja eriväljaõppe saanud spetsialistid. See on eriti oluline, võttes arvesse, et eelduste kohaselt suureneb aastatel 2023–2050
Eestis vanusestandarditud depressioonijuhtumite arv 100 000 elaniku kohta vähktõve tõttu 23 võrra aastas, mida on märksa rohkem kui 17 juhtumit 100 000 elaniku kohta ELis. Samal ajal on psühholoogilise toe kättesaadavust raskendanud tööjõupuudus, sest kuigi psühholoogide ja psühhoterapeutide arv suurenes 13-lt 100 000 elaniku kohta 2013. aastal 27-le 100 000 elaniku kohta 2023. aastal, on nõudlus hooldusasutustes ja
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kogukonnas hüppeliselt kasvanud (Tervise Arengu Instituut, 2024a).
Eestis ei toimu süstemaatilist suunamist onkoloogilise rehabilitatsiooniteenuse pakkuja juurde eesmärgiga parandada vähipatsientide ja vähktõvest jagusaanute elukvaliteeti. Vaatamata mitmes valdkonnas tehtud edusammudele, puuduvad vähipatsientide viljakuse säilitamisega seotud meetmed ja vähktõvest jagusaanute õigus olla unustatud ning Eestis ei ole vähktõvest jagusaanute kliinikute organiseeritud võrgustikku. Järelravi puhul sõltuvad patsiendid esmatasandi tervishoiusüsteemist.
Palliatiivse ravi kättesaadavus on piirkonniti erinev Palliatiivne ravi, sealhulgas statsionaarne ja ambulatoorne palliatiivne ravi ning elulõpuravi, kuulub Eestis Tervisekassa hüvitatavate teenuste hulka. Ambulatoorsete teenuste ja hooldekodude puhul kohaldatakse omaosalust ning kasutajad tasuvad osa ravikuludest, näiteks opioidide ja muu valuravi eest. Patsiendid maksavad hooldekodudes ja hospiitsides ka voodipäevatasu.
2019. aastal osutati Eestis rohkem palliatiivse ravi teenuseid kui ELis keskmiselt. Neid teenuseid osutasid haiglad, kutseliidud ja patsientide ühendused, kusjuures alates 2020. aastast on 48 teenuseosutajat pakkunud koduõendusteenust (kõigis maakondades). Analüüsis leiti siiski, et teenused on jaotatud ebaühtlaselt ja juurdepääs, eelkõige vaimse tervise teenustele, on piirkonniti väga erinev. Äärealade elanikel on keeruline terviklikele teenustele ligi pääseda, kuna puudub hüvitis, sealhulgas reisikulude katmiseks.
Lisaks takistavad õigeaegset juurdepääsu tervishoiutöötajate vähene teadlikkus, koordineeritud palliatiivse ravi võrgustiku puudumine ja rahaliste vahendite nappus. Seega sõltub juurdepääs sageli patsiendi või tema hooldaja teadlikkusest. Vaja on paremat integreerimist, meeskonnatööd ja juhtumite haldamist, et vältida patsientide süsteemis kaotsiminekut (HAAP Consulting, 2023).
Eesti töötab välja palliatiivse ravi teenuste mudelit, mis vastaks paremini patsientide vajadustele Vähitõrje tegevuskavas 2021–2030 on püstitatud eesmärk parandada veelgi palliatiivse ravi kättesaadavust, koolitades tervishoiutöötajaid, suurendades patsientide ja töötajate teadlikkust ning tagades piisava rahastamise. Pidades esmatähtsaks vähipatsientide elukvaliteeti, on tegevuskavas ette nähtud riikliku palliatiivse ravi teenuste mudeli väljatöötamine. Eesti kavatseb
ühineda ELi algatustega tervishoiu ja palliatiivse ravi, sealhulgas pediaatrilise palliatiivse ravi valdkonnas. Tuginedes sotsiaalministeeriumi tellitud aruandele (HAAP Consulting, 2023), kujundatakse ümber palliatiivse ravi võrgustik, et jõuda kõikides piirkondades paremini patsientideni, pöörates tähelepanu esmatasandi arstiabi rollile ja mitteametlike hooldajate suuremale toetamisele. Selles strateegias on kesksel kohal koduõendus, mille eesmärk on vähendada haiglas viibimist, pakkudes hooldust kodus. Lisaks on vähitõrje tegevuskavas seatud eesmärk tagada patsientidele terviklik, kvaliteetne ja õigeaegne onkoloogilise rehabilitatsiooni teenus ning standardida selle teenusega seotud terminoloogia ning kodeerimis- ja hindamissüsteem.
Palliatiivse ravi alast koolitust pakutakse tervishoiutöötajatele osana meditsiiniharidusest, samal ajal soovitatakse palliatiivse ravi juhendis lisakoolitust, kuid see ei ole kohustuslik. Nõrgaks kohaks peetakse praktilise koolituse võimalusi. Palliatiivse ravi teenuste koolitusmudeli väljatöötamise raames on kavas koolitust laiendada, muuta see kohustuslikuks ja koostada spetsiaalne koolituskava koordinaatoritele.
