The EU's fifth enlargement, which saw 12 new member states join in 2004-07, changed European averages in many ways.
Bringing in poorer countries with less advanced healthcare drew EU attention to health inequalities. The gap between ‘old' and ‘new' Europe is wide: between Stockholm and Riga, life expectancy drops by one decade. The gap is also reflected in cancer survival rates, which are lower in central and eastern Europe (see below). Adamos Adamou, a Cypriot left-wing (GUE-NGL) MEP and co-chair of MEPs against Cancer, says that health inequalities in an enlarged Europe are one of the key factors in explaining new demands for EU “co-ordination” on cancer.
Long before enlargement, differences in cancer survival were evident across the EU. Data from the 1990s showed that people diagnosed with cancer had the best chance of survival in the Nordic countries, a lower chance in southern Europe and lower still in Denmark and the UK. There are a few caveats to this: some cancers are hard to treat in any country. Lung cancer, which is deadly and difficult to treat, accounts for one in four cancer deaths in countries as diverse as Belgium, Poland, Greece and the UK.
Closing the health gap is of growing importance for EU policymakers. The Commission hopes to use guidelines and statistics to spur best practice across the EU. For instance, if every EU country followed what the best countries do on breast cancer screening, it is estimated that 25,000 lives could be saved each year.
A difficult legacy
With lower incomes and historically poorer healthcare systems, the new member states have a difficult legacy. Nevertheless, Franco Berrino and Riccardo Capocaccia, two Italian cancer researchers writing in a publication for the Slovenian presidency earlier this year*, argue that the gap in cancer survival rates “may well diminish in the near future”.
Their analysis of recent data suggests that some new member states are beginning to catch up: five-year survival rates for breast, colorectal and prostate cancers have increased in all countries, but the jump has been most dramatic in central European countries. For instance, in Poland and Hungary, survival rates increased by 30-47% for colorectal cancer, 60-74% for breast cancer and 40-68% for prostate cancer between 1991 and 2002.
