Answers to Inquiry

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 the European Commission. The opinions expressed and arguments employed herein do not necessarily reflect the official views of the Member countries of the OECD or of the European Union. This document, as well as any data and map included herein, are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. The names of countries and territories and maps used in this joint publication follow the practice of the OECD. 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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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 4 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025  5 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 6 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025  7 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 8 1 Cancer burden 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025  9 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 0 100 200 300 400 500 600 700 800 Colorectum Corpus uteri 12% 5% Breast Lung All other cancer sites Women 488 30% 9% 43% Prostate Lung Colorectum Bladder All other cancer sites Men 684 23% 14% 14% 9% 41% 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 10  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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   11 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 Total Men Women 2011-21 change, EU average 500 450 -8% 400 -16% 350 Men Women 300 250 200 150 100 50 0 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 12  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 Men Women % 50 40 30 20 10 0 -10 -20 -30 -40 -50 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   13 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 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 Rate % 2 500 50 2 000 40 1 500 30 1 000 20 500 10 0 0 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 14  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 Early Diagnosis & Quality of Research & full Prevention Inequalities Paediatrics alignments detection treatment life 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). EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   15 2 Risk factors and prevention policies 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). EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 16  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 2022 (or nearest year) 2012 (or nearest year) % 35 29 30 25 21 22 20 25 25 25 20 23 23 22 21 21 20 20 19 15 19 19 17 17 16 16 15 10 15 14 14 13 12 11 5 9 8 6 0 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). EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   17 Figure 2.2. Adolescent smoking is strongly associated with the prevalence of smoking among adults Adolescents - Self-reported smoking at least once over the last 30 days (%) 35 BG HU 30 IT HR 25 PL RO FI LT AT SK LV 20 DE EU27 EL NL ES CZ SI 15 SE DK BE LU FR CY NO PT EE MT 10 IE R² = 0.38 5 IS 0 5 10 15 20 25 30 Adults - Population prevalence of daily smoking (%) 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 Smoking at least once in the last 30 days Drunkenness more than once in a lifetime Overweight or obese % 30 25 25 23 22 21 20 17 17 15 10 2014 2018 2022 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 18  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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   19 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 Total women High education Low education % 70 60 50 40 30 20 10 0 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 20  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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   21 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 22  3 Early detection 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   23 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 2022 or nearest year 2014 2019 Survey 2014 Survey 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Spain Sweden Czechia Croatia Cyprus Cyprus Finland Lithuania Malta Greece Malta Romania Netherlands Iceland Slovenia Austria Norway Germany Poland France Denmark Ireland Estonia Belgium EU average Italy Latvia Hungary Slovak Republic Bulgaria Luxembourg Programme data Portugal Survey data 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 24  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 2022 or nearest year 2014 2019 Survey 2014 Survey 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Sweden Czechia Spain Finland Iceland Lithuania Malta Croatia Greece Cyprus Malta Romania Slovenia Netherlands Poland Austria Germany Norway France Ireland Estonia Denmark Latvia Slovak Republic Belgium EU average Italy Hungary Bulgaria Luxembourg Portugal Programme data Survey data 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%). EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   25 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 26  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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   27 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]). EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 28  4 Cancer care performance 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   29 Figure 4.1. The availability of nurses per cancer case varies more than 5-fold across EU+2 countries Number of nurses per 1 000 new cancer cases Physicians low Physicians high 3 500 Nurses high Nurses high IS 3 000 IE 2 500 LU FI NO AT 2 000 DE BE SE NL SI RO CZ 1 500 MT EU average: 1 376 FR DK EU27 LT EE PT PL SK ES 1 000 HR CY IT BG HU LV EL 500 Physicians low Physicians high Nurses low EU average: 679 Nurses low 0 450 550 650 750 850 950 1 050 1 150 Number of physicians per 1 000 new cancer cases 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 30  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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   31 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 2023 (or nearest year) 2013 (or nearest year) 14 12 10 8 6 4 2 0 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 32  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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   33 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 34  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 Percentage change in potential years of life lost 2012-22 (or nearest available year) 5% 0% -5% Pancreas -10% Colorectal -15% Cervix uteri Breast Ovary -20% -25% Stomach Lung -30% -35% 0 50 100 150 200 250 300 350 Potential years of life lost per 100 000 population 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   35 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%. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 36  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 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 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]). EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   37 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 Employment (combining unemployment and part-time) Absenteeism Presenteeism 0 -100 -200 -300 -400 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). EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 38  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 0 -0.5 -1 -1.5 -2 -2.5 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 EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   39 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 40  5 Spotlight on paediatric cancer care 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 Incidence per 100 000 population, 2022 (left axis) Mortality per 100 000 population, 3-year average, 2021 (right axis) Incidence rate Mortality rate 20 4 15 3 10 2 5 1 0 0 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   41 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 42  6 Cancer performance trackers 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   43 Figure 6.1. Belgium’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration BE No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 3.1 6.1 Daily smoking 6.2 29.1 -3.5 pp Cancer prevention % of population aged 15+ 15.4 18.6 Alcohol consumption 6.3 11.9 -11 % Litres per capita, population aged 15+ 9.2 10.0 Overweight and obesity 41.9 62.5 +0.3 pp % of population aged 18+ with BMI ≥ 25 48.9 51.3 Air pollution 4.9 17.8 -34 % Exposure to PM2.5 (µg/m³) 11.1 11.7 HPV vaccination 7 96 +11 pp % of girls aged 15 64 72 Breast cancer screening 9 83 -1.8 pp Cancer early % of target population 56 57 detection Cervical cancer screening -0.8 pp 11 85 % of target population 55 55 Colorectal cancer screening 3 77 - % of target population 42 52 Physicians - 499 1 094 per 1 000 cancer cases 571 679 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 1 376 1 859 Reimbursed cancer medicines 0 100 - % of selected indications 59 77 CT scanners 11 F 49 +73 % r per 1 000 000 population a 26 26 MRI units 6 38 +9 % per 1 000 000 population 12 18 Cancer mortality -18 % 198 310 ASMR per 100 000 population 220 235 Colorectal cancer mortality 19 50 -29 % ASMR per 100 000 population 21 27 Breast cancer mortality 22 37 -25 % ASMR per 100 000 women Cancer care outcomes 31 31 Lung cancer mortality 33 78 -25 % ASMR per 100 000 population 47 49 Cancer PYLL 826 1 961 -24 % years per 100 000 population 1 113 1 355 Colon cancer 5-year survival 49 72 +3.6 pp % survival for patients diagnosed 2010-2014 60 68 Breast cancer 5-year survival 74 93 +1.6 pp % survival for women diagnosed 2010-2014 83 86 Lung cancer 5-year survival 8 20 +2.8 pp % survival for patients diagnosed 2010-2014 15 18 Educational inequalities 18 106 - % difference in cancer mortality by education 37 43 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 44  Figure 6.2. Bulgaria’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration BG No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 3.9 6.1 Daily smoking 6.2 29.1 +0.9 pp Cancer prevention % of population aged 15+ 18.6 29.1 Alcohol consumption 6.3 11.9 +13 % Litres per capita, population aged 15+ 10.0 11.1 Overweight and obesity 41.9 62.5 -5.8 pp % of population aged 18+ with BMI ≥ 25 51.3 53.7 Air pollution 4.9 17.8 -25 % Exposure to PM2.5 (µg/m³) 11.7 17.2 HPV vaccination 7 96 -14 pp % of girls aged 15 7 64 Breast cancer screening 9 detection 83 +3.7 pp Cancer early % of target population 36 56 Cervical cancer screening 11 85 +4.6 pp % of target population 55 57 Physicians - 499 1 094 per 1 000 cancer cases 679 967 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 943 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 59 85 CT scanners 11 F 49 +47 % r per 1 000 000 population a 26 47 MRI units 6 38 +61 % per 1 000 000 population 12 18 Radiation therapy equipment 5 12 +113 % per 1 000 000 population 8 11 Cancer mortality +0 % 198 310 ASMR per 100 000 population 229 235 Colorectal cancer mortality 19 50 +8 % ASMR per 100 000 population 27 35 Breast cancer mortality 22 37 -5 % ASMR per 100 000 women Cancer care outcomes 30 31 Lung cancer mortality 33 78 -4 % ASMR per 100 000 population 42 47 Cancer PYLL 826 1 961 -16 % years per 100 000 population 1 355 1 695 Colon cancer 5-year survival 49 72 +8.5 pp % survival for patients diagnosed 2010-2014 52 60 Breast cancer 5-year survival 74 93 +7.4 pp % survival for women diagnosed 2010-2014 78 83 Lung cancer 5-year survival 8 20 +1.9 pp % survival for patients diagnosed 2010-2014 8 15 Educational inequalities 18 106 - % difference in cancer mortality by education 37 86 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   45 Figure 6.3. Czechia’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration CZ No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 8.1 Daily smoking 6.2 29.1 -6.7 pp Cancer prevention % of population aged 15+ 16.2 18.6 Alcohol consumption 6.3 11.9 +2 % Litres per capita, population aged 15+ 10.0 11.6 Overweight and obesity 41.9 62.5 -5.8 pp % of population aged 18+ with BMI ≥ 25 51.3 56.5 Air pollution 4.9 17.8 -32 % Exposure to PM2.5 (µg/m³) 11.7 14.1 HPV vaccination 7 96 -3 pp % of girls aged 15 64 71 Breast cancer screening 9 83 -0.4 pp Cancer early % of target population 56 60 detection Cervical cancer screening -0.3 pp 11 85 % of target population 55 74 Colorectal cancer screening 3 77 - % of target population 29 42 Physicians - 499 1 094 per 1 000 cancer cases 679 737 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 376 1 549 Reimbursed cancer medicines 0 100 - % of selected indications 59 77 CT scanners 11 F 49 +9 % r per 1 000 000 population a 16 26 MRI units 6 38 +67 % per 1 000 000 population 12 18 Radiation therapy equipment 5 12 -1 % per 1 000 000 population 8 8 Cancer mortality -15 % 198 310 ASMR per 100 000 population 235 257 Colorectal cancer mortality 19 50 -23 % ASMR per 100 000 population 27 32 Breast cancer mortality 22 37 -9 % ASMR per 100 000 women Cancer care outcomes 30 31 Lung cancer mortality 33 78 -24 % ASMR per 100 000 population 45 47 Cancer PYLL 826 1 961 -19 % years per 100 000 population 1 355 1 367 Colon cancer 5-year survival 49 72 +8.1 pp % survival for patients diagnosed 2010-2014 56 60 Breast cancer 5-year survival 74 93 +5.7 pp % survival for women diagnosed 2010-2014 81 83 Lung cancer 5-year survival 8 20 +2 pp % survival for patients diagnosed 2010-2014 11 15 Educational inequalities 18 106 - % difference in cancer mortality by education 37 106 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 46  Figure 6.4. Denmark’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration DK No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 8.8 Daily smoking 6.2 29.1 -5.3 pp Cancer prevention % of population aged 15+ 11.7 18.6 Alcohol consumption 6.3 11.9 -12 % Litres per capita, population aged 15+ 9.5 10.0 Overweight and obesity 41.9 62.5 +0.1 pp % of population aged 18+ with BMI ≥ 25 51.3 54.6 Air pollution 4.9 17.8 -31 % Exposure to PM2.5 (µg/m³) 8.9 11.7 HPV vaccination 7 96 +6 pp % of girls aged 15 64 83 Breast cancer screening 9 83 -1.3 pp Cancer early % of target population 56 83 detection Cervical cancer screening -5.5 pp 11 85 % of target population 55 61 Colorectal cancer screening 3 77 - % of target population 42 61 Physicians - 499 1 094 per 1 000 cancer cases 601 679 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 376 1 384 Reimbursed cancer medicines 0 100 - % of selected indications 59 69 CT scanners 11 F 49 +31 % r per 1 000 000 population a 26 43 MRI units 6 38 % per 1 000 000 population 9 18 Radiation therapy equipment 5 12 -13 % per 1 000 000 population 8 12 Cancer mortality -15 % 198 310 ASMR per 100 000 population 235 271 Colorectal cancer mortality 19 50 -26 % ASMR per 100 000 population 27 30 Breast cancer mortality 22 37 -24 % ASMR per 100 000 women Cancer care outcomes 31 33 Lung cancer mortality 33 78 -23 % ASMR per 100 000 population 47 57 Cancer PYLL 826 1 961 -29 % years per 100 000 population 1 092 1 355 Colon cancer 5-year survival 49 72 +10.1 pp % survival for patients diagnosed 2010-2014 60 62 Breast cancer 5-year survival 74 93 +5.8 pp % survival for women diagnosed 2010-2014 83 86 Lung cancer 5-year survival 8 20 +7.1 pp % survival for patients diagnosed 2010-2014 15 17 Educational inequalities 18 106 37 70 - % difference in cancer mortality by education Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   47 Figure 6.5. Germany’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration DE No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 6.6 Daily smoking 6.2 29.1 -6.3 pp Cancer prevention % of population aged 15+ 14.6 18.6 Alcohol consumption 6.3 11.9 -9 % Litres per capita, population aged 15+ 10.0 10.6 Overweight and obesity 41.9 62.5 -2.2 pp % of population aged 18+ with BMI ≥ 25 46.5 51.3 Air pollution 4.9 17.8 -36 % Exposure to PM2.5 (µg/m³) 10.3 11.7 HPV vaccination 7 96 +25 pp % of girls aged 15 54 64 Breast cancer screening 9 83 -2.7 pp Cancer early % of target population 52 56 detection Cervical cancer screening -2.4 pp 11 85 % of target population 55 78 Colorectal cancer screening 3 77 - % of target population 42 55 Physicians - 499 1 094 per 1 000 cancer cases 679 715 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 1 376 1 882 Reimbursed cancer medicines 0 100 - % of selected indications 59 100 CT scanners 11 F 49 +7 % r per 1 000 000 population a 26 36 MRI units 6 38 +22 % per 1 000 000 population 18 35 Cancer mortality -10 % 198 310 ASMR per 100 000 population 235 236 Colorectal cancer mortality 19 50 -24 % ASMR per 100 000 population 24 27 Breast cancer mortality 22 37 -9 % ASMR per 100 000 women Cancer care outcomes 31 34 Lung cancer mortality 33 78 -9 % ASMR per 100 000 population 47 47 Cancer PYLL 826 1 961 -13 % years per 100 000 population 1 243 1 355 Colon cancer 5-year survival 49 72 +2.8 pp % survival for patients diagnosed 2010-2014 60 65 Breast cancer 5-year survival 74 93 +2.1 pp % survival for women diagnosed 2010-2014 83 86 Lung cancer 5-year survival 8 20 +3.4 pp % survival for patients diagnosed 2010-2014 15 18 Educational inequalities 18 106 - % difference in cancer mortality by education 33 37 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 48  Figure 6.6. Estonia’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration EE No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 8.8 Daily smoking 6.2 29.1 -10.1 pp Cancer prevention % of population aged 15+ 15.9 18.6 Alcohol consumption 6.3 11.9 -2 % Litres per capita, population aged 15+ 10.0 11.2 Overweight and obesity 41.9 62.5 +1.3 pp % of population aged 18+ with BMI ≥ 25 51.3 57.4 Air pollution 4.9 17.8 -31 % Exposure to PM2.5 (µg/m³) 6.1 11.7 HPV vaccination 7 96 -5 pp % of girls aged 15 43 64 Breast cancer screening 9 83 +4.6 pp Cancer early % of target population 56 63 detection Cervical cancer screening +8.2 pp 11 85 % of target population 55 58 Colorectal cancer screening 3 77 - % of target population 42 55 Physicians - 499 1 094 per 1 000 cancer cases 591 679 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 121 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 46 59 CT scanners 11 F 49 +19 % r per 1 000 000 population a 21 26 MRI units 6 38 +73 % per 1 000 000 population 17 18 Radiation therapy equipment 5 12 +37 % per 1 000 000 population 5 8 Cancer mortality -10 % 198 310 ASMR per 100 000 population 235 266 Colorectal cancer mortality 19 50 -3 % ASMR per 100 000 population 27 34 Breast cancer mortality 22 37 -11 % ASMR per 100 000 women Cancer care outcomes 29 31 Lung cancer mortality 33 78 -16 % ASMR per 100 000 population 44 47 Cancer PYLL 826 1 961 -28 % years per 100 000 population 1 283 1 355 Colon cancer 5-year survival 49 72 +9.5 pp % survival for patients diagnosed 2010-2014 58 60 Breast cancer 5-year survival 74 93 +7 pp % survival for women diagnosed 2010-2014 78 83 Lung cancer 5-year survival 8 20 +6.1 pp % survival for patients diagnosed 2010-2014 15 17 Educational inequalities 18 106 - % difference in cancer mortality by education 37 80 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   49 Figure 6.7. Ireland’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration IE No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 5.9 6.1 Daily smoking 6.2 29.1 -5 pp Cancer prevention % of population aged 15+ 14.0 18.6 Alcohol consumption 6.3 11.9 -12 % Litres per capita, population aged 15+ 10.0 10.2 Overweight and obesity 41.9 62.5 -4.1 pp % of population aged 18+ with BMI ≥ 25 51.3 53.0 Air pollution 4.9 17.8 -21 % Exposure to PM2.5 (µg/m³) 8.0 11.7 HPV vaccination 7 96 +7 pp % of girls aged 15 64 75 Breast cancer screening 9 83 -6.2 pp Cancer early % of target population 56 70 detection Cervical cancer screening -3.9 pp 11 85 % of target population 55 73 Colorectal cancer screening 3 77 - % of target population 34 42 Physicians - 499 1 094 per 1 000 cancer cases 679 728 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 376 2 626 Reimbursed cancer medicines 0 100 - % of selected indications 38 59 CT scanners 11 F 49 +17 % r per 1 000 000 population a 20 26 MRI units 6 38 +38 % per 1 000 000 population 17 18 Radiation therapy equipment 5 12 +1 % per 1 000 000 population 8 10 Cancer mortality -17 % 198 310 ASMR per 100 000 population 235 248 Colorectal cancer mortality 19 50 -28 % ASMR per 100 000 population 27 27 Breast cancer mortality 22 37 -22 % ASMR per 100 000 women Cancer care outcomes 31 33 Lung cancer mortality 33 78 -23 % ASMR per 100 000 population 47 49 Cancer PYLL 826 1 961 -18 % years per 100 000 population 1 165 1 355 Colon cancer 5-year survival 49 72 +7.2 pp % survival for patients diagnosed 2010-2014 60 61 Breast cancer 5-year survival 74 93 +4.8 pp % survival for women diagnosed 2010-2014 82 83 Lung cancer 5-year survival 8 20 +7.4 pp % survival for patients diagnosed 2010-2014 15 18 Educational inequalities 18 106 - % difference in cancer mortality by education 37 65 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 50  Figure 6.8. Greece’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration EL No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 4.0 6.1 Cancer prevention Daily smoking 6.2 29.1 -2.4 pp % of population aged 15+ 18.6 24.9 Alcohol consumption 6.3 11.9 -24 % Litres per capita, population aged 15+ 6.3 10.0 Overweight and obesity 41.9 62.5 +0.1 pp % of population aged 18+ with BMI ≥ 25 51.3 54.9 Air pollution 4.9 17.8 -29 % Exposure to PM2.5 (µg/m³) 11.7 14.2 Breast cancer screening 9 83 +6.1 pp Cancer early % of target population 56 66 detection Cervical cancer screening -2.6 pp 11 85 % of target population 55 73 Colorectal cancer screening 3 77 - % of target population 28 42 Physicians - 499 1 094 per 1 000 cancer cases 679 1 094 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 641 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 54 59 CT scanners 11 F 49 +47 % r per 1 000 000 population a 26 49 MRI units 6 38 +71 % per 1 000 000 population 18 38 Radiation therapy equipment 5 12 +25 % per 1 000 000 population 7 8 Cancer mortality -2 % 198 310 ASMR per 100 000 population 235 239 Colorectal cancer mortality 19 Cancer care outcomes 50 -1 % ASMR per 100 000 population 22 27 Breast cancer mortality 22 37 +6 % ASMR per 100 000 women 31 32 Lung cancer mortality 33 78 -4 % ASMR per 100 000 population 47 57 Cancer PYLL 826 1 961 -9 % years per 100 000 population 1 355 1 361 Educational inequalities 18 106 - % difference in cancer mortality by education 33 37 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   51 Figure 6.9. Spain’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration ES No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 3.6 6.1 Daily smoking 6.2 29.1 -3.2 pp Cancer prevention % of population aged 15+ 18.6 19.8 Alcohol consumption 6.3 11.9 +20 % Litres per capita, population aged 15+ 10.0 11.8 Overweight and obesity 41.9 62.5 -0.4 pp % of population aged 18+ with BMI ≥ 25 51.2 51.3 Air pollution 4.9 17.8 -22 % Exposure to PM2.5 (µg/m³) 9.7 11.7 HPV vaccination 7 96 +19 pp % of girls aged 15 64 85 Breast cancer screening 9 83 -6 pp Cancer early % of target population 56 74 detection Cervical cancer screening -0.3 pp 11 85 % of target population 55 68 Colorectal cancer screening 3 77 - % of target population 32 42 Physicians - 499 1 094 per 1 000 cancer cases 679 773 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 106 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 59 62 CT scanners 11 F 49 +25 % r per 1 000 000 population a 21 26 MRI units 6 38 +39 % per 1 000 000 population 18 21 Radiation therapy equipment 5 12 +52 % per 1 000 000 population 7 8 Cancer mortality -13 % 198 310 ASMR per 100 000 population 213 235 Colorectal cancer mortality 19 50 -19 % ASMR per 100 000 population 27 29 Breast cancer mortality 22 37 -13 % ASMR per 100 000 women Cancer care outcomes 22 31 Lung cancer mortality 33 78 -9 % ASMR per 100 000 population 45 47 Cancer PYLL 826 1 961 -19 % years per 100 000 population 1 166 1 355 Colon cancer 5-year survival 49 72 +6.8 pp % survival for patients diagnosed 2010-2014 60 63 Breast cancer 5-year survival 74 93 +2.4 pp % survival for women diagnosed 2010-2014 83 85 Lung cancer 5-year survival 8 20 +2.7 pp % survival for patients diagnosed 2010-2014 14 15 Educational inequalities 18 106 - % difference in cancer mortality by education 18 37 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 52  Figure 6.10. France’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration FR No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 5.7 6.1 Daily smoking 6.2 29.1 -3.2 pp Cancer prevention % of population aged 15+ 18.6 25.3 Alcohol consumption 6.3 11.9 -12 % Litres per capita, population aged 15+ 10.0 10.8 Overweight and obesity 41.9 62.5 +0.4 pp % of population aged 18+ with BMI ≥ 25 46.4 51.3 Air pollution 4.9 17.8 -30 % Exposure to PM2.5 (µg/m³) 9.5 11.7 HPV vaccination 7 96 +29 pp % of girls aged 15 45 64 Breast cancer screening 9 83 -3.8 pp Cancer early % of target population 48 56 detection Cervical cancer screening - 11 85 % of target population 55 60 Colorectal cancer screening 3 77 - % of target population 34 42 Physicians - 499 1 094 per 1 000 cancer cases 499 679 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 376 1 379 Reimbursed cancer medicines 0 100 - % of selected indications 54 59 CT scanners 11 F 49 +50 % r per 1 000 000 population a 20 26 MRI units 6 38 +107 % per 1 000 000 population 18 18 Radiation therapy equipment 5 12 +7 % per 1 000 000 population 8 11 Cancer mortality -12 % 198 310 ASMR per 100 000 population 223 235 Colorectal cancer mortality 19 50 -19 % ASMR per 100 000 population 23 27 Breast cancer mortality 22 37 -8 % ASMR per 100 000 women Cancer care outcomes 30 31 Lung cancer mortality 33 78 -14 % ASMR per 100 000 population 43 47 Cancer PYLL 826 1 961 -18 % years per 100 000 population 1 269 1 355 Colon cancer 5-year survival 49 72 +3 pp % survival for patients diagnosed 2010-2014 60 64 Breast cancer 5-year survival 74 93 -0.1 pp % survival for women diagnosed 2010-2014 83 87 Lung cancer 5-year survival 8 20 +3.2 pp % survival for patients diagnosed 2010-2014 15 17 Educational inequalities 18 106 - % difference in cancer mortality by education 37 51 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   53 Figure 6.11. Croatia’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration HR No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 4.4 6.1 Cancer prevention Daily smoking 6.2 29.1 -2.9 pp % of population aged 15+ 18.6 22.1 Alcohol consumption 6.3 11.9 -16 % Litres per capita, population aged 15+ 9.0 10.0 Overweight and obesity 41.9 62.5 -2.8 pp % of population aged 18+ with BMI ≥ 25 51.3 58.1 Air pollution 4.9 17.8 -25 % Exposure to PM2.5 (µg/m³) 11.7 15.8 Breast cancer screening 9 83 +2 pp Cancer early % of target population 56 62 detection Cervical cancer screening +1.1 pp 11 85 % of target population 55 78 Colorectal cancer screening 3 77 - % of target population 26 42 Physicians - 499 1 094 per 1 000 cancer cases 556 679 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 081 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 59 62 CT scanners 11 F 49 +42 % r per 1 000 000 population a 22 26 MRI units 6 38 +77 % per 1 000 000 population 17 18 Radiation therapy equipment 5 12 +18 % per 1 000 000 population 8 8 Cancer mortality -10 % 198 310 ASMR per 100 000 population 235 308 Colorectal cancer mortality 19 50 -4 % ASMR per 100 000 population 27 49 Breast cancer mortality 22 37 -24 % ASMR per 100 000 women Cancer care outcomes 30 31 Lung cancer mortality 33 78 -6 % ASMR per 100 000 population 47 63 Cancer PYLL 826 1 961 -14 % years per 100 000 population 1 355 1 761 Colon cancer 5-year survival 49 72 +3.8 pp % survival for patients diagnosed 2010-2014 51 60 Breast cancer 5-year survival 74 93 +5 pp % survival for women diagnosed 2010-2014 79 83 Lung cancer 5-year survival 8 20 -1.2 pp % survival for patients diagnosed 2010-2014 10 15 Educational inequalities 18 106 - % difference in cancer mortality by education 37 86 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 54  Figure 6.12. Italy’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration IT No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 6.7 Daily smoking 6.2 29.1 -2.3 pp Cancer prevention % of population aged 15+ 18.6 19.8 Alcohol consumption 6.3 11.9 +10 % Litres per capita, population aged 15+ 7.7 10.0 Overweight and obesity 41.9 62.5 +1.6 pp % of population aged 18+ with BMI ≥ 25 41.9 51.3 Air pollution 4.9 17.8 -27 % Exposure to PM2.5 (µg/m³) 11.7 14.3 HPV vaccination 7 96 -3 pp % of girls aged 15 64 64 Breast cancer screening 9 83 -3.5 pp Cancer early % of target population 54 56 detection Cervical cancer screening -0.3 pp 11 85 % of target population 40 55 Colorectal cancer screening 3 77 - % of target population 34 42 Physicians - 499 1 094 per 1 000 cancer cases 615 679 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 947 1 376 CT scanners F +23 % 11 r 49 per 1 000 000 population a 26 40 MRI units 6 38 +35 % per 1 000 000 population 18 33 Radiation therapy equipment 5 12 +9 % per 1 000 000 population 7 8 Cancer mortality -15 % 198 310 ASMR per 100 000 population 222 235 Colorectal cancer mortality 19 50 -17 % ASMR per 100 000 population 25 27 Breast cancer mortality 22 37 -7 % ASMR per 100 000 women Cancer care outcomes 31 31 Lung cancer mortality 33 78 -18 % ASMR per 100 000 population 44 47 Cancer PYLL 826 1 961 -17 % years per 100 000 population 1 157 1 355 Colon cancer 5-year survival 49 72 +5.2 pp % survival for patients diagnosed 2010-2014 60 64 Breast cancer 5-year survival 74 93 +1.8 pp % survival for women diagnosed 2010-2014 83 86 Lung cancer 5-year survival 8 20 +1.9 pp % survival for patients diagnosed 2010-2014 15 16 Educational inequalities 18 106 - % difference in cancer mortality by education 32 37 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   55 Figure 6.13. Cyprus’ Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration CY No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 3.1 6.1 Daily smoking 6.2 29.1 -3.2 pp Cancer prevention % of population aged 15+ 18.6 22.5 Alcohol consumption 6.3 11.9 -15 % Litres per capita, population aged 15+ 9.6 10.0 Overweight and obesity 41.9 62.5 -4.8 pp % of population aged 18+ with BMI ≥ 25 47.9 51.3 Air pollution 4.9 17.8 -27 % Exposure to PM2.5 (µg/m³) 11.7 13.4 HPV vaccination 7 96 +13 pp % of girls aged 15 64 67 Breast cancer screening 9 83 - Cancer early % of target population 29 56 detection Cervical cancer screening +4.6 pp 11 85 % of target population 55 69 Colorectal cancer screening 3 77 - % of target population 22 42 Physicians - 499 1 094 Cancer care per 1 000 cancer cases 679 1 017 capacity Nurses 641 3 462 - per 1 000 cancer cases 1 040 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 31 59 Cancer mortality +10 % 198 310 ASMR per 100 000 population 213 235 Colorectal cancer mortality 19 50 +17 % ASMR per 100 000 population 19 27 Breast cancer mortality 22 Cancer care outcomes 37 +13 % ASMR per 100 000 women 31 37 Lung cancer mortality 33 78 +8 % ASMR per 100 000 population 42 47 Colon cancer 5-year survival 49 72 +1.4 pp % survival for patients diagnosed 2010-2014 60 72 Breast cancer 5-year survival 74 93 +3.5 pp % survival for women diagnosed 2010-2014 83 93 Lung cancer 5-year survival 8 20 +0.4 pp % survival for patients diagnosed 2010-2014 15 19 Educational inequalities 18 106 - % difference in cancer mortality by education 33 37 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 56  Figure 6.14. Latvia’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration LV No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 5.1 6.1 Daily smoking 6.2 29.1 -2 pp Cancer prevention % of population aged 15+ 18.6 22.6 Alcohol consumption 6.3 11.9 +21 % Litres per capita, population aged 15+ 10.0 11.9 Overweight and obesity 41.9 62.5 +3.4 pp % of population aged 18+ with BMI ≥ 25 51.3 60.4 Air pollution 4.9 17.8 -35 % Exposure to PM2.5 (µg/m³) 11.7 11.8 HPV vaccination 7 96 -15 pp % of girls aged 15 46 64 Breast cancer screening 9 83 +0.2 pp Cancer early % of target population 36 56 detection Cervical cancer screening +27.4 pp 11 85 % of target population 55 55 Colorectal cancer screening 3 77 - % of target population 26 42 Physicians - 499 1 094 per 1 000 cancer cases 575 679 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 706 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 31 59 CT scanners 11 F 49 +23 % r per 1 000 000 population a 26 40 MRI units 6 38 +100 % per 1 000 000 population 18 20 Cancer mortality -6 % 198 310 ASMR per 100 000 population 235 284 Colorectal cancer mortality 19 50 -12 % ASMR per 100 000 population 27 32 Breast cancer mortality 22 37 -5 % ASMR per 100 000 women Cancer care outcomes 31 34 Lung cancer mortality 33 78 -8 % ASMR per 100 000 population 46 47 Cancer PYLL 826 1 961 -12 % years per 100 000 population 1 355 1 777 Colon cancer 5-year survival 49 72 +8.3 pp % survival for patients diagnosed 2010-2014 49 60 Breast cancer 5-year survival 74 93 +7.6 pp % survival for women diagnosed 2010-2014 77 83 Lung cancer 5-year survival 8 20 +4.7 pp % survival for patients diagnosed 2010-2014 15 18 Educational inequalities 18 106 - % difference in cancer mortality by education 37 83 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   57 Figure 6.15. Lithuania’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration LT No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 5.6 6.1 Daily smoking 6.2 29.1 -1.4 pp Cancer prevention % of population aged 15+ 18.6 18.9 Alcohol consumption 6.3 11.9 -17 % Litres per capita, population aged 15+ 10.0 11.2 Overweight and obesity 41.9 62.5 +3.2 pp % of population aged 18+ with BMI ≥ 25 51.3 59.4 Air pollution 4.9 17.8 -33 % Exposure to PM2.5 (µg/m³) 9.2 11.7 HPV vaccination 7 96 +43 pp % of girls aged 15 64 76 Breast cancer screening 9 83 +16.8 pp Cancer early % of target population 56 58 detection Cervical cancer screening +8 pp 11 85 % of target population 55 55 Colorectal cancer screening 3 77 - % of target population 42 56 Physicians - 499 1 094 per 1 000 cancer cases 679 773 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 304 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 38 59 CT scanners 11 F 49 +39 % r per 1 000 000 population a 26 33 MRI units 6 38 +69 % per 1 000 000 population 17 18 Radiation therapy equipment 5 12 -6 % per 1 000 000 population 7 8 Cancer mortality -9 % 198 310 ASMR per 100 000 population 235 259 Colorectal cancer mortality 19 50 -13 % ASMR per 100 000 population 27 30 Breast cancer mortality 22 37 -4 % ASMR per 100 000 women Cancer care outcomes 30 31 Lung cancer mortality 33 78 -24 % ASMR per 100 000 population 37 47 Cancer PYLL 826 1 961 -14 % years per 100 000 population 1 355 1 699 Colon cancer 5-year survival 49 72 +12.4 pp % survival for patients diagnosed 2010-2014 57 60 Breast cancer 5-year survival 74 93 +8.9 pp % survival for women diagnosed 2010-2014 74 83 Lung cancer 5-year survival 8 20 +1.1 pp % survival for patients diagnosed 2010-2014 10 15 Educational inequalities 18 106 - % difference in cancer mortality by education 37 94 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 58  Figure 6.16. Luxembourg’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration LU No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 6.4 Daily smoking 6.2 29.1 +3.5 pp Cancer prevention % of population aged 15+ 18.6 20.3 Alcohol consumption 6.3 11.9 -8 % Litres per capita, population aged 15+ 10.0 11.0 Overweight and obesity 41.9 62.5 +0.4 pp % of population aged 18+ with BMI ≥ 25 49.7 51.3 Air pollution 4.9 17.8 -33 % Exposure to PM2.5 (µg/m³) 8.7 11.7 HPV vaccination 7 96 +1 pp % of girls aged 15 43 64 Breast cancer screening 9 83 -10.3 pp Cancer early % of target population 52 56 detection Cervical cancer screening -7.4 pp 11 85 % of target population 55 60 Colorectal cancer screening 3 77 - % of target population 31 42 Physicians - 499 1 094 per 1 000 cancer cases 647 679 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 1 376 2 538 CT scanners F +4 % 11 r 49 per 1 000 000 population a 25 26 MRI units 6 38 +36 % per 1 000 000 population 18 18 Radiation therapy equipment 5 12 +22 % per 1 000 000 population 8 9 Cancer mortality -24 % 198 310 ASMR per 100 000 population 203 235 Colorectal cancer mortality 19 Cancer care outcomes 50 -28 % ASMR per 100 000 population 22 27 Breast cancer mortality 22 37 -17 % ASMR per 100 000 women 31 31 Lung cancer mortality 33 78 -24 % ASMR per 100 000 population 41 47 Cancer PYLL 826 1 961 -37 % years per 100 000 population 826 1 355 Educational inequalities 18 106 - % difference in cancer mortality by education 34 37 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   59 Figure 6.17. Hungary’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration HU No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 7.6 Daily smoking 6.2 29.1 -0.9 pp Cancer prevention % of population aged 15+ 18.6 24.9 Alcohol consumption 6.3 11.9 -2 % Litres per capita, population aged 15+ 10.0 10.6 Overweight and obesity 41.9 62.5 +2.1 pp % of population aged 18+ with BMI ≥ 25 51.3 58.4 Air pollution 4.9 17.8 -31 % Exposure to PM2.5 (µg/m³) 11.7 14.0 HPV vaccination 7 96 +2 pp % of girls aged 15 64 76 Breast cancer screening 9 83 -12.3 pp Cancer early % of target population 30 56 detection Cervical cancer screening -9.6 pp 11 85 % of target population 26 55 Colorectal cancer screening 3 77 - % of target population 8 42 Physicians - 499 1 094 per 1 000 cancer cases 538 679 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 845 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 38 59 CT scanners 11 F 49 +39 % r per 1 000 000 population 11 a 26 MRI units 6 38 +99 % per 1 000 000 population 6 18 Cancer mortality -13 % 198 310 ASMR per 100 000 population 235 310 Colorectal cancer mortality 19 Cancer care outcomes 50 -13 % ASMR per 100 000 population 27 50 Breast cancer mortality 22 37 -5 % ASMR per 100 000 women 31 37 Lung cancer mortality 33 78 -14 % ASMR per 100 000 population 47 78 Cancer PYLL 826 1 961 -27 % years per 100 000 population 1 355 1 961 Educational inequalities 18 106 - % difference in cancer mortality by education 37 78 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 60  Figure 6.18. Malta’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration MT No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 1.2 6.1 Daily smoking 6.2 29.1 +0.5 pp Cancer prevention % of population aged 15+ 18.6 20.6 Alcohol consumption 6.3 11.9 +15 % Litres per capita, population aged 15+ 8.1 10.0 Overweight and obesity 41.9 62.5 +0.3 pp % of population aged 18+ with BMI ≥ 25 51.3 62.5 Air pollution 4.9 17.8 -31 % Exposure to PM2.5 (µg/m³) 11.7 11.8 HPV vaccination 7 96 -6 pp % of girls aged 15 64 82 Breast cancer screening 9 83 - Cancer early % of target population 44 56 detection Cervical cancer screening - 11 85 % of target population 16 55 Colorectal cancer screening 3 77 - % of target population 25 42 Physicians - capacity 499 1 094 Cancer per 1 000 cancer cases care 679 868 Nurses 641 3 462 - per 1 000 cancer cases 1 376 1 505 Cancer mortality -20 % 198 310 ASMR per 100 000 population 198 235 Colorectal cancer mortality 19 50 -27 % ASMR per 100 000 population 23 27 Breast cancer mortality 22 Cancer care outcomes 37 -31 % ASMR per 100 000 women 29 31 Lung cancer mortality 33 78 -7 % ASMR per 100 000 population 40 47 Colon cancer 5-year survival 49 72 +0.5 pp % survival for patients diagnosed 2010-2014 58 60 Breast cancer 5-year survival 74 93 +7.2 pp % survival for women diagnosed 2010-2014 83 87 Lung cancer 5-year survival 8 20 +5.7 pp % survival for patients diagnosed 2010-2014 15 15 Educational inequalities 18 106 - % difference in cancer mortality by education 34 37 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   61 Figure 6.19. The Netherlands’ Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration NL No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 8.6 Daily smoking 6.2 29.1 -5.7 pp Cancer prevention % of population aged 15+ 12.7 18.6 Alcohol consumption 6.3 11.9 -7 % Litres per capita, population aged 15+ 8.5 10.0 Overweight and obesity 41.9 62.5 +1.4 pp % of population aged 18+ with BMI ≥ 25 48.3 51.3 Air pollution 4.9 17.8 -33 % Exposure to PM2.5 (µg/m³) 10.8 11.7 HPV vaccination 7 96 +8 pp % of girls aged 15 64 65 Breast cancer screening 9 83 -9 pp Cancer early % of target population 56 70 detection Cervical cancer screening -18.9 pp 11 85 % of target population 46 55 Colorectal cancer screening 3 77 - % of target population 42 68 Physicians - 499 1 094 per 1 000 cancer cases 593 