Kuigi Tervisekassa teeb kõigi oma partnerite puhul kvaliteediauditeid ja tervishoiuteenuste osutajatel on seadusest tulenev kohustus teha patsiend- ikogemust käsitlevaid uuringuid, sealhulgas palliatiivse ravi ja elulõpuravi valdkonnas, puuduvad andmed konkreetselt vähipatsientidele mõeldud palliatiivse ravi kättesaadavuse ja kvaliteedi kohta riigis.
Suur osa elulõpuravist sõltub Eestis mitteametlikest hooldajatest, kuigi kavas on välja arendada spetsialistide võrgustik Eestis pakutakse elulõpuravi kodus ja haiglates, hooldekodudes ja hospiitsides. Ravi võib juhendada pere- või eriarst, sealhulgas kaugkonsultatsiooni teel. Suur osa hoolduskoormusest jääb siiski mitteametlikele hooldajatele, kellel on õigus saada pereliikme hooldamise eest hüvitist vaid 80 % ulatuses kuni seitsme päeva eest. Puudub palgata puhkuse süsteem ja paindlikku töökorraldust ei toetata. Mitteametlikule hooldajale makstava rahalise toetuse määrab kindlaks omavalitsus, kes teeb otsuse toetuse saamise õiguse ja antava toetuse liigi kohta (Rocard & Llena-Nozal, 2022). Vähitõrje tegevuskavas 2021–2030 peetakse esmatähtsaks parandada elulõpuravi teenuste kättesaadavust, tagada, et tervishoiutöötajatel on palliatiivse ravi jaoks vajalikud oskused, arendada elu lõpus pakutavat psühholoogilist tuge ning reguleerida patsientidele ja peredele elulõpuraviga seotud otsuste kohta teabe andmist.
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17: Age-standardised incidence rate per 100 000 in 2022
31%
15% 15%
6%
Leukeemia: 4,3
Ajuvähk, kesknärvisüsteemi kasvaja: 2,1
Lümfoomid (Hodgkini lümfoom ja mitte-Hodgkini lümfoomid): 2,0
Neeruvähk: 0,8
Muu: 4,5
36 %
23 % 3 %
6 %
Leukeemia: 5,1
Ajuvähk, kesknärvisüsteemi kasvaja: 3,2
Lümfoomid (Hodgkini lümfoom ja mitte-Hodgkini lümfoomid): 0,4
Neeruvähk: 0,9
Muu: 4,6
EL27Eesti
Kõik vähipaikmed: 13,7 100 000 elaniku kohtaKõik vähipaikmed: 14,2 100 000 elaniku kohta
Hinnanguline vanusestandarditud haigestumus 100 000 elaniku kohta (0–14aastased) (2022)
9 161 uut vähijuhtumit 2022. aastal31 uut vähijuhtumit 2022. aastal
Vanusestandarditud suremus 100 000 elaniku kohta (0–14aastased) (kolme aasta keskmine, 2021)
2.9 (Eesti) > 2.1 (EL27)
6. Pilguheit laste vähktõvele
Euroopa vähiteabesüsteemi andmete kohaselt oli 2022. aastal Eestis laste ja noorukite seas hinnanguliselt 31 vähijuhtumit. Haigestumus 0–14aastaste seas oli 2022. aastal hinnanguliselt 14,2 juhtumit 100 000 elaniku kohta, mis on sarnane 13,7 juhtumiga 100 000 elaniku kohta EL 27s (Joonis 20). Kõige sagedamini diagnoositud
vähk oli hinnangute kohaselt leukeemia (5 juhtumit 100 000 elaniku kohta), millele järgnesid ajuvähk ja kesknärvisüsteemi kasvajad, lümfoomid ja neeruvähk. Eurostati andmetest on näha, et laste vähktõvest põhjustatud suremus oli 2,9 inimest 100 000 elaniku kohta, ja see näitaja on olnud pidevalt üks ELi kõrgemaid.
Joonis 20. Laste vähihaigestumus on Eestis veidi suurem kui ELi keskmine
Märkused. 2022. aasta näitajad on varasemate aastate haigestumussuundumustel põhinevad hinnangud ja võivad hilisematel aastatel täheldatud haigestumusest erineda. „Kõik vähipaikmed“ ei hõlma mittemelanoomset nahavähki. Allikad: Euroopa vähiteabesüsteem (vähihaigestumuse puhul), https://ecis.jrc.ec.europa.eu (vaadatud 10. märtsil 2022), © Euroopa Liit, 2024.
Eestis diagnoositakse ja ravitakse laste vähktõbe kahes laste hematoloogia-onkoloogia keskuses (Tartu Ülikooli Kliinikum ja Tallinna Lastehaigla). Eesti vähitõrje tegevuskavas 2021–203 osutatakse meditsiinitöötajate ebapiisavale teadlikkusele sellest, et 0–18aastaste patsientide pahaloomuliste kasvajate diagnoosimist ja ravi juhib lasteonkoloog.
