Incidence rates of melanoma are expected to continue rising. These trends are worrying in terms of disease burden, particularly in eastern European countries.

Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age‐standardized survival. The aim of this study is to explain these survival differences. Population‐based data on stage at diagnosis, diagnostic procedures, treatment and follow‐up were collected for about 20,000 women diagnosed with breast cancer aged 15–99 years during 1996–98 in 7 US states and 12 European countries. Age‐standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node‐negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5–6%). Net survival in Northern, Western and Southern Europe (81–84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70–99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment.

Although incidence and mortality rates in general were low, some countries displayed high- to intermediate-level incidence rates; under-reporting and under-ascertainment of cases could contribute to the geographic variations observed. There is a need to improve both the ascertainment of cases and the accuracy of histological diagnosis. Monitoring of brain and CNS cancers along with etiological research remain priorities.

Survival in the case of lung cancer patients not only remains poor and decreases with advancing age at diagnosis, but recent European studies also report that it differs by sex. Our study sought to describe sex-related differences in lung cancer survival in Spain, and evaluate the role played by histologic type. Our analysis covered seven Spanish regions with population-based cancer registries. Cases diagnosed with lung cancer during the period 1995e1999 were followed up until December 31, 2004. To ascertain possible sex differences we performed multiple regression analysis. Age-standardized 5-year relative survival proved significantly higher in women (11.8%) than in men (9.2%), and among the youngest patients relative survival at 5 years conditional on surviving 1 year, was 1.74 times significantly higher in women than in men. The regression analysis showed that men had a higher relative excess risk of dying (RER) than did women (1.1 [95% CI 1.03e1.18]), with this being particularly marked among the 15e54 age group (1.42 [1.24e1.64]). Analysis by histologic type showed that in small cell carcinoma, men had a higher RER than women (1.29 [1.02e1.61]); in

A comparative analysis of cancer prevalence in France, Spain and Italy is presented as part of the EUROPREVAL project. The three countries are culturally and sociologically relatively homogeneous compared with Europe as a whole. However, in all three countries, the cancer registries (CRs) providing the data for prevalence calculation cover only small fractions of the populations, and have been operating for relatively short periods. This leads to problems of representativity and to prevalence underestimates as surviving cases diagnosed before operation of the CR are not recorded. Partial prevalences obtained directly from CR data were therefore corrected using a completeness index obtained by modelling to provide estimates of the complete prevalence. For CRs operating for only 5 years, only approximately half the prevalence was observed. Thus, due to the rather recent start of most of southern European CRs, the role of correction is very important. The prevalence of all cancers was highest in Italy for women and in France for men, while lowest in Spain. Differences in the age structures of the populations were the major cause of these discrepancies and after age adjustment only the prevalence of stomach cancer remained highest in Italy, although differences in incidence also contributed to the prevalence differences. Survival varied little between the three countries and differences in incidence are more important determinants of prevalence. Prevalence of cancer in the elderly represents an increasing load for the community, particularly for France, Italy and Spain due to the ageing population in these countries. Elderly patients with cancer frequently suffer from problems of co-morbidity and disability factors, thus placing a burden on the local medical system where this proportion is high. Prevalent cases diagnosed 1-5 years before the prevalence date formed approximately one-third of the total prevalence, with higher proportions for melanoma, and prostate cancer in males and breast and colorectal cancer in females, and lower proportions for uterine cancer. This subset of the prevalent population consists of those probably on intensive follow-up, or being treated for cancer recurrence or sequelae to primary therapy.