679 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 1 376 1 745 Reimbursed cancer medicines 0 100 - % of selected indications 59 92 CT scanners 11 F 49 +45 % r per 1 000 000 population a 16 26 MRI units 6 38 +28 % per 1 000 000 population 15 18 Cancer mortality -15 % 198 310 ASMR per 100 000 population 235 256 Colorectal cancer mortality 19 50 -28 % ASMR per 100 000 population 26 27 Breast cancer mortality 22 37 -17 % ASMR per 100 000 women Cancer care outcomes 31 33 Lung cancer mortality 33 78 -22 % ASMR per 100 000 population 47 56 Cancer PYLL 826 1 961 -25 % years per 100 000 population 1 180 1 355 Colon cancer 5-year survival 49 72 +5 pp % survival for patients diagnosed 2010-2014 60 63 Breast cancer 5-year survival 74 93 +2.7 pp % survival for women diagnosed 2010-2014 83 87 Lung cancer 5-year survival 8 20 +4.9 pp % survival for patients diagnosed 2010-2014 15 17 Educational inequalities 18 106 - % difference in cancer mortality by education 34 37 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 62  Figure 6.20. Austria’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration AT No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 10.4 Daily smoking 6.2 29.1 -3.7 pp Cancer prevention % of population aged 15+ 18.6 20.6 Alcohol consumption 6.3 11.9 -4 % Litres per capita, population aged 15+ 10.0 11.6 Overweight and obesity 41.9 62.5 +2.7 pp % of population aged 18+ with BMI ≥ 25 51.3 52.7 Air pollution 4.9 17.8 -32 % Exposure to PM2.5 (µg/m³) 10.9 11.7 HPV vaccination 7 96 +48 pp % of girls aged 15 53 64 Breast cancer screening 9 83 +2.5 pp Cancer early % of target population 41 56 detection Cervical cancer screening -1.9 pp 11 85 % of target population 55 85 Colorectal cancer screening 3 77 - % of target population 42 64 Physicians - 499 1 094 per 1 000 cancer cases 679 1 091 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 376 2 170 Reimbursed cancer medicines 0 100 - % of selected indications 59 77 CT scanners 11 F 49 -5 % r per 1 000 000 population 26 28 a MRI units 6 38 +38 % per 1 000 000 population 18 26 Radiation therapy equipment 5 12 +18 % per 1 000 000 population 6 8 Cancer mortality -12 % 198 310 ASMR per 100 000 population 225 235 Colorectal cancer mortality 19 50 -22 % ASMR per 100 000 population 22 27 Breast cancer mortality 22 37 -4 % ASMR per 100 000 women Cancer care outcomes 31 31 Lung cancer mortality 33 78 -3 % ASMR per 100 000 population 45 47 Cancer PYLL 826 1 961 -24 % years per 100 000 population 1 081 1 355 Colon cancer 5-year survival 49 72 +3 pp % survival for patients diagnosed 2010-2014 60 64 Breast cancer 5-year survival 74 93 +3.1 pp % survival for women diagnosed 2010-2014 83 85 Lung cancer 5-year survival 8 20 +4.3 pp % survival for patients diagnosed 2010-2014 15 20 Educational inequalities 18 106 - % difference in cancer mortality by education 37 40 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   63 Figure 6.21. Poland’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration PL No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 2.1 6.1 Cancer prevention Daily smoking 6.2 29.1 -5.6 pp % of population aged 15+ 17.1 18.6 Alcohol consumption 6.3 11.9 +10 % Litres per capita, population aged 15+ 10.0 11.0 Overweight and obesity 41.9 62.5 +2.3 pp % of population aged 18+ with BMI ≥ 25 51.3 58.4 Air pollution 4.9 17.8 -33 % Exposure to PM2.5 (µg/m³) 11.7 17.8 Breast cancer screening detection 9 83 +0.1 pp Cancer % of target population early 37 56 Cervical cancer screening 11 85 -4.8 pp % of target population 11 55 Physicians499 1 094 - per 1 000 cancer cases 647 679 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 057 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 59 62 CT scanners 11 F 49 +52 % r per 1 000 000 population a 23 26 MRI units 6 38 +137 % per 1 000 000 population 13 18 Radiation therapy equipment 5 12 +60 % per 1 000 000 population 6 8 Cancer mortality -13 % 198 310 ASMR per 100 000 population 235 260 Colorectal cancer mortality 19 50 -8 % ASMR per 100 000 population 27 33 Breast cancer mortality 22 37 +4 % ASMR per 100 000 women Cancer care outcomes 30 31 Lung cancer mortality 33 78 -19 % ASMR per 100 000 population 47 56 Cancer PYLL 826 1 961 -23 % years per 100 000 population 1 355 1 508 Colon cancer 5-year survival 49 72 +7.6 pp % survival for patients diagnosed 2010-2014 53 60 Breast cancer 5-year survival 74 93 +5.2 pp % survival for women diagnosed 2010-2014 77 83 Lung cancer 5-year survival 8 20 +2.3 pp % survival for patients diagnosed 2010-2014 14 15 Educational inequalities 18 106 - % difference in cancer mortality by education 37 71 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 64  Figure 6.22. Portugal’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration PT No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 3.2 6.1 Daily smoking 6.2 29.1 -2.6 pp Cancer prevention % of population aged 15+ 14.2 18.6 Alcohol consumption 6.3 11.9 -8 % Litres per capita, population aged 15+ 10.0 10.4 Overweight and obesity 41.9 62.5 -0.3 pp % of population aged 18+ with BMI ≥ 25 51.3 53.0 Air pollution 4.9 17.8 -21 % Exposure to PM2.5 (µg/m³) 8.3 11.7 HPV vaccination 7 96 -5 pp % of girls aged 15 64 91 Breast cancer screening 9 83 +9.2 pp Cancer early % of target population 50 56 detection Cervical cancer screening +31.3 pp 11 85 % of target population 55 60 Colorectal cancer screening 3 77 - % of target population 14 42 Physicians - 499 1 094 per 1 000 cancer cases 679 889 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 169 1 376 Reimbursed cancer medicines 0 100 - % of selected indications 54 59 CT scanners 11 F 49 +15 % r per 1 000 000 population a 18 26 MRI units 6 38 +94 % per 1 000 000 population 12 18 Radiation therapy equipment 5 12 +17 % per 1 000 000 population 5 8 Cancer mortality -8 % 198 310 ASMR per 100 000 population 226 235 Colorectal cancer mortality 19 50 -22 % ASMR per 100 000 population 27 29 Breast cancer mortality 22 37 -5 % ASMR per 100 000 women Cancer care outcomes 26 31 Lung cancer mortality 33 78 +3 % ASMR per 100 000 population 37 47 Cancer PYLL 826 1 961 -6 % years per 100 000 population 1 355 1 494 Colon cancer 5-year survival 49 72 +4.4 pp % survival for patients diagnosed 2010-2014 60 61 Breast cancer 5-year survival 74 93 +6 pp % survival for women diagnosed 2010-2014 83 88 Lung cancer 5-year survival 8 20 +5.1 pp % survival for patients diagnosed 2010-2014 15 16 Educational inequalities 18 106 - % difference in cancer mortality by education 33 37 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   65 Figure 6.23. Romania’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration RO No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 3.7 6.1 Cancer prevention Daily smoking 6.2 29.1 -1.1 pp % of population aged 15+ 18.6 18.7 Alcohol consumption 6.3 11.9 +16 % Litres per capita, population aged 15+ 10.0 11.6 Overweight and obesity 41.9 62.5 -3.2 pp % of population aged 18+ with BMI ≥ 25 51.3 59.7 Air pollution 4.9 17.8 -30 % Exposure to PM2.5 (µg/m³) 11.7 13.9 Breast cancer screening 9 83 +2.6 pp Cancer early % of target population 9 56 detection Cervical cancer screening - 11 85 % of target population 39 55 Colorectal cancer screening 3 77 - % of target population 3 42 Physicians - 499 1 094 per 1 000 cancer cases 679 694 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 1 376 1 548 CT scanners F +165 % 11 r 49 per 1 000 000 population a 24 26 MRI units 6 38 +288 % per 1 000 000 population 15 18 Radiation therapy equipment 5 12 +27 % per 1 000 000 population 5 8 Cancer mortality -8 % 198 310 ASMR per 100 000 population 235 243 Colorectal cancer mortality 19 50 +7 % ASMR per 100 000 population 27 33 Breast cancer mortality 22 37 +1 % ASMR per 100 000 women Cancer care outcomes 31 31 Lung cancer mortality 33 78 -17 % ASMR per 100 000 population 44 47 Cancer PYLL 826 1 961 -13 % years per 100 000 population 1 355 1 946 Colon cancer 5-year survival 49 72 - % survival for patients diagnosed 2010-2014 52 60 Breast cancer 5-year survival 74 93 - % survival for women diagnosed 2010-2014 75 83 Lung cancer 5-year survival 8 20 - % survival for patients diagnosed 2010-2014 11 15 Educational inequalities 18 106 - % difference in cancer mortality by education 37 86 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 66  Figure 6.24. Slovenia’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration SI No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 5.4 6.1 Daily smoking 6.2 29.1 -1.5 pp Cancer prevention % of population aged 15+ 17.4 18.6 Alcohol consumption 6.3 11.9 -3 % Litres per capita, population aged 15+ 10.0 10.0 Overweight and obesity 41.9 62.5 +1.2 pp % of population aged 18+ with BMI ≥ 25 51.3 55.7 Air pollution 4.9 17.8 -25 % Exposure to PM2.5 (µg/m³) 11.7 14.0 HPV vaccination 7 96 +8 pp % of girls aged 15 52 64 Breast cancer screening 9 83 +1.1 pp Cancer early % of target population 56 77 detection Cervical cancer screening +2.8 pp 11 85 % of target population 55 74 Colorectal cancer screening 3 77 - % of target population 42 65 Physicians - 499 1 094 per 1 000 cancer cases 519 679 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 376 1 602 Reimbursed cancer medicines 0 100 - % of selected indications 59 69 CT scanners 11 F 49 +38 % r per 1 000 000 population a 26 17 MRI units 6 38 +94 % per 1 000 000 population 17 18 Radiation therapy equipment 5 12 +13 % per 1 000 000 population 7 8 Cancer mortality -13 % 198 310 ASMR per 100 000 population 235 277 Colorectal cancer mortality 19 50 -31 % ASMR per 100 000 population 27 30 Breast cancer mortality 22 37 -12 % ASMR per 100 000 women Cancer care outcomes 31 32 Lung cancer mortality 33 78 -12 % ASMR per 100 000 population 47 51 Cancer PYLL 826 1 961 -19 % years per 100 000 population 1 355 1 388 Colon cancer 5-year survival 49 72 +8.3 pp % survival for patients diagnosed 2010-2014 60 62 Breast cancer 5-year survival 74 93 +4.8 pp % survival for women diagnosed 2010-2014 83 84 Lung cancer 5-year survival 8 20 +4.9 pp % survival for patients diagnosed 2010-2014 15 15 Educational inequalities 18 106 - % difference in cancer mortality by education 31 37 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   67 Figure 6.25. Slovak Republic’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration SK No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 1.6 6.1 Cancer prevention Daily smoking 6.2 29.1 -1.9 pp % of population aged 15+ 18.6 21.0 Alcohol consumption 6.3 11.9 -6 % Litres per capita, population aged 15+ 9.5 10.0 Overweight and obesity 41.9 62.5 +3.9 pp % of population aged 18+ with BMI ≥ 25 51.3 58.4 Air pollution 4.9 17.8 -28 % Exposure to PM2.5 (µg/m³) 11.7 15.3 Breast cancer screening 9 83 -1.6 pp Cancer early % of target population 29 56 detection Cervical cancer screening -0.5 pp 11 85 % of target population 46 55 Colorectal cancer screening 3 77 - % of target population 42 52 Physicians - 499 1 094 per 1 000 cancer cases 679 691 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 1 056 1 376 CT scanners 11 F 49 +29 % r per 1 000 000 population a 20 26 MRI units 6 38 +67 % per 1 000 000 population 10 18 Radiation therapy equipment 5 12 -3 % per 1 000 000 population 8 12 Cancer mortality -16 % 198 310 ASMR per 100 000 population 235 275 Colorectal cancer mortality 19 50 -21 % ASMR per 100 000 population 27 41 Breast cancer mortality 22 37 -4 % ASMR per 100 000 women Cancer care outcomes 31 37 Lung cancer mortality 33 78 -23 % ASMR per 100 000 population 41 47 Cancer PYLL 826 1 961 -23 % years per 100 000 population 1 355 1 516 Colon cancer 5-year survival 49 72 +1.4 pp % survival for patients diagnosed 2010-2014 52 60 Breast cancer 5-year survival 74 93 +0.2 pp % survival for women diagnosed 2010-2014 76 83 Lung cancer 5-year survival 8 20 +1.7 pp % survival for patients diagnosed 2010-2014 11 15 Educational inequalities 18 106 - % difference in cancer mortality by education 37 69 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 68  Figure 6.26. Finland’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration FI No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 6.1 8.3 Daily smoking 6.2 29.1 -5.7 pp Cancer prevention % of population aged 15+ 11.3 18.6 Alcohol consumption 6.3 11.9 -22 % Litres per capita, population aged 15+ 7.6 10.0 Overweight and obesity 41.9 62.5 -1.3 pp % of population aged 18+ with BMI ≥ 25 51.3 59.8 Air pollution 4.9 17.8 -30 % Exposure to PM2.5 (µg/m³) 4.9 11.7 HPV vaccination 7 96 +15 pp % of girls aged 15 64 76 Breast cancer screening 9 83 -1.3 pp Cancer early % of target population 56 82 detection Cervical cancer screening +1.4 pp 11 85 % of target population 55 72 Colorectal cancer screening 3 77 - % of target population 42 77 Physicians - 499 1 094 per 1 000 cancer cases 568 679 Cancer care capacity Nurses 641 3 462 - per 1 000 cancer cases 1 376 2 223 CT scanners F -15 % 11 r 49 per 1 000 000 population a 19 26 MRI units 6 38 +55 % per 1 000 000 population 18 33 Radiation therapy equipment 5 12 +17 % per 1 000 000 population 8 11 Cancer mortality -7 % 198 310 ASMR per 100 000 population 210 235 Colorectal cancer mortality 19 50 -2 % ASMR per 100 000 population 22 27 Breast cancer mortality 22 37 -7 % ASMR per 100 000 women Cancer care outcomes 26 31 Lung cancer mortality 33 78 -9 % ASMR per 100 000 population 37 47 Cancer PYLL 826 1 961 -16 % years per 100 000 population 986 1 355 Colon cancer 5-year survival 49 72 +3.6 pp % survival for patients diagnosed 2010-2014 60 65 Breast cancer 5-year survival 74 93 +2 pp % survival for women diagnosed 2010-2014 83 89 Lung cancer 5-year survival 8 20 +1.1 pp % survival for patients diagnosed 2010-2014 13 15 Educational inequalities 18 106 - % difference in cancer mortality by education 37 53 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   69 Figure 6.27. Sweden’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration SE No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 4.3 6.1 Daily smoking 6.2 29.1 -4.1 pp Cancer prevention % of population aged 15+ 8.7 18.6 Alcohol consumption 6.3 11.9 +1 % Litres per capita, population aged 15+ 7.5 10.0 Overweight and obesity 41.9 62.5 -4.3 pp % of population aged 18+ with BMI ≥ 25 51.3 53.2 Air pollution 4.9 17.8 -28 % Exposure to PM2.5 (µg/m³) 5.6 11.7 HPV vaccination 7 96 +7 pp % of girls aged 15 64 85 Breast cancer screening 9 83 +1 pp Cancer early % of target population 56 81 detection Cervical cancer screening -2.6 pp 11 85 % of target population 55 79 Colorectal cancer screening 3 77 - % of target population 42 64 Physicians - 499 1 094 per 1 000 cancer cases 679 746 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 376 1 844 Reimbursed cancer medicines 0 100 - % of selected indications 59 85 CT scanners 11 F 49 +17 % r per 1 000 000 population a 24 26 MRI units 6 38 +20 % per 1 000 000 population 17 18 Radiation therapy equipment 5 12 -22 % per 1 000 000 population 6 8 Cancer mortality -13 % 198 310 ASMR per 100 000 population 207 235 Colorectal cancer mortality 19 50 -14 % ASMR per 100 000 population 26 27 Breast cancer mortality 22 37 -18 % ASMR per 100 000 women Cancer care outcomes 23 31 Lung cancer mortality 33 78 -19 % ASMR per 100 000 population 33 47 Cancer PYLL 826 1 961 -25 % years per 100 000 population 840 1 355 Colon cancer 5-year survival 49 72 +4.7 pp % survival for patients diagnosed 2010-2014 60 65 Breast cancer 5-year survival 74 93 +3.2 pp % survival for women diagnosed 2010-2014 83 89 Lung cancer 5-year survival 8 20 +5.6 pp % survival for patients diagnosed 2010-2014 15 20 Educational inequalities 18 106 - % difference in cancer mortality by education 37 54 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 70  Figure 6.28. Iceland’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration IS No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 3.8 6.1 Daily smoking 6.2 29.1 -7.6 pp Cancer prevention % of population aged 15+ 6.2 18.6 Alcohol consumption 6.3 11.9 +9 % Litres per capita, population aged 15+ 7.4 10.0 Overweight and obesity 41.9 62.5 +10.1 pp % of population aged 18+ with BMI ≥ 25 51.3 62.0 Air pollution 4.9 17.8 -22 % Exposure to PM2.5 (µg/m³) 5.5 11.7 HPV vaccination 7 96 +5 pp % of girls aged 15 64 96 Breast cancer screening 9 detection 83 -2 pp Cancer early % of target population 56 57 Cervical cancer screening 11 85 -11 pp % of target population 55 62 Physicians - 499 1 094 per 1 000 cancer cases 679 1 025 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 376 3 462 Reimbursed cancer medicines 0 100 - % of selected indications 59 69 CT scanners 11 F 49 +10 % r per 1 000 000 population a 26 44 MRI units 6 38 +8 % per 1 000 000 population 18 24 Radiation therapy equipment 5 12 -15 % per 1 000 000 population 8 8 Cancer mortality -17 % 198 310 ASMR per 100 000 population 217 235 Colorectal cancer mortality 19 50 -4 % ASMR per 100 000 population 21 27 Breast cancer mortality 22 37 +29 % ASMR per 100 000 women Cancer care outcomes 31 33 Lung cancer mortality 33 78 -30 % ASMR per 100 000 population 44 47 Cancer PYLL 826 1 961 -10 % years per 100 000 population 1 040 1 355 Colon cancer 5-year survival 49 72 +6.8 pp % survival for patients diagnosed 2010-2014 60 68 Breast cancer 5-year survival 74 93 +1.7 pp % survival for women diagnosed 2010-2014 83 89 Lung cancer 5-year survival 8 20 +6.1 pp % survival for patients diagnosed 2010-2014 15 20 Educational inequalities 18 106 - % difference in cancer mortality by education 37 65 Note: ASMR = Age-standardised mortality rate; PYLL = potential years of life lost; pp = percentage point. *Please see Figure 6.31 for information on trend. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   71 Figure 6.29. Norway’s Cancer Performance Tracker (CaPTr) Better than EU / improvement EU Worse than EU / deterioration NO No value judgement Trend over Min Max time* Prevention expenditure 1.2 10.4 - % of health spending 3.1 6.1 Daily smoking 6.2 29.1 -8 pp Cancer prevention % of population aged 15+ 8.0 18.6 Alcohol consumption 6.3 11.9 0% Litres per capita, population aged 15+ 6.6 10.0 Overweight and obesity 41.9 62.5 +4.4 pp % of population aged 18+ with BMI ≥ 25 51.3 53.5 Air pollution 4.9 17.8 -23 % Exposure to PM2.5 (µg/m³) 6.1 11.7 HPV vaccination 7 96 +20 pp % of girls aged 15 64 93 Breast cancer screening 9 detection 83 +5.3 pp Cancer % of target population early 56 76 Cervical cancer screening 11 85 +3 pp % of target population 55 71 Physicians - 499 1 094 per 1 000 cancer cases 679 724 Nurses 641 Cancer care capacity 3 462 - per 1 000 cancer cases 1 376 2 267 Reimbursed cancer medicines 0 100 - % of selected indications 59 69 CT scanners 11 F 49 +82 % r per 1 000 000 population a 26 28 MRI units 6 38 +613 % per 1 000 000 population 18 31 Radiation therapy equipment 5 12 -8 % per 1 000 000 population 8 11 Cancer mortality -17 % 198 310 ASMR per 100 000 population 220 235 Colorectal cancer mortality 19 50 -15 % ASMR per 100 000 population 27 32 Breast cancer mortality 22 Cancer care outcomes 37 -17 % ASMR per 100 000 women 22 31 Lung cancer mortality 33 78 -19 % ASMR per 100 000 population 44 47 Colon cancer 5-year survival 49 72 +6.5 pp % survival for patients diagnosed 2010-2014 60 65 Breast cancer 5-year survival 74 93 +3 pp % survival for women diagnosed 2010-2014 83 87 Lung cancer 5-year survival 8 20 +6.3 pp % survival for patients diagnosed 2010-2014 15 18 Educational inequalities 18 106 - % difference in cancer mortality by education 37 82 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 72  Figure 6.30. EU’s Cancer Performance Tracker (CaPTr) Trend EU Min Max over time Prevention expenditure - % of health spending 1.2 6.1 10.4 Daily smoking -3.1 pp Cancer prevention % of population aged 15+ 6.2 18.6 29.1 Alcohol consumption -3% Litres per capita, population aged 15+ 6.3 10.0 11.9 Overweight and obesity -0.5 pp % of population aged 18+ with BMI ≥ 25 41.9 51.3 62.5 Air pollution -31% Exposure to PM2.5 (µg/m³) 4.9 11.7 17.8 HPV vaccination +9 pp % of girls aged 15 7 64 96 Breast cancer screening - Early cancer % of target population 9 56 83 detection Cervical cancer screening - % of target population 11 55 85 Colorectal cancer screening - % of target population 3 42 77 Physicians per 1 000 cancer cases 499 679 1 094 - Nurses Cancer care capacity per 1 000 cancer cases 641 1 376 3 462 - Reimbursed cancer medicines % of selected indications 0 59 100 - CT scanners F 29% r per 1 000 000 population a 11 26 49 MRI units 53% per 1 000 000 population 6 18 38 Radiation therapy equipment 9% per 1 000 000 population 5 8 12 Cancer mortality -12% ASMR per 100 000 population 198 235 310 Colorectal cancer mortality -18% ASMR per 100 000 population 19 27 50 Breast cancer mortality -9% ASMR per 100 000 women Cancer care outcomes 22 31 37 Lung cancer mortality -14% ASMR per 100 000 population 33 47 78 Cancer PYLL -19% years per 100 000 population 826 1 355 1 961 Colon cancer 5-year survival +5 pp % survival for patients diagnosed 2010-2014 49 60 72 Breast cancer 5-year survival +4 pp % survival for women diagnosed 2010-2014 74 83 93 Lung cancer 5-year survival +3 pp % survival for patients diagnosed 2010-2014 8 15 20 Educational inequalities - % difference in cancer mortality by education 18 37 106 Improvement ■ Deterioration ■ No value judgement ■ 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 COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   73 Figure 6.31. Cancer Performance Tracker (CaPTr) methods table Year/Perio EU average d of (number of Dimension Indicator Definition change countries) Source Prevention expenditure Share of total current health expenditure allocated to preventive care 2021 27 Eurostat OECD Health Statistics and Daily smoking Share of people aged 15 and over reporting smoking daily 2012-22 27 Cancer prevention Eurostat OECD Health Statistics and Alcohol consumption Average litres of alcohol consumption per person aged 15 and over 2010-22 27 Eurostat Percentage of individuals aged 18 and over reporting body mass Overweight and obesity 2017-22 27 EU-SILC and EHIS index is >=25 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 Proportion of target population who have undergone breast cancer Cancer early detection Breast cancer screening screening based on the country’s breast cancer screening policy or 2014-22 24 OECD Health Statistics and EHIS EHIS survey definition Proportion of target population who have undergone cervical cancer Cervical cancer screening screening based on the country’s cervical cancer screening policy or 2014-22 20 OECD Health Statistics and EHIS EHIS survey definition Proportion of target population who have undergone colorectal cancer Colorectal cancer screening screening based on the country’s colorectal cancer screening policy 2022 20 OECD Health Statistics and EHIS or EHIS survey definition OECD Health Statistics and Physicians Number of practising physicians per 1 000 new cancer cases 2022 27 European Cancer Information OECD Health Statistics and Nurses Number of practising nurses per 1 000 new cancer cases 2022 27 Cancer care capacity European Cancer Information Proportion of reimbursed indications among a sample of new cancer Hofmarcher, T., C. Berchet and Reimbursed cancer medicines 2023 22 medicines for breast and lung cancers with high clinical benefit 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 Malignant neoplasms age-standardised mortality rate per 100 000 Cancer mortality 2011-21 27 Eurostat population Colon, rectosigmoid junction, rectum, anus and anal canal cancer Colorectal cancer mortality 2011-21 27 Eurostat age-standardised mortality rate per 100 000 population Breast cancer mortality Breast cancer age-standardised mortality rate per 100 000 women 2011-21 27 Eurostat Cancer care outcomes Trachea, bronchus and lung cancer age-standardised mortality rate Lung cancer mortality 2011-21 27 Eurostat per 100 000 population Cancer PYLL Potential Years of Life Lost due to cancer per 100 000 population 2012-22 25 OECD Health Statistics Age-standardised 5-year net survival estimates (%) for patients 2000/04- Colon cancer 5-year survival 24 CONCORD-3 diagnosed with colon cancer, 2010-14 2010/14 Age-standardised 5-year net survival estimates (%) for women 2000/04- Breast cancer 5-year survival 24 CONCORD-3 diagnosed with breast cancer, 2010-14 2010/14 Age-standardised 5-year net survival estimates (%) for patients 2000/04- Lung cancer 5-year survival 24 CONCORD-3 diagnosed with lung cancer, 2010-14 2010/14 Socio-economic inequality gap in cancer mortality between people Educational inequalities 2015/19 27 IARC with higher and low education (%) 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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 74  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. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025   75 References Aarts, M. et al. (2024), Socioeconomic Differences in the Consequences of Cancer, Integraal [7] Kankercentrum Nederland (IKNL). De Angelis, R. et al. (2024), “Complete cancer prevalence in Europe in 2020 by disease duration [9] 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. Desimpel F, L. (2024), Lung cancer screening in a high risk population - Synthesis. Health [11] Technology Assessment (HTA), Federal Knowledge Centre for Health Care (KCE), Brussels. European Commission/IARC/Erasmus MC (2024), Mapping Socio-economic Inequalities in [6] Cancer Mortality across European Countries. Global Burden of Disease Collaborative Network (2021), Global burden of disease study 2021 [10] (GBD 2021) results, https://vizhub.healthdata.org/gbd-results/ (accessed on 4 November 2024). Hassaine, Y. et al. (2022), “Evolution of breast cancer incidence in young women in a French [2] 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. Hofmarcher, T., C. Berchet and G. Dedet (2024), “Access to oncology medicines in EU and [15] OECD countries”, OECD Health Working Papers, No. 170, OECD Publishing, Paris, https://doi.org/10.1787/c263c014-en. Koldehoff, A. et al. (2021), “Cost-Effectiveness of Targeted Genetic Testing for Breast and [12] Ovarian Cancer: A Systematic Review”, Value in Health, Vol. 24/2, pp. 303-312, https://doi.org/10.1016/j.jval.2020.09.016. OECD (2024), Beating Cancer Inequalities in the EU: Spotlight on Cancer Prevention and Early [8] Detection, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/14fdc89a-en. OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, OECD [16] Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/85e7c3ba-en. OECD/European Commission (2024), Health at a Glance: Europe 2024: State of Health in the [14] EU Cycle, OECD Publishing, Paris, https://doi.org/10.1787/b3704e14-en. SIOPE (2024), Childhood cancer country profile, https://siope.eu/activities/joint-projects/OCEAN- [17] Country-Cancer-Profiles. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 76  Sung, H. et al. (2024), “Differences in cancer rates among adults born between 1920 and 1990 [3] 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. Sung, H. et al. (2025), “Colorectal cancer incidence trends in younger versus older adults: an [5] 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. Teppala, S. et al. (2023), “A review of the cost-effectiveness of genetic testing for germline [13] variants in familial cancer”, Journal of Medical Economics, Vol. 26/1, pp. 19-33, https://doi.org/10.1080/13696998.2022.2152233. Vaccarella, S. et al. (2024), “Prostate cancer incidence and mortality in Europe and implications [1] for screening activities: population based study”, BMJ, p. e077738, https://doi.org/10.1136/bmj-2023-077738. Vassal, G. et al. (2021), “Access to essential anticancer medicines for children and adolescents [18] in Europe”, Annals of Oncology, Vol. 32/4, pp. 560-568, https://doi.org/10.1016/j.annonc.2020.12.015. Vuik, F. et al. (2019), “Increasing incidence of colorectal cancer in young adults in Europe over [4] the last 25 years”, Gut, Vol. 68/10, pp. 1820-1826, https://doi.org/10.1136/gutjnl-2018- 317592. EU COUNTRY CANCER PROFILES SYNTHESIS REPORT 2025 © OECD/EUROPEAN UNION 2025 European Cancer Inequalities Registry EESTI Riigi vähiprofiil 2025  Riikide vähiprofiilide sari Sisukord | Vähktõve ebavõrdsuse register on Euroopa vähktõvevastase 1. PÕHIPUNKTID 3 võitluse kava juhtalgatus. Sellest saab kindlat ja EESTI | | 2 0 2 5 usaldusväärset teavet vähktõve ennetamise ja ravi 2. VÄHKTÕBI EESTIS 4 kohta, et selgitada välja suundumused ning erinevused 3. RISKITEGURID JA ENNETUSPOLIITIKA 8 ja ebavõrdsus liikmesriikide, piirkondade ja elanikkon- narühmade vahel. Riikide vähiprofiilides tuuakse 4. VARAJANE AVASTAMINE 13 välja tugevad küljed, probleemid ja konkreetsed tegevusvaldkonnad kõigis 27 ELi liikmesriigis, Islandil ja 5. VÄHIRAVI TOIMIVUS 17 Norras, et suunata Euroopa vähktõvevastase võitluse kava 5.1. Kättesaadavus 17 alusel investeeringuid ja sekkumisi ELi, riigi ja piirkonna tasandil. Lisaks toetab Euroopa vähktõve ebavõrdsuse 5.2. Kvaliteet 20 | register nullsaaste tegevuskava 1. juhtalgatust. Profiilid 5.3. Kulud ja kulutõhusus 23 koostab Majanduskoostöö ja Arengu Organisatsioon (OECD) koostöös Euroopa Komisjoniga. Töörühm on tänulik riiklikele 5.4. Heaolu ja elukvaliteet 24 ekspertidele väärtusliku panuse ning OECD tervisekomiteele 6. PILGUHEIT LASTE VÄHKTÕVELE 26 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 APeamised tervisesüsteemi ja demograafilised ametlikul statistikal, mis valideeriti, et tagada andmete võimalikult suur võrreldavus. Teave andmete algallikate ja Anäitajad alusmeetodite kohta on kättesaadav Eurostati andmebaasis Oodatav eluiga sünnihetkel (aastates) 81,5 ja OECD terviseandmebaasis. 80,2 Oodatav eluiga sünnihetkel (aastates) 81,5 78,8 Lisaks saadi andmeid ja teavet sellistest allikatest nagu 80,2 Euroopa Komisjoni Teadusuuringute Ühiskeskus, sissetulekuid 76,7 78,8 ja elamistingimusi käsitlev ELi statistika, Maailma Terviseor- 76,7 ganisatsioon (WHO), Rahvusvaheline Vähiuurimiskeskus (IARC), Rahvusvaheline Aatomienergiaagentuur (IAEA), Euroopa pediaatrilise onkoloogia ühing, Euroopa Liidu 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Eesti EL27 Põhiõiguste Amet (LGBTIQ kogukonda käsitlev uuring), 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 kooliealiste laste tervisekäitumist käsitlev uuring ja Eesti EL27 2023. aasta riikide tervise- ja vähiprofiilid ning muudest B riiklikest allikatest (mis on sõltumatud era- ja ärihuvidest). B ELi kohta arvutatud keskmised on 27 liikmesriigi kaalutud 65aastaste ja vanemate elanike osakaal (%) keskmised, kui ei ole märgitud teisiti. ELi keskmised ei 21,3 % 65aastaste ja vanemate elanike osakaal (%) hõlma Islandit ja Norrat. Suremus- ja haigestumuskordajad 18,0 % 21,3 % on standarditud vanuse järgi 2013. aastal Eurostati poolt 20,2 % kinnitatud Euroopa standardrahvastiku põhjal. 18,0 % 17,7 % 20,2 % Ostujõu pariteet on valuutavahetuskurss, mille abil A võrdsustatakse eri vääringute ostujõud, kõrvaldades riikide C17,7 (a)% C (b) hinnatasemete erinevused. 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 C (a) Eesti EL27 C (b) Oodatav eluiga sünnihetkel (aastates) 81,5 2012 2013 2014 2015 2016 2017 2018 Vastutuse välistamine: Käesolev dokument avaldatakse OECD Tervishoiukulud protsendina SKPst2019 (20222020 2021aasta) või lähim 2022 2023 80,2 peasekretäri ja Euroopa Komisjoni presidendi vastutusel. Dokumendis Eesti EL27 15 % Oodatav eluigaesitatud arvamused sünnihetkel (aastates) ja väited ei pruugi tingimata 81,5 kajastada OECD 78,8 Tervishoiukulud protsendina SKPst (2022 või lähim aasta) 10,4 % T 80,2 või Euroopa Liidu liikmesriikide ametlikke seisukohti. Käesoleva 10 % 15 % (j 76,7 dokumendiga ega ka selles esitatud andmete ja diagrammidega 7,0 % 78,8 3 ei piirata ühegi territooriumi staatust ega selle suveräänsust, Inside cover 10,4 % 10 % 5% 76,7 rahvusvaheliste piiride ja riigipiiride piiristamist ega ühegi 7,0 % territooriumi, linna või piirkonna nime. Käesolevas ühisväljaandes Inside cover 2 0% 2012 kasutatud riikide 2013 2014 2015 ja 2017 2016 territooriumide nimed 2018 2019 2020 2021ja2022 kaardid 2023 on kooskõlas 5% OECDs järgitava tavaga. Eesti EL27 Eesti EL27 1 OECD vastutuse 0% 2012 2013 2014 2015 2016 2017välistamine seoses 2018 2019 2020 2021konkreetsete 2022 2023 territooriumidega: B Märkus Türgi Eesti Vabariigilt:EL27 käesolevas dokumendis sisalduv teave D Eesti EL27 Küprose kohta puudutab saare lõunaosa. Ükski ametlik võim saarel ei esinda korraga nii türgi kui ka kreeka rahvusest küproslasi. Türgi 65aastaste ja vanemate elanike osakaal (%) D tunnustab Põhja-Küprose Türgi Vabariiki. Türgi jääb Küprose Vanusestandarditud suremus 100 000 elaniku kohta (2021) 21,3 % küsimuses oma seisukohale seni, kuni ÜRO raames on leitud alaline ja Vereringesüsteemi haigused 65aastaste ja vanemate elanike erapooletu osakaal (%) lahendus. 18,0 % Vanusestandarditud suremus 100 000 elaniku kohta (2021) Vähk 21,3 % 20,2 % Märkus kõigilt OECDsse kuuluvatelt Euroopa Liidu liikmesriikidelt ja Vereringesüsteemi haigusedCOVID-19 Tuvastatud 18,0 % 17,7 %Euroopa Liidult: Küprose Vabariiki on tunnustanud kõik Ühinenud Rahvaste Organisatsiooni liikmed peale Türgi. Vähkhaigused 20,2 %Käesolevas dokumendis Hingamisteede esitatud teave puudutab piirkonda, mis on Küprose Vabariigi tegeliku Tuvastatud COVID-19 Muu 17,7 % kontrolli all. 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Hingamisteede haigused 0 500 1000 © OECD / Euroopa Liit, 2025 Käesoleva Eesti EL27 dokumendi originaali ja tõlke Muu Eesti EL27 mis tahes vastuolu korral tuleks lugeda kehtivaks üksnes dokumendi 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 originaal. Eesti EL27 0 500 1000 Eesti EL27 Allikas: Eurostati andmebaas. Inside cover 02 | EESTI | Riigi vähiprofiil 2025 ide cover  1. Põhipunktid | | EESTI A. Cancer in Eesti B (a). Adolescent risk factors and prevention policies | Vähktõbi EestisSuitsetamine | 2025 A. Cancer in Eesti Vanusestandarditud kordajad 100 000 elaniku kohta 2022. aastal oliB%hinnanguline 11–15aastastest (a). Adolescent risk vähihaigestumus factors and prevention Eestis meeste policies 0 5 10 15 20 25 0 100 200 300 400 500 600 700 800 900 seas suurem, kuid naiste seas väiksem kui ELi keskmine. Alkoholitarbimine Suitsetamine Sooline erinevus vähisuremuses % 11–15aastastest oli üks ELi suurimaid: meeste Vähihaigestu % 11–15aastastest Vanusestandarditud kordajad 100 000 elaniku kohta mus (2022) suremus ületas naiste oma enam 0 0 kui kaks 10 5 korda. 10 20 Tänu pidevatele 15 20 30 25 0 100 200 300 400 500 600 700 800 900 edusammudele suurenes Ülekaal vähielulemus (sh rasvumine) Alkoholitarbimine aastatel 2010–2020 % 11–15aastastest Vähisuremus Vähihaigestu peaaegu 40 %. 2025. aastal toimub % 11–15aastastest 5 Eesti 15 vähitõrje 25 tegevuskava 35 45 Ülekaaluliste (sh rasvunud) naiste osakaal 0 10 20 30 (2021) mus 70 % (2022) 2021–2030 eesmärkide vahehindamine. Eesti - Alumised 20% Eesti - Ülemised 20% Ülekaal (sh rasvumine) 60 % EL27 - Alumised 20% EL27 - Ülemised 20% Eesti EL27 Mehed Naised % 11–15aastastest Vähisuremus 50 % 5 15 25 35 45 (2021) 40 % Eesti - Alumised 20% Eesti - Ülemised 20% Riskitegurid ja ennetuspoliitika B (b). Risk factors and socioeconomic inequalities 30 % EL27 - Alumised 20% EL27 - Ülemised 20% Eesti EL27 Mehed Naised 40,0 45,0 50,0 55,0 60,0 65,0 70,0 75,0 80,0 85,0 90,0 95,0 100,0 105,0 110,0 115,0 120,0 125,0 130,0 135,0 140,0 145,0 150,0 155,0 160,0 165,0 170,0 175,0 180,0 185,0 190,0 195,0 200,0 205,0 210,0 215,0 220,0 225,0 230,0 235,0 240,0 245,0 250,0 255,0 260,0 265,0 270,0 275,0 280,0 20 % Ülekaaluliste (sh rasvunud) naiste osakaal Kuigi igapäevane suitsetamine on märkimisväärselt vähenenud, 10 % 70 % on Eesti elanike tulemused mitme riskiteguri puhul, mille hulka 60 %0 % kuuluvad ülekaalulisus ning puu- ja köögiviljade tarbimine, Eesti EL27 Eesti EL27 40,0 45,0 50,0 55,0 60,0 65,0 70,0 75,0 80,0 85,0 90,0 95,0 100,0 105,0 110,0 115,0 120,0 125,0 130,0 135,0 140,0 145,0 150,0 155,0 160,0 165,0 170,0 175,0 180,0 185,0 190,0 195,0 200,0 205,0 210,0 215,0 220,0 225,0 230,0 235,0 240,0 245,0 250,0 255,0 260,0 265,0 270,0 275,0 280,0 50 % 2017 2022 viletsamad kui ELi keskmine. Sotsiaal-majanduslikud erinevused Madal haridustase Kõrge haridustase 40 % naiste ülekaalulisuses on Eestis siiski väiksemad kui ELis B (b). Risk factors and socioeconomic inequalities 30 % Ülekaaluliste (sh rasvunud) naiste osakaal keskmiselt ja need on viimastel aastatel vähenenud. Alkoholi- 20 % 70 % tarbimine on riigis tänu alkoholi taskukohasemaks muutumisele 60 % 10 % 50 % kasvanud ja on üks kõrgemaid ELis, ulatudes 2022. aastal C. Early detection 0% 40 % (ver. 1) D. (a) Cancer 11,2 liitrini elaniku care performance kohta. Lisaks võib osa suitsetajate(healthosakaalu expenditure) Eesti EL27 Eesti EL27 30 % 20 % 2017 2022 vähenemisest seostada suurenenud e-sigarettide kasutamisega, Oodatava eluea vähist tingitud 10 % Madal haridustase Kõrge haridustase mis on eriti prognoositud levinud noorte vähenemine seas. Vähiga seotud kulude prognoositud C.%Early sihtrühma kuulunud elanikest, kes osales sõeluuringus (2022 või lähim aasta) 0 % detectionEesti (ver. 1) EL27 Eesti EL27 D. (a) Cancer care performance (health osakaal tervishoiukuludes aastates (2023.–2050. aasta (2023.– expenditure) keskmine) 2050. aasta keskmine) 2017naiste osakaal Ülekaaluliste (sh rasvunud) 2022 80 % Madal haridustase Kõrge haridustase Varajane avastamine 2,5 Oodatava eluea vähist tingitud 8% 70 % prognoositud vähenemine Vähiga seotud kulude prognoositud 60sihtrühma % % kuulunud elanikest, kes osales sõeluuringus (2019-2022 2023. aastal 2,0 oliaastates Eesti(2023.–2050. rinna-, emakakaela- ja tervishoiukuludes osakaal kolorektaalvähi 60 % 50 % või lähim aasta) aasta 6,8 % (2023.– 40 % Depressioonijuhtumite arvu vähist sõeluuringu programmides keskmine)1,9 osalusmäär 1,9 5% läbi 2050. aegade aasta keskmine)kõrgeim. 80 % 1,5 2,5 30 % 40 % tingitud prognoositud Seda tänu jõupingutustele parandada mitmesuguste 8% vahendite 20 %Oodatava eluea vähist tingitud suurenemine aastas 10 % 60 %prognoositud vähenemine 100 000 elaniku kohta abil, nagu HPV kodutestid ja maapiirkondi külastavad 1,0 2,0 3,6 % 6,8 % 20 %0 %aastates (2023.–2050. aasta (vanusestandarditud) (2023.– 3% keskmine)Eesti EL27 2050. aasta Eesti keskmine) EL27 mammograafiabussid, 0,5 1,5 programmide 1,9 1,9 kättesaadavust 5% ja 63 % 58 % 55 % 40 % 0 % 2,5 2017 25 2022 teadlikkust neist programmidest. Ühes maakonnas on katsetatud 0,0 1,0 0% RinnavähkMadal haridustase Emakakaelavähk Kõrge haridustase Kolorektaalvähk 23 ka kopsuvähi sõeluuringut ja samuti uuritakse 3 EL27 % eesnäärmevähi 3,6 % 20 % 2,0 20 Eesti 1,9 2022 2019 Use1,9alternative below 5517% sõeluuringu teostatavust. 0,5 1,5 63 % 58 % 15 0% Depressioonijuhtumite arvu vähist tingitud prognoositud 0,0 0% 1,0 Rinnavähk Emakakaelavähk 10 Kolorektaalvähk Oodatava eluea vähist tingitud suurenemine aastas Eesti EL27 2022 2019 prognoositud 0,5 vähenemine 1005 000 elaniku kohta aastates (2023.–2050. aasta (vanusestandarditud) (2023.– keskmine) 0,0 2050. 0 aasta keskmine) 2,5 Eesti 25 EL27 Vähiravi toimivus 2,0 Depressioonijuhtumite arvu vähist 20 23 Viie aasta elulemus paranes 54 %-lt aastatel 2007–2011 tingitud prognoositud Oodatava eluea Use alternative below 1,9 vähist1,9 tingitud suurenemine aastas diagnoositud vähijuhtude puhul 58 %-le vähijuhtude puhul, 1,5prognoositud vähenemine 15 100 000 elaniku kohta 17 (vanusestandarditud) (2023.– mis diagnoositi aastatel 2017–2021. Eestis toimub tsentral- aastates (2023.–2050. aasta 1,0keskmine) 10 2050. aasta keskmine) iseeritud vähiravi ning arendatakse personaalmeditsiini ja 0,5 2,5 25 5 inimesekeskseid lähenemisviise ravi kvaliteedi hindamiseks. 2,0 20 23 Samas on oluline tagada ülevaade ooteaegadest, mis praegu 0,0 0 Highlights1,5pg1 1,9 1,9 puudub, ja piisav tööjõud. Esmatähtsaks peetakse ka Eesti 15 EL27 17 vähiravimite ning diagnoosimis- ja raviviiside kättesaadavust. 1,0 Depressioonijuhtumite 10 arvu vähist tingitud prognoositud Palliatiivne ravi on Eestis killustunud ja teenustes esineb lünki, 0,5 Highlights Oodatavapg1 eluea vähist tingitud 5 suurenemine aastas eriti hajuasustusega piirkondades. On oodata, et vähktõvest prognoositud vähenemine 100 000 elaniku kohta 0,0 (2023.–2050. aasta aastates 0 (vanusestandarditud) (2023.– põhjustatud depressioonijuhtumite esinemissagedus on Eestis Restricted Use - À usage restreint keskmine) Eesti 2050.EL27 aasta keskmine) aastatel 2023–2050 suurem kui ELis keskmiselt, ehkki vähktõve # 2,5 25 mõju oodatavale elueale on sarnane. 