Variation in survival of patients with digestive tract cancers in Europe, 1978-1989.

International comparisons suggest important intercountry differences in survival of digestive cancers. The present study is concerned with variations in survival trends among European countries. The EUROCARE study is a European Union project to collect survival data from population-based cancer registries. We compared survival rates from 17 countries between 1985 and 1989 and investigated time trends in survival over the 1978 1989 period in 13 countries. Relative survival rates were computed using age-specific general population mortality rates to take into account the widely differing mortality backgrounds of participating countries. Mean European or regional survival rates were estimated as the weighted mean of 5-year survival rates in the corresponding countries. Five-year relative survival rates ranged from 3% to 14% for oesophageal cancer, 9% to 27% for gastric cancer, 26% to 54% for colon cancer and 25% to 54% for rectal cancer. In general, survival was lower in Eastern Europe, Denmark and the UK than in northern or continental Europe. Survival rates for digestive tract cancer increased in most European countries but most regional differences in survival persisted. The highest increase in survival rate was observed for large bowel cancers. The weighted European survival rate increased from 40% to 48% for colon cancer and 38% to 46% for rectal cancer. Improvements in survival were greater for Ž . older patients aged 65 99 at diagnosis . Differences in survival rates between the countries from northern and continental Europe decreased, particularly for colorectal cancer and partially for stomach cancer. The large geographical differences in survival rates for digestive tract cancers suggest differences in the availability of diagnostic and therapeutic facilities. The substantial improvement in survival suggests that cancers are being diagnosed earlier and that treatments are more effective but inter-country differences in survival rates have not decreased.