In 2021, 1.15 million people died from cancer in EU countries, accounting for more than one in five (22%) deaths. Cancer is the second leading cause of mortality in the EU on average after cardiovascular diseases, although it is already the leading cause of death in five EU countries (Belgium, Denmark, France, the Netherlands and Spain). Globally, preventable risk factors are estimated to cause about half of cancer deaths in men and over a third in women. Early diagnosis via population-based screening programmes and high-quality care delivered through comprehensive cancer networks, multidisciplinary teams and timely care pathways can reduce cancer mortality (OECD, 2024[1]).
In 2021, there were 227 000 lung cancer deaths in the EU, 132 000 colorectal cancer deaths, 85 000 breast cancer deaths and 68 000 prostate cancer deaths. Lung cancer is by far the leading cause of cancer death among men, responsible for almost a quarter of deaths (23%), followed by colorectal cancer (12%) and prostate cancer (11%). Among women, breast cancer is the leading cause of death, accounting for about one in six cancer deaths (16%), followed closely by lung cancer (15%) and colorectal cancer (11%). While incidence of breast cancer has been on the rise in the decade before COVID‑19, efforts at earlier diagnosis and better treatment have led to improvements in survival rates. For example, in the Netherlands, five‑year relative breast cancer survival increased from 82% for those diagnosed between 1995‑2004 to 89% for those diagnosed between 2015‑22. In Belgium, five‑year relative breast cancer survival increased from 88% for patients diagnosed in 2004 to 92% for those diagnosed in 2017 (OECD, forthcoming[2]).
In 2021, mortality rates from cancer were more than 10% lower than the EU average in Malta, Luxembourg and Sweden, while they were over 20% higher in Hungary, Croatia and Latvia (Figure 3.9). Similar to incidence patterns (see indicator “Cancer incidence and prevalence”), cancer mortality rates are two‑thirds higher among men than women in the EU. Lithuania, Estonia and Latvia had particularly high gender gaps in 2021, with mortality rates for men double or more those of women.
There are also gaps within countries. Large disparities in cancer mortality (of over 30%) have been found between regions in Romania, Poland, France, Spain and Germany (OECD, 2024[1]). Socio-economic disparities persist as well. A study on educational inequalities in cancer mortality between 2015‑19 found that, on average across 14 EU countries and Norway, lower educated men had an 84% higher overall cancer mortality than higher educated men. The gap between lower and higher educated women was narrower, but nonetheless substantial at 37% (International Agency for Research on Cancer, 2024[3]). In a number of countries, cancer survival rates are lower among those with lower socio-economic status (OECD, 2024[1]). These gaps reflect differences in the prevalence of risk factors, in screening participation, and in access to timely and high-quality care.
Since 2011, there has been a substantial reduction in age‑standardised cancer mortality rates in the EU (12%), which has occurred in all countries except Cyprus (10% increase) and Bulgaria (where it remained flat). Men have seen a particularly large reduction in mortality during this period (16% reduction compared to an 8.5% reduction among women).
Age‑standardised mortality rates have decreased across most cancer types in the decade through 2021 (Figure 3.10), with the largest decreases in stomach (‑29%), and colorectal and cervical (both ‑17%). Ovarian, bladder, lung, leukaemia, liver and breast cancers also decreased by about 10% or more. For lung cancer, however, the overall reduction masks a diverging trend between genders: while mortality rates among men have decreased by 24% since 2011, they have increased by 9% among women. This reflects the legacy of a later increase in smoking rates among more recent birth cohorts of women.
In cervical and colorectal cancer, the improvement in mortality is related to major efforts to introduce or expand population-based screening programmes in EU countries over the last two decades, including via home‑based sampling in some countries.
However, pancreatic cancer, responsible for about 7% of total cancer deaths, has seen a 3% increase during this period among men and a 6% increase among women. Increased pancreatic cancer mortality is driven by its growing incidence among women and younger people (The Lancet Gastroenterology & Hepatology, 2023[4]), alongside very low survival rates compared to other cancer types.