23 2,0 20 # Restricted Use - À usage restreint 1,9 1,9 1,5 15 17 1,0 10 0,5 5 0,0 0 Riigi vähiprofiil 2025 | EESTI | 03 Eesti EL27  2. Vähktõbi Eestis | EESTI | | 2 0 2 5 Vähihaigestumus on Eestis meeste seas Eesti meeste vähijuhtumite seas oli suurim suurem, kuid naiste seas väiksem kui ELi osakaal eesnäärmevähil (28 %), kusjuures selle keskmine esinemissagedus oli 42 % suurem kui ELi keskmine. | Teadusuuringute Ühiskeskuse Euroopa Teine meeste seas kõige enam levinud vähivorm vähiteabesüsteemi (ECIS) andmete kohaselt oli kolorektaalvähk (14 %), millele järgnes oli Eestis 2022. aastal – tuginedes pandeemi- kopsuvähk1 (14 %). Naiste seas oli Eestis levinuim aeelsete aastate haigestumussuundumustele – vähivorm rinnavähk, mis moodustas 24 % kõigist hinnanguliselt 7817 vähijuhtumit: 3726 naiste vähijuhtumitest, kuigi selle esinemissagedus oli ja 4091 meeste seas. Vanusestandarditud 26 % väiksem kui ELi keskmine. Eesti maakondade hinnanguline haigestumus oli meeste puhul lõikes oli vähihaigestumus 2021. aastal väga 780 juhtumit 100 000 elaniku kohta, mis oli erinev. See oli mõlema soo puhul kõige suurem suuruselt kuues ELis ja 14 % suurem kui ELi Lõuna- ja Ida-Eesti maakondades ning kõige keskmine (Joonis 1). Naiste seas oli hinnanguline väiksem Tallinna ja Tartu piirkonnas (Tervise haigestumus 452 juhtumit 100 000 elaniku kohta, Arengu Instituut, 2024a). mis jääb 7 % alla ELi keskmise. Joonis 1. Eestis on vähihaigestumus meeste seas suurem, kuid naiste seas väiksem kui ELi keskmine Hinnanguline vanusestandarditud haigestumus 100 000 elaniku kohta (2022) 900 780 800 684 700 Muu 297 (38 %) 600 Muu 282 (41 %) 488 500 452 Põievähk 48 (6 %) 400 Kopsuvähk 110 (14 %) Põievähk 61 (9 %) Muu 212 (43 %) Muu 220 (49 %) 300 Kopsuvähk 95 (14 %) Kolorektaalvähk 107 (14 %) Emakakehavähk 27 (5 %) Emakakehavähk 32 (7 %) Kopsuvähk 44 (9 %) 200 Kolorektaalvähk 93 (14 %) Kopsuvähk 29 (6 %) Kolorektaalvähk 58 (12 %) Kolorektaalvähk 62 (14 %) 100 Eesnäärmevähk 219 (28 %) Eesnäärmevähk 154 (23 %) Rinnavähk 148 (30 %) Rinnavähk 110 (24 %) 0 Eesti EL27 Eesti EL27 Mehed Naised 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 emakakaelavähki. Hinnanguline vanusestandarditud haigestumus 100 000 elaniku kohta (2022) Allikas: 900 Euroopa vähiteabesüsteem (ECIS), https://ecis.jrc.ec.europa.eu (vaadatud 10. märtsil 2024), © Euroopa Liit, 2024. Haigestumuse protsentuaalne 780 jaotus arvutati vanusestandarditud haigestumuse põhjal ümber ja seetõttu erineb see ECISe veebisaidil 800 esitatud absoluutarvude protsentuaalsest jaotusest. 684 700 Võrreldes 2000. aastaga oli vanusestandardimata Muu 297 (38 %) vähihaigestumus on püsinud alates 2010. aastast 600 vähihaigestumus 2019. aastaks Eestis mõlema nii meeste kui ka naiste puhul stabiilne. Meeste Muu 282 (41 %) 488 soo 500 puhul suurenenud: 55 % meeste ja 44 % hulgas on alates 452 1990. aastate lõpust vähenenud Põievähk 48 (6 %) naiste 400 seas (Tervise Arengu Instituut, 2024a). vanusestandarditud haigestumus kopsuvähki Kopsuvähk 110 (14 %) Põievähk 61 (9 %) Muu 212 (43 %) Pärast korrigeerimist elanikkonna vananemise (Zimmermann et%)al., 2024), samas kui rinnavähki Muu 220 (49 300 Kopsuvähk 95 (14 %) mõju arvesse võtmiseks Kolorektaalvähk on 107 (14 %)siiski näha, et haigestumus naiste seas on suurenenud Emakakehavähk(Tervise 27 (5 %) Emakakehavähk 32 (7 %) Kopsuvähk 44 (9 %) 200 Kolorektaalvähk 93 (14 %) Kopsuvähk 29 (6 %) Kolorektaalvähk 58 (12 %) Kolorektaalvähk 62 (14 %) Eesnäärmevähk 1100 Kopsuvähk 219 (28 %) hõlmab ka hingetoru- ja bronhivähki. Eesnäärmevähk 154 (23 %) Rinnavähk 148 (30 %) Rinnavähk 110 (24 %) 0 Eesti EL27 Eesti EL27 Mehed Naised 04 | EESTI | Riigi vähiprofiil 2025  Arengu Instituut, 2024b). 2021. aastal oli koguvähi- 100 000 elaniku kohta – vähk põhjustas 20 % kõigist | haigestumus mõlema soo puhul Eestis 8 % surmadest ja suremus oli 13 % suurem kui ELis | väiksem kui COVID-19 pandeemia eelne viie aasta keskmiselt. Eesti meeste vähisuremus oli ELis EESTI keskmine (2015–2019), osaliselt viivituste tõttu suuruselt neljas (34 % üle ELi keskmise), naiste mõne vähivormi diagnoosimisel, mida täheldati suremus oli keskmisele lähemal (4 % üle keskmise). nii 2020. kui ka 2021. aasta puhul. Haigestumuse Koguvähisuremus oli alates 2011. aastast siiski | vähenemist saab osaliselt seostada riskitegurite vähenenud 11 % nii meeste kui ka naiste puhul. | 2025 pikaajalise vähenemisega (nt kopsu- ja maovähi Tuleb märkida, et meeste seas kahanes suremus puhul) ning emakakaelavähi sõeluuringu vähem kui ELis ja sarnase ostujõuga riikides programmi mõjuga (Zimmermann et al., 2024). keskmiselt,2 ent naiste puhul rohkem kui teistes Tulevikku vaadates prognoosib ECIS siiski, et riikides keskmiselt (Joonis 2). vähijuhtumite arv suureneb 2022.–2040. aastal Ehkki suremus kopsuvähki on vähenenud Eestis 19 %. alates 2011. aastast 16 %, oli kopsuvähk 2021. aastal Vähk põhjustab Eestis viiendiku kõigist endiselt kõige sagedasem surma kaasa toonud vähiliik, põhjustades 16 % kõigist vähisurmadest; surmadest sellele järgnes kolorektaalvähk 13 %ga. 2021. aastal oli vähktõvest tingitud vanusestandarditud suremus Eestis 266 juhtumit Joonis 2. Eestis on ühed ELi suurimaid soolised erinevused vähisuremuses Muutus vähisuremuses (2011–2021) Muutus vähisuremuses (2011–2021) Mehed Naised Mehed Naised Vanusestandarditud suremus vähi tõttu 100 000 elaniku kohta (2021) 0% Vanusestandarditud suremus vähi tõttu 100 000 elaniku kohta (2021) 0% -5 % 500 -5 % 500 -10 % -10 % 450 -15 % 450 -15 % 400 -20 % 400 -20 % Eesti EL27 Sarnase ostujõuga riigid 350 Eesti EL27 Sarnase ostujõuga riigid 350 300 300 250 250 200 200 150 150 100 100 50 50 0 0 Kokku Mehed Naised Kokku Mehed Naised 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. Muutus vähisuremuses (2011–2021) Allikas: Eurostati andmebaas. Muutus vähisuremuses (2011–2021) Vanusestandarditud suremus vähi tõttu 100 000 elaniku kohta (2021) Mehed Naised Vanusestandarditud suremus vähi tõttu 100 000 elaniku kohta (2021) Mehed Naised 0% 500 0% -5 % 500 Soolised 450 erinevused vähisuremuses on Eestis nooremate -10 % inimeste hulgas. Langus oli suurem alla -5 % -10 -15 % % 450 ühed 400 ELi suurimad 65aastaste -15 % meeste seas (25 %) kui üle 65aastastel -20 % 400 -20 % Eesti meeste seas (7 %) ja EL27 Eesti alla 65aastaste Sarnase naiste Sarnase ostujõugaseas ostujõuga riigid 350 on Läti ja Leedu kõrval üks kolmest ELi riigist, Eesti EL27 riigid 350 (26 %) kui üle 65aastastel naiste seas (5 %). kus 300 vähisuremus on meeste seas enam kui kaks 300 korda 250 suurem kui naiste seas, mis kujutab endast Eestis on eriti suured haridustasemest tingitud 250 ühte 200 suurimaid soolisi erinevusi ELis. Kõige suurem sotsiaalsed erinevused vähisuremuses. Meeste 200 erinevus 150 võrreldes ELi keskmisega oli vanemate seas on erinevus madalama ja kõrgema 150 meeste 100 hulgas: üle 65aastaste suremus ületas haridustasemega inimeste vahel peaaegu 130 % 100 ELi 50 keskmist 37 %, olles Horvaatia ja Läti näitaja (võrreldes 84 %ga ELis), naiste seas peaaegu 60 % 50 järel 0 ELis suuruselt kolmas. Nagu mujalgi ELis, (võrreldes 36 %ga ELis) (Joonis 3). 0 vähenes suremus aastatel 2011–2022 märksa enam 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. Kokku Mehed Naised Kokku Mehed Naised 2: 2: Cancer Cancer mortality mortality by by gender gender & & change change over over 10-year 10-year period period Riigi vähiprofiil 2025 | EESTI | 05  Joonis 3. Eestis on madalama haridustasemega Ehkki ennetatav suremus kopsuvähki väheneb, meeste suremus üle kahe korra suurem kui on probleemiks raviga välditav suremus | kõrgema haridustasemega meeste suremus kolorektaalvähki EESTI | | 2 0 2 5 Vanusestandarditud koguvähisuremus 100 000 elaniku kohta 2021. aastal oli ennetatavaks suremuseks liigituv 1000 välditav suremus3 kopsuvähki naiste seas 900 12 juhtumit 100 000 elaniku kohta (41 % väiksem 800 kui ELi keskmine) ja meeste seas 51 juhtumit 700 100 000 elaniku kohta (17 % suurem kui ELi 600 500 keskmine). Võrreldes 2011. aastaga on see näitaja kahanenud naiste puhul 9 % ja meeste puhul | 400 300 27 % (Joonis 4), mis on kooskõlas suitsetamise 200 vähenemisega (vt punkt 3). 100 0 Raviga välditav suremus rinnavähki oli Eestis Eesti EL15 Eesti EL15 2021. aastal 18 juhtumit 100 000 naise kohta, Mehed Naised mis on 4 % väiksem kui ELi keskmine. Seda Madal haridustase Keskmine haridustase Kõrge haridustase on 23 % vähem kui 2011. aastal, mis tähendab suuremat kahanemist kui ELi keskmine. Raviga Märkused. Andmed tulevad ELi CanIneqi uuringust ja on aastate 2015–2019 kohta. EL 15 keskmine on 14 ELi riigi ja Norra välditav suremus kolorektaalvähki oli Eestis kaalumata keskmine. märkimisväärselt suurem – naiste seas 37 % ja Allikas: Euroopa Komisjon / IARC / Erasmus MC (2024), „Mapping meeste seas 24 % üle ELi keskmise. Võrreldes Social-economic Enequalities in Cancer Mortality in European Countries“, vähktõve ebavõrdsuse registri teabeleht vähktõvega 2011. aastaga oli standarditud suremus 2021. aastal seotud erinevuste kohta. 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 Vanusestandarditud välditav Vanusestandarditud välditav suremus kopsuvähki Vanusestandarditud välditav suremus suremus rinnavähki 100 000 naisest 100 000 elaniku kohta kolorektaalvähki 100 000 elaniku kohta elaniku kohta 120 50 30 100 25 40 EE EL27 80 20 30 EL27 EE EE 60 EL27 EE 15 EE EL27 EE 20 EL27 EL27 40 10 EE EL27 20 EL27 10 EL27 EL27 EE 5 EE EE 0 0 0 2011 2021 2011 2021 2011 2021 2011 2021 2011 2021 Naised Mehed Naised Mehed Naised Märkus. Välditava suremuse näitajad hõlmavad alla 75aastaseid inimesi. 3:Allikas: Avoidable mortality Eurostati byAndmed andmebaas. cancerontype and year 2021. aasta kohta. Use - À usage restreint 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. 06 | EESTI | Riigi vähiprofiil 2025  Vähilevimus on suurenenud Eestis alates see on üks suuremaid suhtelisi kasve kogu | 2010. aastast rohkem kui kolmandiku võrra ELis, tuleb märkida, et 2010. aastal oli Eesti | 2022. aastal oli viie aasta levimus4 Eestis vähilevimus poolest ELis tagantpoolt kuuendal EESTI 1780 vähijuhtumit 100 000 elaniku kohta, kohal. Muutused levimuses kajastavad varajase mis on 5 % väiksem kui ELi keskmine. Tänu avastamise ning vähiravi kättesaadavuse ja muutustele mõne vähivormi esinemissageduses kvaliteedi paranemist ning neil on ulatuslik mõju | ja elulemuse paranemisele (vt punkt 5.2) vajadusele tagada vähktõvega elavatele inimestele | 2025 suurenes vanusestandarditud vähilevimus ja vähktõvest jagusaanutele pikaajaline hooldus ja riigis 2010.–2020. aastal 39 % (Joonis 5). Kuigi psühhosotsiaalne tugi. Joonis 5. Vähilevimus suureneb Eestis kiiresti Viie aasta elulemus 100 000 elaniku kohta (2022, Globocan) Muutus vanusestandarditud elulemuses (2010–2020, EUROCARE-6) Viie aasta elulemus 100 000 elaniku kohta (2022, Globocan) Muutus vanusestandarditud elulemuses (2010–2020, EUROCARE-6) 2 500 50 % 2 500 50 % 2 000 40 % 2 000 40 % 1 500 30 % 1 500 30 % 1 000 20 % 1 000 20 % 500 10 % 500 10 % 0 0% 0 0% Vähielulemus (vasak telg) Muutus elulemuses (parem telg) Vähielulemus (vasak telg) Muutus elulemuses (parem telg) Allikad: Rahvusvahelise Vähiuurimiskeskuse (IARC) Globocani andmebaas, 2024; uuring EUROCARE-6 (De Angelis et al., 2024). 2025. aastal toimub Eesti vähitõrje Eesti vähiregister sisaldab enam kui 50 aasta Viie aasta elulemus 100 000 elaniku kohta (2022, Globocan)Muutus vanusestandarditud elulemuses (2010–2020, EUROCARE-6) tegevuskava Viie aasta elulemus2021–2030 100 000 elanikuvahehindamine andmeid, kohta (2022, Globocan) mis hõlmavadelulemuses Muutus vanusestandarditud kõiki pahaloomulisi (2010–2020, EUROCARE-6) 2 500 50 % Eestis 2 500 on tehtud alates 2021. aastast ulatuslikke kasvajaid, sealhulgas in situ kasvajaid ja 50 % jõupingutusi, 2 000 et parandada vähktõve tõrjet, mõningaid piirpahaloomulisi kasvajaid. 40 % 2 000 rakendades vähitõrje tegevuskava 2021–2030 Register jälgib vähidiagnoosi saanud isikuid 40 % 1 500 kogu nende elu jooksul, kogudes eri allikatest 30 % (sotsiaalministeerium 1 500 ja Tervise Arengu Instituut, 30 % 2021) 1 000 (Tekstikast 1). Kasutusel on jooksev andmeid haigestumuse, suremuse, elulemuse, 20 % 1 000 rakenduskava, et vaadata regulaarselt läbi eri vähi staadiumide, diagnoosimise ja ravi kohta. 20 % 500 Tervise Arengu Instituut juhib ennetustegevust10 % sidusrühmade 500 tegevus. Hoolimata COVID-19 10 % põhjustatud viivitustest vähitõrje tegevuskava ja sõeluuringute korraldamist, mida 0 0% 0 elluviimisel hinnatakse 2025. aastal tegevuskava rahastab Tervisekassa. Andmete kogumine 0% eesmärkide saavutamisel tehtud edusamme ja protsessinäitajad on valdkond, mis vajab kooskõlas Eesti riikliku tervisekava 2020–2030 parandamist, kuna oluline teave, näiteks vahehindamisega. Vähielulemus (vasak telg) vähikahtluse Muutusning diagnoosi elulemuses ja ravi vahele (parem telg) Vähielulemus (vasak telg) Muutus elulemuses jäävate ooteaegade (parem kohta, telg) puudub. Jälgimise parandamiseks tehakse tööd vähikeskuste 4: Cancer prevalence 2022 (GLOBOCAN) & change 2010-2020 andmestruktuuride (EUROCARE-6)ühtlustamiseks. 4: Cancer prevalence 2022 (GLOBOCAN) & change 2010-2020 (EUROCARE-6) 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. Riigi vähiprofiil 2025 | EESTI | 07  Tekstikast 1. Eesti vähitõrje tegevuskava 2020–2030 on üldjoontes kooskõlas Euroopa | vähktõvevastase võitluse kava põhisammastega EESTI | | 2 0 2 5 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 valdkonnaülesed Euroopa kava sambad teemad Varajane Diagnoosimine Teadusuuringud Ennetus Elukvaliteet Ebavõrdsus Pediaatria avastamine ja ravi 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 Eesti peab esmatähtsaks vähendada vähi terviklikuma koolitervishoiu kaudu. 1995. aastal riskitegurite levimust elanikkonna seas vastu võetud määruse alusel on kogu riigis tööle 2019. aastal oli ennetuse eesmärgil tehtud võetud riigi palgal olevad kooliõed, kes tegelevad tervishoiukulutuste osakaal Eestis 4 %5. peamiselt tervise edendamise ja haiguste Järgmistel aastatel kulus kuni 9 % tervishoiuku- ennetamisega. Lisaks, et rakendada koordineeritud lutustest COVID-19ga seotud tegevusele, mille strateegiaid ja parimaid tavasid, osaleb Tervise järel oli ennetusele kulutatud vahendite osakaal Arengu Instituut ELi ühisprojektis (Joint Action 2022. aastal 6 %. Oluline on märkida, et Eesti PreventNCD), mille eesmärk on ennetada kulutab tervishoiule ELi keskmisega võrreldes vähe mitmesuguste riskiteguritega seotud meetmete ning kuigi ennetusele kulutatud osa tervishoiuku- abil vähktõbe ja muid mittenakkuslikke haigusi. lutustest oli suurem kui ELi keskmine, olid Joonisel 6 on näidatud Eesti paiknemine valitud Eesti ennetuskulutused elaniku kohta (mida on riskitegurite osas võrreldes teiste ELi riikide, Islandi kohandatud ostujõu erinevuste alusel) 2019. aastal ja Norraga. Teiste riikidega võrreldes läheb Eestil ELi keskmisest 31 % väiksemad. hästi õhusaastega kokkupuutumise vaatenurgast. Eesti vähitõrje tegevuskava 2021–2030 üks Samas on kõrge levimuse tõttu jätkuvalt olulisteks põhieesmärke on vähendada riskitegurite levimust riskideks alkoholitarbimine, ülekaalulisus ja elanikkonnas. Iga riskiteguriga tegelemiseks viletsad toitumisharjumused ning inimeste on algatatud mitmeid meetmeid, sealhulgas papilloomiviiruse (HPV) vastu vaktsineerituse pandud rõhku noorukite kaitsmisele riskide eest tase Eestis oli 2023. aastal üks madalamaid ELis. Kuigi sissetulekuid ja elamistingimusi käsitleva 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. 08 | EESTI | Riigi vähiprofiil 2025  ELi uuringu (EU-SILC) andmetest on näha, et Eesti võrreldes suhteliselt head, osutavad riiklikud | tulemused igapäevase suitsetamise ja vähese uuringud, et need riskitegurid on jätkuvalt | kehalise aktiivsuse osas on teiste ELi riikidega probleemiks. EESTI Joonis 6. Eestis on võrreldes ELi keskmisega laialt levinud sellised olulised vähi riskitegurid nagu alkoholitarbimine ning ülekaalulisus ja rasvumine | Igapäevane suitsetamine | 2025 HPV vastu vaktsineerimine Alkoholitarbimine Õhusaaste Ülekaal ja rasvumine Riskitegurid töökeskkonnas Vähene kehaline aktiivsus Vähene köögiviljade tarbimine Vähene puuviljade tarbimine 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)). evalence of behavioral cancer risk factors among adults & environmental risk factors Suitsetamise levimuse vähenemist varjutavad 30 päeva jooksul vähemalt korra suitsetanute uued riskid – noored on hakanud üha rohkem osakaal 15aastaste seas vähenes Eestis aastatel veipima 2014–2022 mõlema soo puhul, ehkki poiste seas Igapäevane suitsetamine on Eestis alates rohkem (vähenes 49 %) kui tüdrukute seas (36 %) 2010. aastast märkimisväärselt vähenenud, (Joonis 7). Seda saab osaliselt seostada viimati olles kahanenud 2022. aastaks rohkem kui 2019. aastal muudetud tõhusa tubakatoodete 10 protsendipunkti võrra 16 %-le. Kahanemine on tarbimise piiramise poliitikaga, millega olnud eriti järsk meeste seas – 37 %-lt 2010. aastal reguleeritakse tubakatoodete ja nendega seotud 21 %-le 2022. aastal –, mis on kooskõlas kopsuvähki toodete reklaami ja väljapanekut. haigestumuse ja suremuse vähenemisega. Viimase Riigi vähiprofiil 2025 | EESTI | 09  Joonis 7. Eesti 15aastased tüdrukud suitsetavad ja teatavad, et nad on olnud purjus, suurema tõenäosusega kui samas vanuses poisid | 30 päeva jooksul vähemalt korra suitsetanute Elus rohkem kui korra purjus olnute osakaal Ülekaaluliste (sh rasvunute) osakaal EESTI | | 2 0 2 5 osakaal 15aastaste seas (%) 15aastaste seas (%) 15aastaste seas (%) 35 % 30 % 25 % | 20 % 15 % 10 % 5% 0% 2014 2018 2022 2014 2018 2022 2014 2018 2022 EE - Poisid EL - Poisid EE- Tüdrukud EL - Tüdrukud Märkus. ELi keskmine on kaalumata keskmine. Andmed on 2022. aasta kohta. Allikas: kooliealiste laste tervisekäitumist käsitlev uuring. Paraku on osa suitsetamise vähenemisest tingitud alkoholitarbijate seas korraldatud uuringust, ka sellest, et alternatiivsed nikotiinitooted et vaid 11 % naistest pidas alkoholi rinnavähi on muutunud laialdasest kättesaadavaks – riskiteguriks ja üksnes 27 % inimestest pidas 2022. aastal kasutas neid 10 % Eesti elanikest. seda riskiteguriks kolorektaalvähi puhul, mis Kogunäitajast ei ole näha, kui ulatuslik on see näitab, et üldsuse teadlikkus on suhteliselt madal. probleem noorte hulgas: 15–24aastastest teatas Teadlikkuse suurendamiseks on korraldatud regulaarsest veipimisest peaaegu 30 % (35 % avalikke kampaaniaid, et juhtida tähelepanu naistest ja 24 % meestest); 15aastastest oli viimase alkoholi rollile vähktõve puhul, nagu kampaania 30 päeva jooksul suitsetanud vähemalt üks kord „Septembris ei joo“, veebipõhine eneseabialgatus e-sigaretti 20 % poistest ja 30 % tüdrukutest. Alates „Selge“ ning Euroopa Sotsiaalfondi programm 2019. aastast on olnud tubakaseadusega keelatud „Kainem ja tervem Eesti“. Vaid 9 % neist inimestest, kasutada e-sigarettide vedelikes muid maitse- ja kelle iganädalane alkoholitarbimine kujutab lõhnaained peale tubaka ning samuti on keelatud endast suurt riski (7 standardühikut naiste ja tubakatoodete kaugmüük. Samas on endiselt 14 meeste puhul), teatasid, et nad on saanud võimalik teha internetioste välismaalt. tervishoiutöötajalt soovituse tarbimist vähendada, mis osutab vajadusele tervishoiutöötajaid Pärast alkoholiaktsiisi vähendamist 2019. aastal täiendavalt koolitada ära tundma probleeme ja suurenes Eestis alkoholitarbimine vajaduse korral sekkuma (Tervise Arengu Instituut, Kuigi alkoholitarbimine inimese kohta vähenes 2023). tänu alkoholipoliitika rohelises raamatus ette Tarbimisharjumused on mõnevõrra muutunud: nähtud meetmete süstemaatilisele rakendamisele aastatel 2012–2022 vähenes rohkem kui üks 12 liitrilt 2012. aastal 10 liitrile 2018. aastal, kord nädalas alkoholi tarbivate meeste osakaal suurenes see 2022. aastal 11 liitrile, kuna alkohol (33 %-lt 27 %-le), samal ajal kui naiste seas see muutus 2019. aasta aktsiisivähenduse tulemusel osakaal suurenes (11 %-lt 12 %-le). Naiste hulgas taskukohasemaks. Alkoholitarbimise reguleerimist on suurenenud korrapärane veinijoomine (Tervise riigis raskendab tava osta alkoholi üle piiri Arengu Instituut, 2023). Alkoholitarbimine Eesti Lätist, mis nõuab ühtlustatud poliitikameetmeid. noorukite seas on vähenenud: purjus olnute Kuigi Eesti on piiranud kellaaegu, mil alkohol osakaal 15aastaste noorukite hulgas kahanes on kauplustes kättesaadav, ei ole kehtestatud 2014.–2022. aastal 9 protsendipunkti, kuigi see on piiranguid müügikohtade tihedusele, maksustamist endiselt suurem kui ELi keskmine. Vastupidiselt ei kohandata vastavalt inflatsioonile ning alkoholi varasematele suundumustele oli neid 15aastaseid, puhul ei ole kasutusel spetsiaalseid terviseohust kes olid viimase 30 päeva jooksul purjus olnud, hoiatavaid etikette (OECD, 2024a). 