Five-year survival rates for patients with cancer can differ by as much as 25% between European countries, whereas mortality can vary by up to 1.6 times. These figures, presented at the European Society for Medical Oncology (ESMO) Annual Meeting 2025 held recently in Berlin, Germany, highlight deep inequalities in access to cancer care and outcomes across the continent.

The data were presented by Diego Serraino of Alleanza Contro il Cancro (ACC), Italy’s national oncology research network established in 2002 by the Ministry of Health. “National cancer registries are crucial for shaping health policies and guiding investments, but they must also be interpreted carefully to understand what insights they truly offer and how they can be used,” Serraino told Univadis Italy, a Medscape Network platform. He also helps coordinate I numeri del cancro in Italia, an annual report from the Italian Association of Cancer Registries that provides a comprehensive picture of cancer epidemiology across the country.

When Survival Depends on Where You Live

Serraino’s analysis (abstract 2272O) drew on data from the European Cancer Inequalities Registry and the European Cancer Information System to explore disparities in cancer outcomes across Europe. The findings come from the European Comprehensive Cancer Centres Network (EUNETCCC) initiative, of which ACC is a member, working to create a network of centers of excellence, which will ensure that, by 2028, 90% of patients with cancer in Europe can access high-quality care regardless of where they live.

That goal, however, remains distant. In the 29 countries studied (the 27 EU member states, Iceland, and Norway), where a patient lives still largely determines their likelihood of survival or death from cancer.

In 2022, cancer accounted for 1 in 4 deaths in Europe, ie, about 1.3 million deaths, with an age-adjusted mortality rate of 264 per 100,000 people. The range is stark: Mortality drops to 209 per 100,000 in Malta but rises to 331 per 100,000 in Poland, a 1.6-fold difference. Among women, rates range from 255 per 100,000 in Hungary to 157 per 100,000 in Spain, a disparity that Serraino said means nearly 3000 cancer deaths among Hungarian women could have been prevented if their national rates matched the European average. For men, the gap is even wider: 1.8 times higher between Croatia (the highest) and Luxembourg (the lowest).

Five-year survival data reveal the same inequities, particularly disadvantaging Eastern Europe. Across Europe, average 5-year survival stands at 54.2%, rising to 59.7% in Northern Europe, 58% in Central Europe, and 54% in Southern Europe but dropping to just 45% in Eastern Europe. “That means 450,000 people will not reach 5-year survival simply because they were born in the wrong country,” Serraino told Univadis Italy.

The causes are multifactorial, including economic disparities, aging populations, gender differences, variations in healthcare organization, and unequal healthcare spending. Serraino called for a multilevel response: strengthening primary prevention, harmonizing screening programs, ensuring equitable access to treatment, and improving how resources are distributed.

“We have to work hard to change things,” he said. “Collaboration is the key to success.”

Strategies to Bridge the Gap

One key initiative to advance cancer-care equity is the EUNETCCC project, which aims to create a European network of centers of excellence that share common standards in diagnosis, treatment, research, and training.

“Understanding what ‘equality’ and ‘equity’ mean is important, but it’s not enough because behind these definitions are real people,” said Christine Chomienne, PhD, of the Université de Paris in Paris, France. Chomienne, who also serves as vice chair of the Horizon Europe Cancer Mission Board and a member of the European Cancer Organization’s Research Policy Network, outlined several European Union (EU) initiatives designed to reduce disparities both between countries and within national healthcare systems.

The EU has launched two major complementary programs: the EU Mission on Cancer under Horizon Europe and Europe’s Beating Cancer Plan, both introduced in 2021 and closely coordinated to translate research and innovation into actionable policy. Their shared goal is to combat cancer through collaborative frameworks such as the European Initiative to Understand Cancer (UNCAN.eu), which supports the sharing and analysis of oncology data, and the European Cancer Patient Digital Centre, designed to provide patients with reliable information and digital tools to guide their care journey.

Effective policies, Chomienne emphasized, depend on inclusive, timely, and multidisciplinary data, bringing together researchers, clinicians, patients, and policymakers from the earliest stages of each project. These cancer-focused initiatives also align with the EU’s broader strategies to reduce inequality, including the Gender Equality Strategy, the European Anti-Poverty Strategy, and policies promoting intergenerational justice and LGBTQIA+ inclusion.

“We shouldn’t expect perfection on the first try,” Chomienne said. “Mistakes will happen, but we must be ready to adapt, guided by evidence and experience.”

Serraino and Chomienne declared having no relevant conflicts of interest related to their presentations. 

This story was translated from Univadis Italy.