Enamik laste vähktõve puhul kasutatavaid raviviise on Eestis kättesaadavad. Lastest vähipatsientidel ei ole siiski võimalik saada riigis prootonkiir- itusravi, samuti ei pakuta vähktõvest jagusaanud lastele ellujääja-spetsiifilist hooldust. Eesti vähikeskused tagavad juurdepääsu prootonravile läbi rahvusvahelise koostöö. Lisaks oli Euroopas aastatel 2010–2022 korraldatud 436st kliinilisest uuringust, milles osalesid vähki põdevad lapsed, alla 18aastastele Eesti elanikele ligipääsetav vaid 1 %, mis on üks ELi väiksemaid näitajaid. 68st pediaatria valdkonnas oluliseks tunnistatud ravimist oli Eestis 2018. aastal kättesaadav 59 %, mida on vähem kui ELi keskmine 76 %, kuid
rohkem kui 49 % naabruses asuvas Lätis ja Leedus (Vassal et al., 2021).
Eesti vähitõrje tegevuskavas 2021–2030 on lisaks kindlaks tehtud olulised lüngad sotsiaal- abisüsteemis lastevanematele, kelle laps on saanud vähidiagnoosi, sealhulgas ebapiisav tugi laste arengu tagamiseks pikaajalise haiglaravi ajal ja laste naasmisel lasteaeda või kooli ning haiglavälise psühholoogilise abi puudumine. Laste vähktõbi on üks vähitõrje tegevuskava 2021–2030 prioriteete. Tegvuskavas on seatud eesmärk parandada teenuste kättesaadavust, tõhustada koostööd rahvusvaheliste pädevuskeskustega ning suurendada vähki põdevate laste juurdepääsu kliinilistele uuringutele.
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Country abbreviations (translated)
Austria AT Iirimaa IE Leedu LT Portugal PT Sloveenia SI Belgia BE Island IS Luksemburg LU Prantsusmaa FR Soome FI Bulgaaria BG Itaalia IT Madalmaad NL Rootsi SE Taani DK Eesti EE Kreeka EL Malta MT Rumeenia RO Tšehhi CZ Hispaania ES Küpros CY Norra NO Saksamaa DE Ungari HU Horvaatia HR Läti LV Poola PL Slovakkia SK
Riikide lühendid
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Palume käesolevale väljaandele viidata järgmiselt: OECD/European Commission (2025), „Riigi vähiprofiil: Eesti 2025“, ELi riikide vähiprofiilid, OECD Publishing, Pariis, https://doi.org/10.1787/664a014c-et. Algselt avaldatud inglise keeles pealkirja all: OECD/European Commission (2025), EU Country Cancer Profile: Estonia 2025, OECD Publishing, Paris, https://doi.org/10.1787/bb4eec73-en. Mis tahes lahknevuse korral loetakse kehtivaks ainult ingliskeelne tekst. © OECD/European Union 2025 selle Eesti väljaande jaoks.
European Cancer Inequalities Registry
Riigi vähiprofiil 2025 Vähktõve ebavõrdsuse register on Euroopa vähktõvevastase võitluse kava juhtalgatus. Sellest saab kindlat ja usaldusväärset teavet vähktõve ennetamise ja ravi kohta, et selgitada välja suundumused ning erinevused ja ebavõrdsus liikmesriikide ja piirkondade vahel. Register sisaldab veebisaiti ja andmetööriista, mille on välja töötanud Euroopa Komisjoni Teadusuuringute Ühiskeskus (https://cancer-inequalities. jrc.ec.europa.eu/), samuti vaheldumisi iga kahe aasta järel koostatavaid riiklikke vähiprofiile ja üldist aruannet vähktõve ebavõrdsusest Euroopas.
Riikide vähiprofiilides tuuakse välja tugevad küljed, probleemid ja konkreetsed tegevusvaldkonnad kõigis 27 ELi liikmesriigis, Islandil ja Norras, et suunata Euroopa vähktõvevastase võitluse kava alusel investeeringuid ja sekkumisi ELi, riigi ja piirkonna tasandil. Lisaks toetab Euroopa vähktõve ebavõrdsuse register nullsaaste tegevuskava 1. juhtalgatust.
Profiilid koostab Majanduskoostöö ja Arengu Organisatsioon (OECD) koostöös Euroopa Komisjoniga. Töörühm on tänulik riiklikele ekspertidele, OECD tervisekomiteele ja ELi vähktõve ebavõrdsuse registri eksperdirühmale väärtuslike märkuste ja ettepanekute eest.
Iga riigi terviseprofiilis esitatakse lühikokkuvõte järgmisest:
• vähktõvest tulenev koormus riigis
• vähi riskitegurid, keskendudes käitumuslikele ja keskkonnast tulenevatele riskiteguritele
• varajase avastamise programmid
• vähiravi tulemuslikkus, keskendudes kättesaa- davusele, ravi kvaliteedile, kuludele ja elukvaliteedile
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Inquiry | 02.07.2025 | 1 | RST-1/3291-1 | Sissetulev kiri | ra | SIA Merck Sharp & Dohme Latvija |