2022. aastal tüdrukute seas rohkem kui poiste seas 2021. aastal oli Eestis 4 % kõigist vähijuhtumitest (vt Joonis 7). seostatavad alkoholiga. Samas selgus 2022. aastal 10 | EESTI | Riigi vähiprofiil 2025  Ülekaalulisus ja rasvumine sageneb Eestis seas sagedasem (23 %) kui meeste hulgas (21 %). | mõlema soo puhul Ülekaaluliste osakaal on võrreldes 2017. aastaga | Peaaegu kolm täiskasvanut viiest (57 %) on Eestis suurenenud mõlema soo puhul. Naiste puhul on EESTI ülekaalulised (sh rasvunud) ja 22 % täiskasvanutest ülekaalul seos haridustasemega (Joonis 8), kuid on rasvunud. Ülekaalulisus ja rasvumine on mitte meeste puhul, kuigi rasvumisest teatavad rohkem levinud Eesti meeste seas (62 %) kui naiste nii madalama haridustasemega mehed kui ka | hulgas (53 %), kuigi rasvumine üksi on naiste naised suurema tõenäosusega kui kõrgema | 2025 haridustasemega mehed ja naised. f overweight (including obese) adult women, by educational attainment, 2022 Joonis 8. Eesti on ülekaaluliste (sh rasvunud) naiste osakaalu poolest ELis viiendal kohal % % 18aastastest 18aastastest ja ja vanematest vanematest naistest, naistest, kes kes on on ülekaalulised ülekaalulised (sh (sh rasvunud) rasvunud) (2022) (2022) 70 70 60 60 50 50 40 40 30 30 20 20 10 10 00 Naised Naised kokku kokku Kõrge Kõrge haridustase haridustase Madal Madal haridustase haridustase Märkus. Ülekaalulised (sh rasvunud) inimesed on inimesed, kelle kehamassiindeks on üle 25. Allikas: Eurostati % 18aastastest andmebaas. ja vanematest naistest, kes on ülekaalulised (sh rasvunud) (2022) % 18aastastest ja vanematest naistest, kes on ülekaalulised (sh rasvunud) (2022) 70 70 Eestis suurenes 15aastaste seas ülekaalulisus lastesaadete ajal, kuigi seda juhendit kohaldatakse 60 60 2014.–2022. aastal 5 protsendipunkti võrra (vt ainult alla 12aastaste laste puhul. Lisaks on 50 50 Joonis 7). Olulised soolised erinevused ilmnevad juhend vabatahtlik ja see ei hõlma digiturundust, 40 juba 40 selles vanuses, kuna 2022. aastal teatas otseturundust ega avalikus ruumis korraldatavaid ülekaalulisusest 30 30 29 % poistest võrreldes 13 %ga kampaaniaid. 2024. aastal arutati suhkrumaksu tüdrukutest. 20 20 kehtestamist suhkruga magustatud jookidele ja 10 1995. aasta rahvatervise seaduse läbivaatamist 10 Jätkuvalt on probleemiks kehalise aktiivsuse ja lisapiirangute osas reklaamidele, kuid neist loobuti. 00 toitumisega seotud riskitegurid Ehkki sissetulekuid ja elamistingimusi käsitleva Enam kui pool Eesti elanikest teatas, et nad ELi uuringu (EU-SILC) andmed osutavad sellele, tarbivad puu- (51 %) ja köögivilju (50 %) harvem et Eesti elanike seas on vähene kehaline aktiivsus kui kord päevas, mida on üle 10 protsendipunkti Naised Naised kokku Kõrge Kõrge haridustase Madal haridustase kokku (treenimine haridustase vähem Madal kui kolm korda nädalas) haridustase rohkem kui ELi keskmine (39 % puuviljade ja suhteliselt harv (Joonis 6), on 2021. aasta riiklike 40 % köögiviljade puhul). Väiksema tõenäosusega andmete kohaselt of of overweight overweight (including (including teatasid obese) obese) vähesest adult adult women, tarbimisest naised jaby women, by educational educational attainment, attainment, 2022 peaaegu kolm neljandikku 2022 Eesti täiskasvanutest mitteaktiivsed (vähem kui kõrgharidusega inimesed. 15aastastest teatas üle 120 minutit treenimist nädalas) (Tervise Arengu kahe kolmandiku, et nad ei söö vähemalt kord Instituut, 2024b). Eesti 15aastased tüdrukud päevas puuvilju (tüdrukud veidi vähem (67 %) teatasid vähem igapäevasest kehalisest aktiivsusest kui poisid (74 %)), samal ajal kui peaaegu kolm (9 %) kui poisid (15 %) ja mõlema tulemus jääb alla neljandikku (73 %) teatas, et nad ei söö iga päev ELi keskmise. Eesti on rakendanud noorte kehalise köögivilju. aktiivsuse suurendamiseks programme, nagu Toitumise parandamiseks on koostatud toidu 2016. aastal käivitatud programm „Liikuma kutsuv koostise muutmise kava, mille üle hakatakse kool“, mille eesmärk on tuua liikumine ja kehaline pidama 2023. aasta septembris läbirääkimisi aktiivsus kõigi Eesti õpilasteni. toidutööstusega. 2023. aastal võeti vastu käitumiskoodeks, mis käsitleb ebatervisliku toidu ja joogi vastutustundlikku telereklaami Riigi vähiprofiil 2025 | EESTI | 11  Eesti on teinud edusamme õhusaaste algatas Eesti 2018. aastal 12–14aastaste tüdrukute valdkonnas, kuid töökeskkonnast tulenevad HPV vastu vaktsineerimise programmi; 2024. aasta | riskid on endiselt laialt levinud veebruaris laiendati programmi ka poistele EESTI | | 2 0 2 5 Pärast mitut õhukvaliteedi parandamiseks võetud ja programm võimaldab järelvaktsineerimist. poliitikameedet oli Eesti 2023. aastal üks seitsmest 2023. aastal oli saanud 15. eluaastaks kõik HPV maailma riigist, kus õhukvaliteet vastas WHO vaktsiini doosid 43 % tüdrukutest, mida on vähem kehtestatud PM 2,5 kontsentratsiooni standardile kui 60 % aastal 2022 ning oluliselt vähem kui WHO (alla 5 μg/m³). See kajastub nii elanikkonna eesmärk 90 % ja ELi keskmine 64 %. Murettekitavalt keskmises kokkupuutes PM 2,5-osakestega kui on viimastel aastatel vähenenud üheaastaste laste ka sellest kokkupuutest tingitud enneaegsete kolme doosiga vaktsineerimine B-hepatiidi vastu – | Riskiteguritega seotud eesmärkide saavutamisega surmade hinnangulises määras, mis on langenud aastatel 2023–2050 ära 2023. hoitavate aastal kahanes vähijuhtumite arv see 72 %-le, võrreldes 90 %ga 4 500 varasemate aastakümnete märksa kõrgematelt 2020. aastal ja 95 %ga 2007. aastal. Reageerides 3 980 4 000 tasemetelt ELi madalaimate hulka. madalale üldisele vaktsineerituse tasemele, eraldas 3 500 Tervisekassa aastatel 2024–2028 sihtotstarbeliselt 3 000 Samas 2 500 tekitavad muret riskitegurid töökeskkonnas, rahalisi vahendeid teadlikkuse suurendamise 2 007 kuna 2 000 ligikaudu 26 % nii meestest kui ka naistest kampaaniate korraldamiseks. on 1 500teatanud, et nad puutuvad tööl kokku selliste 1 000 keemiliste toodete või ainetega, mis võivad317 Eesti saaks ära hoida suure hulga 500 123 põhjustada 0 vähktõbe. Eestis puudub tööst vähijuhtumeid, võttes otsustavaid meetmeid tingitud vähisurmade Õhusaasteregistreerimise süsteem,Rasvumine riskide vähendamiseks Alkohol Tubakas kuid hinnangute kohaselt võib kuni 11 % OECD rahvatervise strateegilise planeerimise aastatel 2016–2020 diagnoositud vähijuhtudest, modelleerimise (SPHeP) andmed, võttes arvesse millest suurima osa moodustasid kopsuvähk ja praegust vähihaigestumust, osutavad sellele, mittemelanoomne nahavähk, seostada tööalase et Eesti igal saaks igal aastal ära hoida hulga kokkupuutega. Riskiteguritega seotud2020. aastal eesmärkide täiendati saavutamisega Eesti2023–2050 ära hoitavate aastatel vähijuhtumite arv vähijuhtumeid, kui oleksid täidetud riskitegurite töökeskkonnas 4 500 esinevate keemiliste ohtude loetelu, 3 980 levimusega seotud eesmärgid. Näiteks tubakaga 4 000 lisades 3 500 sellesse vähki tekitavad ained. seotud eesmärkide saavutamisega oleks 3 000 2 500 võimalik hoida 2 007 aastatel 2023–2050 ära peaaegu Eesmärkide saavutamiseks tuleb suurendada 2 000 4000 vähijuhtumit ning alkoholitarbimise inimeste 1 500 papilloomiviiruse ja B-hepatiidi vastu vähendamisega rohkem kui 2000 vähijuhtumit 1 000 317 vaktsineerituse 500 taset 123 (Joonis 9). 0 Selleks et kaotada kooskõlas WHO ülemaailmse Õhusaaste Rasvumine Alkohol Tubakas strateegiaga 2040. aastaks emakakaelavähk, Joonis 9. Aastatel 2023–2050 oleks võimalik ära hoida tuhandeid vähijuhtumeid, võttes otsustavaid meetmeid tubaka ja alkoholiga seotud eesmärkide saavutamiseks Riskiteguritega seotud eesmärkide saavutamisega aastatel 2023–2050 ära hoitavate vähijuhtumite arv 4 500 3 980 4 000 3 500 3 000 2 500 2 007 2 000 1 500 1 000 500 317 123 0 Õhusaaste Rasvumine Alkohol Tubakas 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 cancer cases over 2023-2050, by achieving risk factors taget reduction 12 | EESTI | Riigi vähiprofiil 2025 Sellel on ka mitmesugune positiivne kõrvalmõju: edendamisega, mis suurendab kontrolli oma | vähenevad muud kroonilised haigused ja koormus tervise üle. Eestil puudub riiklik strateegia | tervishoiusüsteemile, sealhulgas tööjõupuudus terviseteadlikkuse suurendamiseks elanike seas või EESTI (vt punkt 5.1). Kõikide riskitegurite lõikes saab organisatsioonides. terviseseisundit parandada ka terviseteadlikkuse | | 2025 4. Varajane avastamine Eesti vähi sõeluuringu programmides tervishoiuteenused olid piiratud. Selle tõttu osalusmäär oli 2023. aastal kõigi aegade olid vähenenud sõeluuringute käigus avastatud kõrgeim juhtumite arv ja tervisekontrolli käigus juhuslikult Eesti on otsinud viise vähi sõeluuringu avastatud kergete sümptomitega juhtumite programmides osalemise suurendamiseks, töötades arv (Zimmermann et al., 2024). Oluline areng selle nimel, et parandada nende programmide toimus 2021. aastal, kui programmiga hõlmati kättesaadavust ja teadlikkust neist programmidest. kindlustamata inimesed, kelle sõeluuringut hakkas Joonisel 10 on näidatud sõeluuringutes rahastama Eesti Haigekassa (Tervisekassa varasem osalusmäära muutumine Eestis ning toimunud nimi); varem oli neil tulnud tasuda sõeluuringu või kavandatud olulised muudatused. 2023. aasta eest ise. Aastatel 2022–2023 suurenes põgenike paistis silma sellega, et kõigis kolmes rahvasti- ja pagulaste seas 20 % rinna- ja kolorektaalvähi kupõhises sõeluuringuprogrammis osalusmäär sõeluuringu eesmärgil tehtud arstivisiitide arv oli läbi aegade kõrgeim (üle 60 %). Sellele oli ning 12 % emakakaelavähi sõeluuringu eesmärgil eelnenud COVID-19 pandeemia, mille ajal riiklikud tehtud arstivisiitide arv, mille peamine põhjus oli sõeluuringuprogrammid ajutiselt peatati ja paljud põgenike suur sissevool Ukrainast (Tervisekassa, 2023). Joonis 10. Osalusmäär rinna, emakakaela ja kolorektaalvähi sõeluuringuprogrammides on oluliselt suurenenud alates 2020. aastast % sihtrühma kuulunud elanikest, kes osales sõeluuringus 2009: mobiilsete üksuste COVID-19 70 (mammograafiabusside) kasutuselevõtt 60 2003: rinnavähi sõeluuringu programm 50–62aastastele 50 naistele 2022–2024: HPV kodutesti katsetamine ja kasutuselevõtt emakakaela sõeluuringu puhul 40 2024: peaaegu kõik rinnavähi sõeluuringu korraldajad 2021: kindlustamata võimaldavad broneerida aja 30 veebis 2016: kolorektaalvähi inimeste tasuta kaasamine 2006: emakakaelavähi sõeluuringu programm 60– kõikidesse sõeluuringu- sõeluuringu programm 30– 68aastastele elanikele programmidesse 2024–25: 1) rinnavähi 20 55aastastele naistele sõeluuringu sihtrühma 2024: peaaegu kõik rinnavähi 2021: 1) emakakaelavähi vanusepiiri tõstmine 50.– sõeluuringu korraldajad sõeluuringu sihtrühma 74. eluaastale, 2) personaalsel vanusepiiri tõstmine 30.– riskihinnangul põhineva 10 võimaldavad broneerida aja veebis 65. eluaastale, 2) PAP-testi rinnavähi sõeluuringu asendamine HPV-testiga programmi katsetamine 0 Rinnavähk Emakakaelavähk Kolorektaalvähk 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). Riigi vähiprofiil 2025 | EESTI | 13  Vähi sõeluuringute register areneb, mil see määr oli 37 %. Vähitõrje tegevuskava võimaldades paremini toetada sõeluuringute 2021–2030 üks põhieesmärke on siiski saavutada | korraldamist kõigis rühmades 70 % osalusmäär (sotsiaalmin- EESTI | | 2 0 2 5 Vähi sõeluuringute juhtrühm, mida juhib isteerium ja Tervise Arengu Instituut, 2021). sotsiaalministeerium, hõlmab peamisi 2023. aastal saavutati see eesmärk rinnavähi sidusrühmi ja patsientide organisatsioone ning puhul 15 Eesti maakonnast neljas, kusjuures kahes hindab olemasolevaid ja algatab uusi sõeluurin- maakonnas jäi puudu vähem kui 1 protsendipunkt. guprogramme. Tervisekassa korraldab ulatuslikke Kõik kuus maakonda asuvad eemal suurematest teadlikkuse suurendamise kampaaniaid ning linnadest, mis näitab, et rinnavähi sõeluuring on Tervise Arengu Instituut haldab vähi sõeluuringute maaelanikele kättesaadav. Ida-Viru maakonnas | registrit, mis hõlmab nii rahvastikupõhiseid oli osalusmäär siiski oluliselt väiksem, jäädes alla kui ka oportunistlikke sõeluuringuid, ning 60 % (Joonis 11), mis võib olla tingitud väiksemast rakendab juurdepääsu- ja kvaliteedimõõtmeid teadlikkusest, keelebarjäärist või kättesaadavusest kvaliteedi parandamiseks. Tervisekassa (ERR, 2024). Ilmselt jääb eesmärk saavutamata ka avaldab kindlustusnõuete andmetele tuginedes madalama haridustasemega inimeste puhul, kes interaktiivse platvormi kaudu reaalajas kolme teatavad pidevalt väiksema tõenäosusega, et nad programmi andmed, sealhulgas tuvastatud on teinud mammogrammi. juhtumid ning osalusmäärad tervishoiuasutuste, Eestis rakendatakse mitmeid meetmeid, asukohtade ja vanuserühmade kaupa. et parandada juurdepääsu sõeluuringule. Vähi sõeluuringute register saab rahvasti- 2024. aastast alates on kõik rinnavähi sõeluuringu kuregistrist esialgse sihtrühma kohordi, mis korraldajad pakkunud võimalust broneerida põhineb konkreetsetel sünniaastatel ja sool. aeg veebis, 2023. aastal oli see võimalik vaid Register sisaldab elanike kontaktandmeid ühes haiglas. Juurdepääsu parandamiseks ja on seotud elektrooniliste terviselugudega maapiirkondades sõidavad kogu aasta mööda (Terviseportaal). Eesti digitaliseeritud Eestit ringi kolm mammograafiabussi, et muuta tervise infosüsteem võimaldab kõrvale jätta sõeluuring kättesaadavamaks kohtades, kuis need inimesed, kellel on teatava aja jooksul naised elavad ja töötavad. See algatus on hästi diagnoositud pahaloomuline kasvaja või kes vastu võetud ja elanike nõudmisel külastavad on hiljuti asjaomases sõeluuringus osalenud. bussid samu paiku rohkem kui kord aastas, mis Vähi sõeluuringute register saadab sihtrühma aitab saavutada maapiirkondades kõrgemaid kuuluvatele elanikele posti ja e-posti teel ning osalusmäärasid (ERR, 2024). 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, 14 | EESTI | Riigi vähiprofiil 2025 Joonis 11. Kättesaadavuse parandamine Eestis on võimaldanud mitmel suurematest linnadest eemal | asuval maakonnal saavutada rinnavähi sõeluuringu osalusmääraks 70 % | EESTI Osalusmäär 74.1 % | 62.6 % 68.0 % 58.0 % | 2025 68.8 % 67.4 % 69.7 % 71.2 % 58.0 % 72.5 % 67.1 % 74.1 % 65.3 % 68.3 % 70.5 % 64.2 % 69.3 % 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 10 protsendipunkti (Tervise Arengu Instituut, Eesti välja täiustatud programmi, kus kasutatakse 2024a). geneetilistel andmetel põhinevaid personaalseid Osalusmäära suurendamiseks katsetati riskiskoore, mis on olemas viiendiku Eesti 2022. aastal HPV kodutesti ning 2023. aasta teises elanikkonna kohta. Programm on suunatud neile pooles võeti see kasutusele naiste puhul, kes 40aastastele naistele, kes annavad oma nõusoleku ei olnud end veel kontrollida lasknud, millega personaalse rinnavähiriski hinnangu koostamiseks kaasnes oluline ajakokkuhoid ja suurenes geneetilise teabe põhjal. Naised, kelle risk leitakse privaatsus kasutajate vaatenurgast. 2023. aastal olevat suurem, kutsutakse iga kahe aasta tagant otsustas kodutesti kasuks enam kui 10 % sõeluuringule alates 40. eluaastast, ülejäänud sõeluuringus osalejatest, sealhulgas – mis on lisatakse tavapärasesse sõeluuringuprogrammi oluline – 14 % osalejatest Ida-Viru maakonnas. alates 50. eluaastast. 2023. aastal pakkusid koduteste täiendavad Eesti on võtnud eesmärgi kaotada 89 apteeki väiksema osalusmääraga maakondades. 2022. aastal tehtud analüüs näitas, et haigestumus 2040. aastaks emakakaelavähk, kasutades emakakaelavähki on Eestis alates 2014. aastast osalusmäära suurendamiseks inimeste vähenenud ning et märkimisväärset vähenemist papiloomviiruse koduteste mõnes vanuserühmas võib seostada sõeluurin- Emakakaelavähi sõeluuringu programmi raames guprogrammi positiivse mõjuga (Zimmermann et kutsutakse 30–65aastaseid naisi osalema uuringus al., 2024). iga viie aasta tagant. 2021. aastal võeti PAP-testi asemel kasutusele HPV-test (vt joonis 10). Uuenduslike sõeluuringulahenduste 2023. aastal oli sõeluuringus osalusmäär riigis rakendamiseks osaleb Tartu Ülikool ühisprojektis, 64 %, võrreldes 45 %ga 2020. aastal ja 30 %ga mille eesmärk on integreerida teaduslikud 2006. aastal, mil selle programmiga alustati. teadmised rahvastikupõhiste terviseregistrite, See märkimisväärne edasiminek ei kajasta tervishoiuteenuste, uuringute ja Eesti geenipanga erinevusi riigi sees: osalusmäärad ulatusid 49 %st andmetega, et töötada välja ja valideerida Ida-Viru maakonnas 71 %ni Saare maakonnas. tehisintellekti tehnoloogia, mis modelleerib Tuleb siiski märkida, et pärast mitut sihipärast emakakaelavähi sõeluuringu raames patsientide sekkumist on osalusmäär Ida-Viru maakonnas tulemusi ja hindab vähiriske riskipõhiseks alates 2021. aastast kasvanud rohkem kui lähenemiseks sõeluuringule. Riigi vähiprofiil 2025 | EESTI | 15  LGBTIQ-inimesed osalevad Eestis rinnavähi Osalusmäär ulatus 51 %st Ida-Viru maakonnas sõeluuringus vähem kui ELis 74 %ni Võru maakonnas (Tervise Arengu Instituut, | 2024a). Programmi üks suur puudus on sihtrühma EESTI | | 2 0 2 5 ELi kolmanda LGBTIQ kogukonda käsitleva uuringu andmete kohaselt teatas Eestis 18 % sellesse kitsas vanusevahemik – hõlmatud on vaid osa kogukonda kuuluvatest cis-soolistest naistest, 50–74aastaste vanuserühmast, mida on soovitatud transsoolistest naistest ja intersoolistest inimestest kolorektaalvähi sõeluuringu programmide puhul vanuses 40–54, et neile on viimase 12 kuu nõukogu 2022. aasta ajakohastatud soovituses vähi jooksul tehtud mammogramm, mis on vähem sõeluuringute kohta. Ehkki vähi sõeluuringute kui ELi keskmine 28 % (Joonis 12). Mis puudutab juhtrühmas on arutatud selle vanusevahemiku emakakaelavähi sõeluuringut, siis sellest, et nad laiendamise üle, on kahtlusi, kas Eesti suudab | on andnud viimase viie aasta jooksul emakakaela täita nõuet, et kõigile, kes saavad positiivse proovi, teatas Eestis 70 % LGBTIQ-inimestest tulemuse, peavad olema kiiresti kättesaadavad vanuses 25–39 (rohkem kui ELi 64 %) ja 83 % endoskoopilised või radioloogilised uuringud. LGBTIQ-inimestest vanuses 40–55 (rohkem kui ELi Töötatakse välja sõeluuringuprogramme 74 %). kopsuvähi ja eesnäärmevähi jaoks 2021. aastal tehtud teostatavusuuringu järel Joonis 12. LGBTIQ kogukonnas on emakakaela laiendati 2022. ja 2023. aastal kopsuvähi prooviga hõlmatus Eestis kõrgem kui ELis sõeluuringu katseprogrammi, et hõlmata % LGBTIQ-inimestest, kes on osalenud rinna- või emakakaelavähi sõeluuringus enamik Tartu maakonna perearstikabinette. 100 % Tartu maakonna perearstid ja -õed esitasid 55–74aastastele inimestele küsimusi suitsetamise 80 % ja kopsuvähi esinemise kohta perekonnas ning 83 % suunasid suure riskiga patsiendid väikesedoosilise 74 % 70 % kompuutertomograafia uuringule, et teha kindlaks 60 % 64 % võimalik kopsuvähk. Tänu esmatasandil toimunud süstemaatilisele osalejate otsimisele oli sihtrühma 40 % kuulunud inimeste osalusmäär 87 %, mis näitab, et see lähenemisviis võib olla tõhus (OECD, 2024a). 20 % 28 % 2024. aastal jätkus programm Tartu maakonnas, 18 % kuid arutatakse ka laienemist Ida-Viru maakonda. 0% Eesmärk on käivitada 2027. aastaks riiklik rahvasti- 40-54 aastad 25-39 aastad 40-55 aastad kupõhine sõeluuringuprogramm, mida rahastab Mammogramm Emakakaela proov Tervisekassa. viimase 12 kuu viimase 5 aasta jooksul jooksul Käimas on eesnäärmevähi sõeluuringu teostata- Eesti EL27 vusuuring. 2024. aasta aprillis alustas Tervise Märkus. LGBTIQ kogukonda käsitleva uuringu tulemused viitavad Arengu Instituut kutsete saatmist enam vanuserühmadele ja/või sõeluuringute intervallidele, mis ei ole kui 13 000-le Tallinnas või Tartus elavale kooskõlas ELi riikides rahvastikupõhiste sõeluuringute tegemisel rakendatava lähenemisviisiga, mistõttu ei tohiks neid võrrelda. 50–69aastasele mehele, kes ei ole teinud viimase Allikas: Euroopa Liidu Põhiõiguste Amet (ELi kolmas LGBTIQ 12 kuu jooksul prostataspetsiifilise antigeeni (PSA) kogukonda käsitlev uuring). testi ja kellel ei ole kunagi olnud eesnäärmevähki. Kõrge PSA tasemega mehed suunatakse uroloogi Kolorektaalvähi sõeluuringu programmi juurde, kes küsitleb patsienti, hindab riske ja laiendamisel on probleemiks diagnostiliste saadab kõrge riskiga isikud magnetresonant- uuringute kättesaadavus stomograafia (MRI) uuringule. See programm on oluline areng, kuna eesnäärmevähk on Eesti Kolorektaalvähi sõeluuringu programm loodi meestel enim diagnoositud vähivorm ja Eesti on 2016. aastal ja see on suunatud 60–68aastastele eesnäärmevähi suremuse poolest ELi riikide seas elanikele, keda kutsutakse iga kahe aasta tagant kolmandal kohal. 