RESEARCH – January 2017

Cancer incidence in Estonia 2009–2013 and 20-year temporal trends

Authors: Mari-Liis Zimmermann, Kaire Innos, Pille Härmaorg, Margit Mägi, Aleksei Baburin, Tiiu Aareleid

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Aim. To provide an overview of cancer incidence in Estonia during 2009–2013 and to analyse temporal trends in cancer incidence and mortality.

Methods. The Estonian Cancer Registry provided data on the incidence of all cancer cases (ICD-10 C00−C96) diagnosed in Estonia during 2009–2013. We calculated the average annual number of cases and incidence rates per 100 000 person-years ( IR) for male and female populations for 27 sites/site groups.

We analysed temporal trends in agestandardised (World) incidence (1994–2013) and mortality (1994–2014) for selected cancer sites using joinpoint regression. Data for cancer deaths were obtained from the Causes of Death Registry.

Results. During 2009–2013, the average number of incident cases of cancer per year was 7899 (4008 male and 3891 female). The age-standardised IR was 395.8 for males and 259.0 for females. The leading sites were prostate (27%), lung (15%) and colorectum (10%) in men and breast (18%), non-melanoma skin (17%) and colorectum (12%) in women. The leading sites differed across age groups. In children (0–14 years), leukaemia was the most common cancer in both sexes (5 cases per year), while in young adults (15–29 years), the leading sites were testis in men and skin melanoma in women.

Since 1994, the age-standardised incidence of all sites has increased in both sexes, accompanied by a decrease in mortality. In men, a steady decline was apparent in the incidence of lung cancer, paralleled by a decrease in mortality (both at an average rate of -2% per year). In women, however, the incidence and mortality of lung cancer increased significantly. Colorectal cancer incidence increased over the study period, while mortality decreased. Breast cancer incidence increased continuously at an average rate of 1.4% per year, while mortality has declined since 2000. A steady increase was seen in the incidence of cervical cancer with no change in mortality. Over the study period, the incidence of prostate cancer increased at an average rate of 6% per year, with a particularly steep rise during 2000–2006 (13% per year). Prostate cancer mortality increased as well (3% per year).

Conclusions. Cancer incidence continued to increase in Estonia. Among cancer sites amenable to prevention, favourable trends were seen only for male lung cancer. A new national cancer plan should be adopted. High-quality population-based cancer incidence and mortality data are a key resource for assessing the increasing cancer burden.