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 %. 16 | EESTI | Riigi vähiprofiil 2025 5. Vähiravi toimivus | | EESTI | 5.1. Kättesaadavus ravimite puhul väiksena. Ravimite puhul, millega | 2025 ravitakse raskeid, eluohtlikke või valutekitavaid Eesti tervishoiusüsteemis on probleemiks haigusi, nagu vähktõbi, tasuvad patsiendid 2,5 euro suuruse fikseeritud omaosaluse, mitte pikad ooteajad; vähitõrje tegevuskavas on teatud protsendi ravimi hinnast. Kui aasta kavandatud eesmärkide süstemaatiline jooksul makstud omaosaluse kogusumma jälgimine ületab 100 eurot, on võimalik saada lisahüvitist. Eesti oli 2023. aastal ELis riik, kus rahuldamata Omaosaluse arvutamine ja arvestamine toimub vajadusest arstiabi järele teatas suurim osa ostu hetkel automaatselt, kasutades ulatuslikku elanikkonnast – 13 % võrreldes ELi keskmise tervisesüsteemi digitaristut. Sotsiaalkindlustus 2 %ga –, ehkki see osakaal on viimastel aastatel on seotud Eestis tööalase staatusega (kuid hõlmab kahanenud. Linnapiirkondades elavad inimesed lapsi ja pensionäre). Sellega seoses oli 2022. aastal teatasid pidevalt suuremast rahuldamata 5 % Eesti elanikest kindlustamata (Tervise Arengu vajadusest eriarstiabi järele kui maapiirkondades Instituut, 2023a). Kuigi patsiendid on pärast elavad inimesed. Kui kuludel ja arstiabi kaugusel vähidiagnoosi saamist kindlustatud invaliidsu- oli väike roll, siis enam kui 90 % rahuldamata shüvitiste kaudu, võib muret tekitavate sümptomite vajadusest teatanud inimestest nimetas peamise esinemise korral arstivisiit kindlustuskatte põhjusena ooteaegu (Riigikontroll, 2022). puudumise tõttu viibida. Kuigi 2011. aastal seati vähiravi ooteajaga seoses eesmärk alustada kiiritusravi 28 päeva jooksul Eesti on suurendanud vastuvõttu alates vähi diagnoosimisest, ei ole ooteaegu meditsiiniõppesse, et tegeleda olulise veel süstemaatiliselt analüüsitud. Vähitõrje tööjõupuuduse probleemiga tegevuskavas 2021–2030 on kindlaks määratud Eesti tervishoiusüsteemi murekohana on pidevalt maksimaalsed ooteajad raviprotsessi eri osades esile tõstetud tervishoiutöötajate nappust. alates esma- ja teise tasandi arstiabist kuni 2021. aastal oli Eestis 100 000 elaniku kohta vähikeskuseni ja ravi alustamiseni (sotsiaalmin- 347 arsti, mis jääb 17 % alla ELi keskmise. Võttes isteerium ja Tervise Arengu Instituut, 2021). arvesse vähktõve esinemissagedust, on Eestis Andmetaristus esinevate lünkade tõttu ei ole arste 1000 uue vähijuhtumi kohta 13 % vähem kui keskmist ooteaega võimalik arvutada, kuid selle ELis keskmiselt (Joonis 13). Peale selle arstkond võimaldamiseks on käimas tervise infosüsteemi vananeb ning peremeditsiini ja psühhiaatria läbivaatamine. valdkonnas, eriti väljaspool suuremaid linnu, valitseb arstide nappus, mis võib põhjustada Eesti otsib digitaalseid lahendusi, et kiirendada lünki ravi integreerimisel ning vähipatsientidele diagnoosi- ja raviotsuste tegemist. Nende ja vähktõvest jagusaanutele pakutava toe hulka kuuluvad perearstide ja spetsialistide kättesaadavuses. vahelised e-konsultatsioonid diagnoosimisel ning veebikonsultatsioonid patsientidele, mis 2023. aastal oli riigis 56 onkoloogi ehk neli moodustasid 2021. aastal üle 40 % arstide ja õdede onkoloogi 100 000 elaniku kohta, kuigi täistööajale töökoormusest (Tervise Arengu Instituut, 2023a). taandatud töötajate arv oli väiksem. Radiolooge Lisaks aitaks riiklik veebipõhine broneerimisteenus oli 100 000 elaniku kohta 15 ja see arv ei ole valitsusel jälgida, millistel tervishoiuteenustel vaatamata suurenenud nõudlusele 2013. aastaga on pikemad ootenimekirjad, ja analüüsida selle võrreldes eriti muutunud. Radioloogide nappust on põhjuseid. nimetatud ka takistusena kopsuvähi sõeluuringu programmi laiendamisel (vt punkt 4), eriti kuna Hoolimata sellest, et rahalised takistused uuenduslikke lahendusi, nagu tehisintellekti vähiravi pakkumisel on väikesed, kasutamine analüüsimisel, peetakse täiendavateks võivad erinevused tööealiste inimeste lahendusteks, mis ei asenda spetsialiste (Alloja et kindlustuskattes põhjustada viivitusi al., 2023). diagnoosimisel Rahaliste vahendite piiratus ei tekita Eestis olulisi takistusi juurdepääsul vähiravile. Kohaldatakse omaosalust, kuid seda hoitakse nii ravi kui ka Riigi vähiprofiil 2025 | EESTI | 17  Joonis 13. Eestis on uute vähijuhtumite arvu arvesse võttes vähem õdesid ja arste kui ELis keskmiselt | Õdede arv 1 000 uue vähijuhtumi kohta 3 500 EESTI | | 2 0 2 5 Arste vähe IS Arste palju Õdesid palju Õdesid palju 3 000 IE 2 500 LU FI NO AT | 2 000 BE DE SE NL SI CZ 1 500 RO MT FR DK EL27 LT ELi keskmine: 1 376 EE PT PL SK ES 1 000 CY HR IT BG HU LV EL 500 Arste vähe Arste palju Õdesid vähe ELi keskmine: 679 Õdesid vähe 0 450 550 650 750 850 950 1 050 1 150 1 250 Arstide arv 1 000 uue vähijuhtumi kohta Märkused. Andmed õdede kohta hõlmavad kõiki õdede kategooriaid (mitte üksnes neid, mis vastavad ELi kutsekvalifikatsioonide Supply of nurses and physicians tunnustamise per new direktiivile). Andmed cancer cases on praktiseerivate 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 Varasema diagnoosimise saavutamiseks on 658 õde , mida on 22 % vähem kui ELis keskmiselt. vaja pöörata suuremat tähelepanu tervisetead- See teeb 1121 õde 1000 vähijuhtumi kohta, mis jääb likkusele ja diagnostiliste uuringute kättesaa- 19 % alla ELi keskmise. Õdede arv 100 000 elaniku davusele kohta on suurenenud alates 2013. aastast peaaegu 2021. aastal diagnoositi Eestis üle poole 100 võrra. 2023. aastal töötas onkoloogiakliinikutes vähijuhtudest 70aastastel ja vanematel inimestel, kokku 177 õde (12,9 õde 100 000 elaniku kohta) kusjuures peaaegu veerand rinnavähi juhtudest (Tervise Arengu Instituut, 2024a). diagnoositi 75aastastel ja vanematel, mis osutab Kõnealuse nappuse leevendamiseks suurendas vajadusele teha vanuseliselt piiratud sõeluurin- Eesti 2023. aastal kuuendiku võrra (700ni) õenduse guprogrammidele lisaks jõupingutusi varajase õppekohtade miinimumarvu, kuigi kulub aastaid, diagnoosimise vallas (Tervise Arengu Instituut, et see kajastuks suuremas tööjõus (Tervise Arengu 2024a). Vähitõrje tegevuskavas 2021–2030 Instituut, 2023a). Eestis on kasutatud mõningal on seatud eesmärk suurendada elanikkonna määral ka võimalust jagada ümber tööülesanded, teadlikkust vähisümptomitest, parandades seeläbi et laiendada õdede rolli, kuna pereõed on õigeaegset jõudmist perearsti juurde, kes suunab sageli esimene kontaktpunkt esmatasandi ligipääsu tervishoiusüsteemile, ning seejärel tervishoius, ning eriõdede (magistrikraadile õigeaegset vähktõve diagnoosimist ja staadiumi vastava kvalifikatsiooniga) teenust on hakatud määramist. Selleks töötatakse välja standardsed rahastama eraldi teenusena kõigil ravitasanditel. patsienditeekonnad alates esmasest pöördumisest Õdede onkoloogiaalane eriväljaõpe toimub siiski kuni ravi alustamiseni (sotsiaalministeerium ja peamiselt töökohal, mis tähendab võimalikku Tervise Arengu Instituut, 2021). lünka koolituskavas võrreldes mõne teise Euroopa 2021. aastal diagnoositi umbes pooltel riigiga. Eesti Onkoloogiaõdede Ühing, mis on Eesti vähipatsientidel lokaalne kasvaja enne selle Õdede Liidu allorganisatsioon, määrab kindlaks levimist külgnevatesse kudedesse; viiendikul koolitusprogrammide eesmärgid ja sisu ning annab meestest ja enam kui kuuendikul naistest olid soovitusi õdede heaolu ning patsientide ja nende siiski diagnoosimise ajal juba kaugmetastaasid. hooldajate ohutuse parandamiseks (sotsiaalmin- Eriti valmistab muret kõhunäärmevähk, isteerium ja Tervise Arengu Instituut, 2021). mille puhul olid metastaasid ligikaudu pooltel 18 | EESTI | Riigi vähiprofiil 2025 # Restricted Use - À usage restreint  patsientidel. Sapipõievähi, söögitoruvähi või Pikk aeg, mis kulub ravimi hüvitatavate | maksavähiga naiste ning kopsuvähiga meeste seas ravimite loetellu kandmiseks, võib takistada | oli kaugemetastaasidega juhtumite osakaal üle juurdepääsu uutele ravimitele EESTI 40 % (Zimmermann et al., 2024). Eestis on nimetatud probleemina juurdepääsu 2022. aastal oli Eestis pildidiagnostikaseadmeid uutele ravimitele, kuna paljudest uuetest elaniku kohta vähem kui ELis keskmiselt ning ravimitest, mis on mujal Euroopas kättesaadavad, | 100 000 elaniku kohta tehti vähem kompuuter- saavad Eestis riiklikult hüvitatavad ravimid | 2025 tomograafia (3 % vähem), magnetresonantsto- alles palju hiljem. Seda seostatakse sellega, et mograafia (33 % vähem) ja positronemissioon- väikeses riigis kulub taotluste läbivaatamiseks tomograafia uuringuid (58 % vähem). Selleks et ja hinnaläbirääkimisteks rohkem aega. Uute parandada juurdepääsu diagnoosimisele, eelkõige ravimite heakskiitmisest Euroopa Ravimiametis piirkondades, mis asuvad suurematest haiglatest (EMA) kuni hüvitamiseni Eestis kulus 559 päeva, kaugemal, ostab Eesti Vähiliit mobiilse kompuuter- mida on rohkem kui ELi keskmine 516 päeva. Riik tomograafia skänneri, kasutades heategevu- hüvitab või katab valitud kliiniliselt tõhusatest sorganisatsioonidelt saadud rahalisi vahendeid uuematest vähiravimitest 46 %, mida on vähem (Heinsalu, 2024). See toetab ka kopsuvähi kui keskmiselt ELis (59 %) ja sarnase ostujõuga sõeluuringu programmi laiendamist, tagades riikides (54 %) (Joonis 14). Mõnel juhul kasutatakse juurdepääsu diagnostilistele uuringutele, eelkõige Eestis müügiloata ravimite ja ettenähtust maapiirkondades (vt punkt 4). 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 100,0 64,6 67,1 59,1 53,8 46,2 % valitud uutest vähiravimitest, mis hüvitatakse % vähiraviks kasutatavatest biosimilaridest, mis hüvitatakse Eesti EL22 Sarnase ostujõuga riigid 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, 100,0 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. 67,1 64,6 59,1 53,8 46,2 Samal ajal hüvitati Eestis kõik valimisse valitud Juurdepääs kliinilistele uuringutele on Eestis kolme vähiravimi 19 biosimilari, millel oli kehtiv keskmiselt väiksem kui teistes riikides, mis võib Euroopa Ravimiameti müügiluba, võrreldes olla tingitud sellest, et paberimajanduse, eetiliste keskmiselt 67 %ga % valitud sarnase uutest ostujõuga vähiravimitest, riikides. mis hüvitatakse aspektide % vähiravikshindamise kasutatavatest jabiosimilaridest, kohalikku keelde tõlkimise mis hüvitatakse Selle põhjuseks on asjaolu, et biosimilareEesti ei EL22 Sarnase kulud onostujõuga riigid riikides suuremad. Olukorra väikestes hüvitata mitte kaubamärgi, vaid toimeaine alusel; parandamiseks luuakse riiklik vähikeskus, kaubamärgi valik sõltub hanke tulemustest. mis tõhustab teadus- ja arendustegevust, 13: Access to new oncology medicines & biosimilars hõlbustab kõigi sidusrühmade koostööd ning hakkab tegutsema rahvusvaheliste kliiniliste ja Riigi vähiprofiil 2025 | EESTI | 19  teadusuuringute keskusena, et saada Euroopa Rinnavähi diagnoosiga naiste seas korraldatud Liidu kõikehõlmava vähikeskuse akrediteering uuring näitas, et kiiritusravi saamine 12 kuu | (sotsiaalministeerium, 2023). jooksul pärast esmast operatsiooni oli sagedasem EESTI | | 2 0 2 5 kõrgema haridustasemega naiste ja abielus naiste Seadmeid 1 000 000 elaniku kohta Eesti hindab kiiritusravi optimaalseks seas, kuid ei sõltunud geograafilisest elukohast. 16 kasutamiseks vajadusi, et tagada piisavate Uuring näitas ka seda, et kiiritusravi kasutamine 14 seadmete kättesaadavus on aja jooksul märkimisväärselt kasvanud: 39 %-lt 12 2023. aastal oli Eestis seitse kiiritusraviseadet, mis aastatel 2007–2009 diagnoosi saanud patsientidest 10 tähendab, et varustatus inimese kohta on 35 % 58 %-le aastatel 2016–2018 diagnoosi saanutest, 8 väiksem kui ELi keskmine (Joonis 15). 2024. aastaks mis on kooskõlas kättesaadavate seadmete arvu | 6 suurenemisega (Shahrabi Farahani, Paapsi & Innos, oli Eesti ostnud seadmeid juurde, lähenedes sellega ELi 4keskmisele. Kõik seadmed on suhteliselt uued, 2021). Käimas on analüüs, et hinnata kiiritusravi vaid2 kaks on vanemad kui 15 aastat. Probleemiks praegust kasutamist eri vähipaikmete puhul, võib0 olla geograafiline ligipääsetavus, sest võttes arvesse rahvusvahelisi soovitusi optimaalse kiiritusravi pakutakse ainult Tallinna ja Tartu kasutamise kohta. Selle raames hinnatakse vähikeskuses ning sageli peab patsient viibima vajadust kiiritusravi järele kuni aastani 2040 ning seal kaua, et saada mitu päeva järjest väikeseid praegust ja tulevast vajadust seadmete ja tööjõu 2023 (või lähim aasta) 2013 (või lähim aasta) annuseid. järele. Joonis 15. Eestis on vähem kiiritusraviseadmeid kui ELis keskmiselt Seadmeid 1 000 000 elaniku kohta 16 14 12 10 8 6 4 2 0 2023 (või lähim aasta) 2013 (või lähim aasta) 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. 12: Volume of radiation therapy equipment 5.2. Kvaliteet Eesti eesmärk on jõuda elulemuse näitajateni, mis on lähedal Põhjamaade näitajatele. Mõne Elulemus on mitme vähivormi puhul Eestis vähipaikme puhul on see juba saavutatud, kuid teiste, sealhulgas mitte-Hodgkini lümfoomi ning paranenud pea- ja kaelavähi puhul, on veel puudujääke. Ehkki Vähipatsientide elulemus on üks peamisi Eesti enamiku vähipaikmete puhul oli elulemus naiste vähitõrje tegevuskava 2021–2030 tulemusnäitajaid, seas suurem kui meeste seas, on mõne puhul kuna see võimaldab terviklikult hinnata (kõhunäärme-, mao-, käärsoole- ja neeruvähk) vähitõrjemeetmeid, hõlmates nii varajast erinevus vähenenud, mis on üks vähitõrje diagnoosimist kui ka vähiravi tõhusust. Aastatel tegevuskava 2021–2030 eesmärke (Zimmermann et 2017–2021 oli kõigi Eestis diagnoositud vähijuhtude al., 2024). (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). # Restricted Use - À usage restre 20 | EESTI | Riigi vähiprofiil 2025  Joonis 16. Viie aasta elulemus paranes Kõige rohkem potentsiaalseid eluaastaid | 2017.–2021. aastal diagnoositud vähijuhtude kaotati Eestis kopsuvähi tõttu | puhul 2007.–2011. aastal diagnoositud EESTI Lisaks elulemusandmetele on näitaja, mis vähijuhtudega võrreldes 4 protsendipunkti võimaldab mõõta erinevate vähivormide mõju Kõik vähipaikmed ühiskonnale, kaotatud potentsiaalsed eluaastad, (v.a mittemelanoomne nahavähk) sest see suurendab nooremate inimeste seas | esinevate vähisurmade kaalu. Aja jooksul eri | 2025 Mittemelanoomne nahavähk vähipaikmete puhul toimunud muutused kaotatud Eesnäärmevähk (mehed) potentsiaalsete eluaastate arvus võivad osutada sellele, et vähiravisüsteem on tänu enneaegse Naha melanoom suremuse vähendamisele paranenud. Eesti Rinnavähk (naised) elanikud kaotasid 2022. aastal vähktõve tõttu Emakakehavähk (naised) 1283 potentsiaalset eluaastat 100 000 elaniku kohta, mida on 5 % vähem kui ELi keskmine ja 28 % Neeruvähk vähem kui 2012. aastal. See näitaja oli meeste seas Emakakaelavähk (naised) 58 % suurem kui naiste seas. 2022. aastal langes Pärasoolevähk kõige enam aastaid – 186 eluaastat 100 000 elaniku Käärsoolevähk kohta – kopsuvähi arvele, kuigi see näitaja oli vähenenud 2012. aastaga võrreldes 46 % (Joonis 17). Leukeemia Naiste seas kaotati rinnavähi tõttu 203 eluaastat Mitte-Hodgkini lümfoom 100 000 naise kohta. Kuigi enamiku vähivormide Suuõõne- ja neeluvähk puhul täheldati kahanemistrendi, suurenes kõhunäärmevähi tõttu kaotatud eluaastate arv Maovähk samal ajavahemikul 12 %. Kopsuvähk Kõhunäärmevähk 0% 20 % 40 % 60 % 80 % 100 % Viie aasta elulemus (%) 2007-11 2017-21 Allikas: Zimmermann et al. (2024). Joonis 17. Kaotatud potentsiaalsete eluaastate arv on enamiku peamiste vähipaikmete puhul vähenemas Muutus kaotatud potentsiaalsete eluaastate arvus (2012–2022 või lähim aasta) (%) 20 % Kõhunäärmevähk 10 % 0% -10 % Kolorektaalvähk -20 % Munasarjavähk Maovähk -30 % -40 % Rinnavähk Eesnäärmevähk -50 % Kopsuvähk -60 % 0 50 100 150 200 250 Kaotatud potentsiaalsete eluaastate arv 100 000 elaniku kohta 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 14: Potential aastal,of Years mille Lifekohta Lostandmed on kättesaadavad), per 100 000 population sinised ringid tähendavad vähenemist. Ringide suurus on võrdeline kaotatud potentsiaalsete eluaastate arvu suurusega 2022. aastal. Allikas: OECD 2024. aasta tervisestatistika. Riigi vähiprofiil 2025 | EESTI | 21  Kuigi inimesekesksust peetakse oluliseks, on ja tervishoiuteenuse osutaja vahel. Tervikliku vaja jõupingutusi suurendada patsienditeekonna tagamiseks on vähikeskustes | loodud õe-koordinaatori teenus, et patsiendil EESTI | | 2 0 2 5 Eestis minnakse vähiravis üle personali- seeritud, väärtuspõhisele ja patsiendikesksele oleks üks kontaktisik, kellele ta saab helistada lähenemisviisile, mille kohaselt peaksid olema kogu ravi vältel. Patsiendikesksust on kavas ravi ja selle talutavuse hindamise lahutamatu veelgi arendada, parandades patsienditeekonda osa patsiendi poolt teatatud ravitulemused. Eestis alates vähikahtlusest kuni ravijärgsesse perioodi, on vähikeskustes ellu viidud mitu asjakohast sealhulgas patsientide rahulolu mõõtmist eri katseprojekti ning selle lähenemisviisi rakendamist etappides. Mõningaid edusamme on juba tehtud: rinna- ja kopsuvähki põdevate patsientide puhul kopsuvähi diagnoosiga patsientide jaoks on välja | peetakse teostatavaks. Sellest hoolimata ei koguta töötatud spetsiifiline raviteekond ja patsientide patsientide teatatud ravitulemusi ja ravikogemusi organisatsioonid on kaasatud juhtorganite tsentraalselt riigi tasandil ning puudub üldine tegevusse, näiteks ravijuhiste väljatöötamisse. mudel nende ravitulemuste jälgimiseks – see Nähes võimalusi kasutada oma digitaliseeritud on vajakajäämine, mis püütakse vähitõrje tervishoiusüsteemi ja parandada geneetilise teabe tegevuskavaga 2021–2030 kaotada. kättesaadavust, et teha paremaid raviotsuseid, on Eesti alustanud jõupingutusi teatavate ravi Käivitatud on mitu inimesekesksust edendavat aspektide personaliseerimiseks, et suurendada algatust, nagu e-platvorm KAIKO, mille eesmärk tõhusust konkreetse patsiendi vaatenurgast on toetada patsienti kodus ning hõlbustada pidevat (tekstikast 2). suhtlemist ja sümptomitest teatamist patsiendi 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 Eesti parandab vähiravi seiret täiustatud läbi ravikorralduse digitaalse tervishoiutaristu kaudu Rakendades ulatuslikke tsentraliseerimis- Eestis on tehtud viimastel aastatel süstemaatiliselt meetmeid ja -kavu, korraldas Eesti ümber oma vähiravi tulemuslikkuse seiret ja auditeid. vähiravivõrgustiku – nüüd toimub täiskasvanute Tervisekassal on kvaliteedinäitajate nõuandekogu, vähiravi enamjaolt riigi põhja- ja lõunaosas et töötada välja tulemustele suunatud tervishoiu- asuvais kolmes vähikeskuses. Väiksemad haiglad teenused, kuid seire- ja infosüsteemides on pakuvad peamiselt süsteemset ravi vähikeskuste mitmeid vajakajäämisi. Vähitõrje tegevuskavas järelevalve all. Kavas on edasine tsentraliseerimine 2021–2030 tunnistatakse lünka juhiste järgimise ning arutatakse ideed jagada operatsioonid süstemaatilises järelevalves. Tänu digitaalsele vähipaikmete kaupa haiglate vahel ära, et tagada tervise infosüsteemile saavad Eesti arstid otsuste piisava oskusteabe kättesaadavus. tegemisel tõenduspõhist tuge, omades ligipääsu patsiendi terviseteabele, sealhulgas diagnoosidele 2021. aastal viibisid vähipatsiendid Eestis haiglas ning teabele ravimite, analüüside ja protseduuride keskmiselt 7,4 päeva, mida on rohkem kui ELi kohta. Raviotsuste tegemises osalevad Eestis keskmine 6,9 päeva. Kuna pikemat haiglaravi tavaliselt multidistsiplinaarses onkoloogilises seostatakse suuremate riskidega, on mitu konsiiliumis, keda rahastab Tervisekassa, kuigi Euroopa riiki, kus on olemas suutlikkus pakkuda praktika on konkreetsete juhiste puudumise tõttu operatsiooni läbinud patsientidele terviklikku erinev. 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 %. 22 | EESTI | Riigi vähiprofiil 2025 5.3. Kulud ja kulutõhusus kasvasid sõeluuringuprogrammide jaoks eraldatud | eelarvevahendid 2023. aastal rinnavähi puhul 5 %, | Vähktõve põhjustatud koormus tervishoiuku- emakakaelavähi puhul 13 % ja kolorektaalvähi EESTI puhul 19 % (Tervisekassa, 2023). lutustele on Eestis eeldatavasti väiksem kui ELis Ravimihindade tõusu tõttu on suurenenud Eesti tervishoiusüsteemi rahastab suures ravimihindade mõju eelarvele. Uuemate | osas Tervisekassa, mis korraldab tervishoiu- vähiravimitega seotud kulude piiramiseks | 2025 teenuste ostmist. Tegemist on poolautonoomse kohaldatakse umbes poolte ravimite hüvitamisel avalik-õigusliku organisatsiooniga, mis hangib piiranguid – ravim hüvitatakse väiksema arvu enamiku rahalistest vahenditest palgafondimaksu näidustuste puhul, kui on heaks kiitnud Euroopa kaudu, kuigi üha suurem roll on ka riigi tehtavatel Ravimiamet (OECD, 2024a). Ravimite hüvitamine ülekannetel. Eesti tervishoiukulutused osana on toimainepõhine, mis võimaldab haiglatel SKPst on ühed ELi väiksemad (2022. aastal 7 %). teha eelarvet mõjutavaid otsuseid ja osutab 2022. aastal hüvitas Tervisekassa 51 000 inimese sellele, et rõhku pannakse eelarve jätkusuut- vähiravi, eraldades operatsioonide, ravi ja ravimite likkusele. Hüvitamisotsustes järgib Tervisekassa jaoks üle 171 miljoni euro (sotsiaalministeerium, üldpõhimõtteid – näiteks peaks geneeriline ravim 2023). Tervisekassa 2023. aasta finantsaruande olema vähemalt 30 % ja biosimilar vähemalt 15 % kohaselt oli 15 % eriarstiabiga seotud odavam kui riiklikku retseptiravimite loetellu tervishoiukuludest seotud vähktõvega, mida on kantud originaalravim. rohkem kui 2022. aasta 14 % (Tervisekassa, 2023). 2023. aastal moodustasid kallite vähiravijuhtude Vähktõbi mõjutab laialdaselt Eesti tööturgu ja (maksumusega üle 104 000 euro) kulud 12 % kõigist majandust kallite ravijuhtude kuludest. Lisaks otsesele kahjule inimese tervisele, nagu haigestumise tagajärjed ja surm, ning vaimsele OECD rahvatervise strateegilise planeerimise ja psühholoogilisele kahjule, mida vähktõbi modelleerimise andmete kohaselt on põhjustab patsiendile ja tema lähedastele, kogukulutused tervishoiule aastatel 2023–2050 tekitab vähktõbi märkimisväärset kaudset vähktõvest tingitud koormuse tõttu Eestis koormust ühiskonnale laiemalt. See tuleneb hinnanguliselt 3,6 % suuremad. See teeb töölt kõrvalejäämise, absentismi ja presentismi6 aastas keskmiselt 37 eurot inimese kohta, suurenemisest, mille tulemuseks on mõju SKP-le ja mida on tunduvalt vähem kui EL 19 keskmine sissetulekute vähenemine, mis mõjutab inimeste (242 eurot). Tuleb siiski märkida, et Eesti praegust heaolu ja tervishoiuteenustesse investeerimiseks rahastamismudelit ei peeta jätkusuutlikuks ning kättesaadava raha kogust. OECD rahvatervise Eesti tervishoiusüsteemi peamised kapitaliinvest- strateegilise planeerimise modelleerimise andmete eeringud on tuginenud ELi struktuurifondidele. kohaselt on tööjõu kadu Eestis hinnanguliselt üks Arvestades suurenevat vähihaigestumust ja suuremaid ELis (Joonis 18). Aastatel 2023–2050 on -elulemust, on oodata, et rohkem inimesi vajab kadu, mis on tingitud vajadusest vähendada vähi tugiteenuseid pikemat aega, mis toob kaasa kulude tõttu töötamist, Eestis eeldatavasti keskmiselt kasvu. Prognooside kohaselt suurenevad vähiraviga 213 täistööajale taandatud töötajat 100 000 elaniku seotud tervishoiukulutused elaniku kohta Eestis kohta, mida on rohkem kui ELi keskmine 2023.–2050. aastal 61 %, võrreldes 59 %ga ELis. 178 täistööajale taandatud töötajat 100 000 elaniku kohta. Samuti on oodata, et absentismist Käivitatud on kulutõhususe algatused, ja presentismist tingitud kadu on Eestis keskendudes sõeluuringute ja ravimite 89 täistööajale taandatud töötajat 100 000 elaniku rahastamisele kohta, mida on rohkem kui ELi keskmine Eestis on kasutatud seni vähem meetmeid 81 täistööajale taandatud töötajat 100 000 elaniku vähiravi kulude piiramiseks, kuna pidevalt on kohta. 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. Riigi vähiprofiil 2025 | EESTI | 23  Tööhõive (töölt kõrvale jäämine ja osaline tööaeg) Absentism Presentism 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 EESTI | | 2 0 2 5 Vähist tingitud prognoositud kadu täistööajale taandatud töötajate arvuna 100 000 elaniku kohta (2023.–2050. aasta) 0 -100 -200 -300 | -400 Oodatava eluea vähistTööhõive tingitud (töölt kõrvale jäämine prognoositud ja osaline vähenemine tööaeg) aastates Absentism (2023.–2050. aasta keskmine) Presentism Märkus: 0 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. -0,5 5.4. -1 Heaolu ja elukvaliteet keskmisega (Joonis 19). Peale selle seostatakse vähktõbe oluliste vaimse ja füüsilise tervise 2020. aasta seisuga oli diagnoositud kunagi elu probleemidega, mis mõjutavad nii patsienti kui -1,5 ka tema lähedasi. Riiklike andmete põhjal oli jooksul vähk enam kui 5 %-l Eesti elanikest 2020. aasta seisuga saanud oma elus vähidiagnoosi OECD rahvatervise strateegilise planeerimise -2 üle 67 000 inimese (5 % Eesti elanikkonnast), mis modelleerimise andmete põhjal prognoositakse, tõstab esile tugiteenuste kättesaadavuse tähtsuse, et vähktõbi vähendab aasatel 2023–2050 et parandada elukvaliteeti ja aidata inimestel toime 15b: Impact -2,5 Eestis of cancer oodatavat on workforce eluiga võrreldes through vähivabaemployment (combining unemployment and part-time work), absenteeism and tulla vähktõve mõjuga. stsenaariumiga 1,9 aasta võrra, mis sarnaneb ELi Joonis 19. Vähktõve mõju elanike keskmisele oodatavale elueale aastatel 2023–2050 on Eestis lähedal ELi keskmisele Oodatava eluea vähist tingitud prognoositud vähenemine aastates (2023.–2050. aasta keskmine) 0 -0,5 -1 -1,5 -2 -2,5 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- of 16: Impact ja cancer rehabilitatsiooniteenused kannatavad on the average population Eestisinvanusestandarditud life expectancy depressioonijuhtumite years, average over 2023-2050 struktuuri puudumise tõttu arv 100 000 elaniku kohta vähktõve tõttu 23 võrra Avaldatud on kaks palliatiivse ravi juhendit, aastas, mida on märksa rohkem kui 17 juhtumit mis hõlmavad sümptomaatilist ravi, soovitusi 100 000 elaniku kohta ELis. Samal ajal on konkreetsete juhtude käsitlemiseks ning psühholoogilise toe kättesaadavust raskendanud interdistsiplinaarse ravi korraldamist, kaasates tööjõupuudus, sest kuigi psühholoogide ja vaimse tervise keskused ja eriväljaõppe saanud psühhoterapeutide arv suurenes 13-lt 100 000 spetsialistid. See on eriti oluline, võttes arvesse, elaniku kohta 2013. aastal 27-le 100 000 elaniku et eelduste kohaselt suureneb aastatel 2023–2050 kohta 2023. aastal, on nõudlus hooldusasutustes ja 24 | EESTI | Riigi vähiprofiil 2025 kogukonnas hüppeliselt kasvanud (Tervise Arengu ühineda ELi algatustega tervishoiu ja palliatiivse | Instituut, 2024a). ravi, sealhulgas pediaatrilise palliatiivse ravi | valdkonnas. Tuginedes sotsiaalministeeriumi EESTI Eestis ei toimu süstemaatilist suunamist tellitud aruandele (HAAP Consulting, 2023), onkoloogilise rehabilitatsiooniteenuse pakkuja kujundatakse ümber palliatiivse ravi võrgustik, et juurde eesmärgiga parandada vähipatsientide ja jõuda kõikides piirkondades paremini patsientideni, vähktõvest jagusaanute elukvaliteeti. Vaatamata | pöörates tähelepanu esmatasandi arstiabi rollile ja mitmes valdkonnas tehtud edusammudele, | 2025 mitteametlike hooldajate suuremale toetamisele. puuduvad vähipatsientide viljakuse säilitamisega Selles strateegias on kesksel kohal koduõendus, seotud meetmed ja vähktõvest jagusaanute mille eesmärk on vähendada haiglas viibimist, õigus olla unustatud ning Eestis ei ole vähktõvest pakkudes hooldust kodus. Lisaks on vähitõrje jagusaanute kliinikute organiseeritud võrgustikku. tegevuskavas seatud eesmärk tagada patsientidele Järelravi puhul sõltuvad patsiendid esmatasandi terviklik, kvaliteetne ja õigeaegne onkoloogilise tervishoiusüsteemist. rehabilitatsiooni teenus ning standardida selle teenusega seotud terminoloogia ning kodeerimis- Palliatiivse ravi kättesaadavus on piirkonniti ja hindamissüsteem. erinev Palliatiivne ravi, sealhulgas statsionaarne ja Palliatiivse ravi alast koolitust pakutakse ambulatoorne palliatiivne ravi ning elulõpuravi, tervishoiutöötajatele osana meditsiiniharidusest, kuulub Eestis Tervisekassa hüvitatavate teenuste samal ajal soovitatakse palliatiivse ravi juhendis hulka. Ambulatoorsete teenuste ja hooldekodude lisakoolitust, kuid see ei ole kohustuslik. Nõrgaks puhul kohaldatakse omaosalust ning kasutajad kohaks peetakse praktilise koolituse võimalusi. tasuvad osa ravikuludest, näiteks opioidide ja muu Palliatiivse ravi teenuste koolitusmudeli valuravi eest. Patsiendid maksavad hooldekodudes väljatöötamise raames on kavas koolitust ja hospiitsides ka voodipäevatasu. laiendada, muuta see kohustuslikuks ja koostada spetsiaalne koolituskava koordinaatoritele. 2019. aastal osutati Eestis rohkem palliatiivse ravi teenuseid kui ELis keskmiselt. Neid teenuseid Kuigi Tervisekassa teeb kõigi oma partnerite puhul osutasid haiglad, kutseliidud ja patsientide kvaliteediauditeid ja tervishoiuteenuste osutajatel ühendused, kusjuures alates 2020. aastast on on seadusest tulenev kohustus teha patsiend- 48 teenuseosutajat pakkunud koduõendusteenust ikogemust käsitlevaid uuringuid, sealhulgas (kõigis maakondades). Analüüsis leiti siiski, et palliatiivse ravi ja elulõpuravi valdkonnas, teenused on jaotatud ebaühtlaselt ja juurdepääs, puuduvad andmed konkreetselt vähipatsientidele eelkõige vaimse tervise teenustele, on piirkonniti mõeldud palliatiivse ravi kättesaadavuse ja väga erinev. Äärealade elanikel on keeruline kvaliteedi kohta riigis. terviklikele teenustele ligi pääseda, kuna puudub hüvitis, sealhulgas reisikulude katmiseks. Suur osa elulõpuravist sõltub Eestis mitteametlikest hooldajatest, kuigi kavas on Lisaks takistavad õigeaegset juurdepääsu välja arendada spetsialistide võrgustik tervishoiutöötajate vähene teadlikkus, Eestis pakutakse elulõpuravi kodus ja haiglates, koordineeritud palliatiivse ravi võrgustiku hooldekodudes ja hospiitsides. Ravi võib juhendada puudumine ja rahaliste vahendite nappus. pere- või eriarst, sealhulgas kaugkonsultatsiooni Seega sõltub juurdepääs sageli patsiendi või teel. Suur osa hoolduskoormusest jääb siiski tema hooldaja teadlikkusest. Vaja on paremat mitteametlikele hooldajatele, kellel on õigus saada integreerimist, meeskonnatööd ja juhtumite pereliikme hooldamise eest hüvitist vaid 80 % haldamist, et vältida patsientide süsteemis ulatuses kuni seitsme päeva eest. Puudub palgata kaotsiminekut (HAAP Consulting, 2023). puhkuse süsteem ja paindlikku töökorraldust ei toetata. Mitteametlikule hooldajale makstava Eesti töötab välja palliatiivse ravi teenuste rahalise toetuse määrab kindlaks omavalitsus, mudelit, mis vastaks paremini patsientide kes teeb otsuse toetuse saamise õiguse ja antava vajadustele toetuse liigi kohta (Rocard & Llena-Nozal, 2022). Vähitõrje tegevuskavas 2021–2030 on püstitatud Vähitõrje tegevuskavas 2021–2030 peetakse eesmärk parandada veelgi palliatiivse ravi esmatähtsaks parandada elulõpuravi teenuste kättesaadavust, koolitades tervishoiutöötajaid, kättesaadavust, tagada, et tervishoiutöötajatel on suurendades patsientide ja töötajate teadlikkust palliatiivse ravi jaoks vajalikud oskused, arendada ning tagades piisava rahastamise. Pidades elu lõpus pakutavat psühholoogilist tuge ning esmatähtsaks vähipatsientide elukvaliteeti, on reguleerida patsientidele ja peredele elulõpuraviga tegevuskavas ette nähtud riikliku palliatiivse ravi seotud otsuste kohta teabe andmist. teenuste mudeli väljatöötamine. Eesti kavatseb Riigi vähiprofiil 2025 | EESTI | 25  6. Pilguheit laste vähktõvele | EESTI | | 2 0 2 5 Euroopa vähiteabesüsteemi andmete kohaselt vähk oli hinnangute kohaselt leukeemia oli 2022. aastal Eestis laste ja noorukite seas (5 juhtumit 100 000 elaniku kohta), millele hinnanguliselt 31 vähijuhtumit. Haigestumus järgnesid ajuvähk ja kesknärvisüsteemi kasvajad, 0–14aastaste seas oli 2022. aastal hinnanguliselt lümfoomid ja neeruvähk. Eurostati andmetest on | 14,2 juhtumit 100 000 elaniku kohta, mis on näha, et laste vähktõvest põhjustatud suremus oli sarnane 13,7 juhtumiga 100 000 elaniku kohta 2,9 inimest 100 000 elaniku kohta, ja see näitaja on EL 27s (Joonis 20). Kõige sagedamini diagnoositud olnud pidevalt üks ELi kõrgemaid. Joonis 20. Laste vähihaigestumus on Eestis veidi suurem kui ELi keskmine Hinnanguline vanusestandarditud haigestumus 100 000 elaniku kohta (0–14aastased) (2022) 31 uut vähijuhtumit 2022. aastal 9 161 uut vähijuhtumit 2022. aastal Kõik vähipaikmed: 14,2 100 000 elaniku kohta Kõik vähipaikmed: 13,7 100 000 elaniku kohta Leukeemia: 5,1 Leukeemia: 4,3 Ajuvähk, kesknärvisüsteemi 31% Ajuvähk, kesknärvisüsteemi kasvaja: 3,2 36 % kasvaja: 2,1 Lümfoomid (Hodgkini lümfoom ja Lümfoomid (Hodgkini lümfoom ja mitte-Hodgkini lümfoomid): 0,4 mitte-Hodgkini lümfoomid): 2,0 Neeruvähk: 0,9 Neeruvähk: 0,8 6% 6% 3% 15% Muu: 4,6 23 % 15% Muu: 4,5 Eesti EL27 Märkused. 2022. aasta näitajad on varasemate aastate haigestumussuundumustel põhinevad hinnangud ja võivad hilisematel Vanusestandarditud suremus 100 000 elaniku kohta (0–14aastased) (kolme aasta aastatel täheldatud haigestumusest erineda. „Kõik vähipaikmed“ ei hõlma mittemelanoomset nahavähki. keskmine, 2021) Allikad: Euroopa vähiteabesüsteem (vähihaigestumuse 2.9 puhul), https://ecis.jrc.ec.europa.eu (vaadatud 10. märtsil 2022), © Euroopa (Eesti) > 2.1 (EL27) Liit, 2024. Eestis diagnoositakse ja ravitakse laste vähktõbe rohkem kui 49 % naabruses asuvas Lätis ja Leedus kahes laste hematoloogia-onkoloogia keskuses (Vassal et al., 2021). (Tartu Ülikooli Kliinikum ja Tallinna Lastehaigla). 17: Age-standardised incidence rate per 100 000 in 2022 Eesti vähitõrje tegevuskavas 2021–2030 on Eesti vähitõrje tegevuskavas 2021–2030 osutatakse lisaks kindlaks tehtud olulised lüngad sotsiaal- meditsiinitöötajate ebapiisavale teadlikkusele abisüsteemis lastevanematele, kelle laps on sellest, et 0–18aastaste patsientide pahaloomuliste saanud vähidiagnoosi, sealhulgas ebapiisav tugi kasvajate diagnoosimist ja ravi juhib lasteonkoloog. laste arengu tagamiseks pikaajalise haiglaravi Enamik laste vähktõve puhul kasutatavaid raviviise ajal ja laste naasmisel lasteaeda või kooli ning on Eestis kättesaadavad. Lastest vähipatsientidel haiglavälise psühholoogilise abi puudumine. Laste ei ole siiski võimalik saada riigis prootonkiir- vähktõbi on üks vähitõrje tegevuskava 2021–2030 itusravi, samuti ei pakuta vähktõvest jagusaanud prioriteete. Tegvuskavas on seatud eesmärk lastele ellujääja-spetsiifilist hooldust. Eesti parandada teenuste kättesaadavust, tõhustada vähikeskused tagavad juurdepääsu prootonravile koostööd rahvusvaheliste pädevuskeskustega ning läbi rahvusvahelise koostöö. Lisaks oli Euroopas suurendada vähki põdevate laste juurdepääsu aastatel 2010–2022 korraldatud 436st kliinilisest kliinilistele uuringutele. 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 26 | EESTI | Riigi vähiprofiil 2025 Viited | | EESTI | Alloja, J., et al. (2023), „Kopsuvähi sõeluuringu Sotsiaalministeerium (2023), „Sotsiaalministeeriumi | 2025 rakendamise efektiivsus ja kulutõhusus: terviseteh- konkursitaotlus vähitõrjega seotud teadus- ja noloogia hindamise raport TTH63“, Tartu Ülikool, arendustöö keskuse rajamiseks sai Vabariigi Tartu. Valitsuselt 2,6 mln eurot“, sotsiaalministeerium, Tallinn, https://www.sm.ee/uudised/sotsiaalmin- De Angelis, R., et al. (2024), „Complete cancer isteeriumi-konkursitaotlus-vahitorjega-seotud-tea- prevalence in Europe 2020 by disease duration dus-ja-arendustoo-keskuse. and country (EUROCARE-6): a population-based study“, Lancet Oncology, 25(3):293-307, doi:10.1016/ Sotsiaalministeerium ja Tervise Arengu Instituut S1470-2045(23)00646-0. (2021), „Vähitõrje tegevuskava 2021–2030“, sotsiaalministeerium ja Tervise Arengu Instituut, ERR (2024), „Maria Suurna: sõeluuringul osalemine Tallinn. võib osutuda elupäästvaks“, ERR, 9. mai, https:// www.err.ee/1609336734/maria-suurna-soeluurin- Zimmermann, M., et al. (2024), „Cancer in Estonia: gul-osalemine-voib-osutuda-elupaastvaks. incidence 2021, survival 2017–2021 and cancer cases diagnosed in screening“, Tervise Arengu Instituut, HAAP Consulting (2023), „Palliatiivse ravi korraldus Tallinn. Euroopas fookusega vaimse tervise teenustele ja ettepanekud Eestile“, HAAP Consulting, Tallinn. Tervise Arengu Instituut (2023), „Alkohol ja selle tarvitamine Eestis“, Tervise Arengu Instituut, Heinsalu, K. (2024), „Vähiliit saab rekordilise Tallinn. annetuse Piilmanni perekonna fondilt“, Meditsiiniuudised, 5. märts, https://www.mu.ee/ Tervise Arengu Instituut (2024a), tervisestatistika ja uudised/2024/03/05/vahiliit-saab-rekordilise-anne- terviseuuringute andmebaas, https://statistika.tai. tuse-piilmanni-perekonna-fondilt. ee/. OECD (2024a), „Beating cancer inequalities in the EU: Tervise Arengu Instituut (2024b), „Rahvastiku tervise spotlight on cancer prevention and early detection“, arenguraamat 2024“, Tervise Arengu Instituut, OECD Health Policy Studies, OECD Publishing, Pariis, Tallinn. https://doi.org/10.1787/14fdc89a-en. Tervise Arengu Instituut (2024c), „HPV kodutest OECD (2024b), Tackling the Impact of Cancer on on aidanud emakakaelavähi sõeluuringutel Health, the Economy and Society, OECD Health osalust jõudsalt kasvatada“, Tervise Arengu Policy Studies, OECD Publishing, Paris, https://doi. Instituut, Tallinn, https://www.tai.ee/et/uudised/ org/10.1787/85e7c3ba-en. hpv-kodutest-aidanud-emakakaelavahi-soeluurin- gul-osalust-joudsalt-kasvatada. Riigikontroll (2022), „Eesti tervishoiu suundumused“, Riigikontroll, Tallinn. Tervise Arengu Instituut (2024d), personaalmeditsiin, Tervise Arengu Instituut, Tallinn, https://www.tai.ee/ Rocard, E., Llena-Nozal, A. (2022), „Supporting et/personaalmeditsiin. informal carers of older people: policies to leave no carer behind“, OECD Health Working Papers, Tervisekassa (2023), 2023. majandusaasta aruanne, nr 140, OECD Publishing, Pariis, https://doi. Tervisekassa, Tallinn. org/10.1787/0f0c0d52-en. Vassal, G., et al. (2021), „Access to essential Shahrabi Farahani, F., Paapsi, K., Innos, K. (2021), anticancer medicines for children and adolescents „The impact of sociodemographic factors on the in Europe”, Annals of Oncology, kd 32/4, lk 560–568, utilization of radiation therapy in breast cancer https://doi.org/10.1016/j.annonc.2020.12.015. patients in Estonia: a register-based study“, International Journal for Equity in Health, 20(1):152, doi:10.1186/s12939-021-01497-0. Country Riikide abbreviations (translated) lühendid 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 Riigi vähiprofiil 2025 | EESTI | 27 European Cancer Inequalities Registry Riigi vähiprofiil 2025 Vähktõve ebavõrdsuse register on Euroopa Profiilid koostab Majanduskoostöö ja Arengu vähktõvevastase võitluse kava juhtalgatus. Sellest saab Organisatsioon (OECD) koostöös Euroopa Komisjoniga. kindlat ja usaldusväärset teavet vähktõve ennetamise Töörühm on tänulik riiklikele ekspertidele, OECD ja ravi kohta, et selgitada välja suundumused ning tervisekomiteele ja ELi vähktõve ebavõrdsuse registri erinevused ja ebavõrdsus liikmesriikide ja piirkondade eksperdirühmale väärtuslike märkuste ja ettepanekute vahel. Register sisaldab veebisaiti ja andmetööriista, eest. mille on välja töötanud Euroopa Komisjoni Iga riigi terviseprofiilis esitatakse lühikokkuvõte Teadusuuringute Ühiskeskus (https://cancer-inequalities. järgmisest: jrc.ec.europa.eu/), samuti vaheldumisi iga kahe aasta järel koostatavaid riiklikke vähiprofiile ja üldist aruannet • vähktõvest tulenev koormus riigis vähktõve ebavõrdsusest Euroopas. • vähi riskitegurid, keskendudes käitumuslikele ja Riikide vähiprofiilides tuuakse välja tugevad küljed, keskkonnast tulenevatele riskiteguritele probleemid ja konkreetsed tegevusvaldkonnad kõigis • varajase avastamise programmid 27 ELi liikmesriigis, Islandil ja Norras, et suunata Euroopa • vähiravi tulemuslikkus, keskendudes kättesaa- vähktõvevastase võitluse kava alusel investeeringuid ja davusele, ravi kvaliteedile, kuludele ja elukvaliteedile sekkumisi ELi, riigi ja piirkonna tasandil. Lisaks toetab Euroopa vähktõve ebavõrdsuse register nullsaaste tegevuskava 1. juhtalgatust. 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. 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 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. Saatja: "Janne Sepp" <[email protected]> Saaja: "Veips, Artūrs" <[email protected]>, "Dzirkale, Ieva" <[email protected]> Teema: Vs: MSD data request clarification Kuupäev: 2025-03-20 09:47 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 <https://www.oecd.org/content/oecd/en/search.html?q=cancer+profiles&orderB y=mostRelevant&page=0> &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 <mailto:[email protected]> [email protected] Nooruse 1, 50411 Tartu, Estonia www.ravimiamet.ee 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. 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. 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. 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? 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 <http://www.msd.lv/> www.msd.lv 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 <http://www.msd.com>