Gastrointestinal (GI) cancer is the new leading cause death by cancer in Europe, according to a major pan-European survey commissioned by United European Gastroenterology (UEG), which revealed several trend alterations regarding both GI and liver diseases as well as disparities in the provision of healthcare services. As a result, the UEG emphasized the need for both political and public awareness about the burden of the disease in Europe, as well as for more funding to support healthcare and research.
The Survey of Digestive Health Across Europe, which was led by a research group from the Swansea University in Wales, United Kingdom, demonstrated that GI cancer has become the most deadly cancer in Europe. In addition, while the mortality rates of colorectal cancer registered lower numbers for decades, in several countries of Western, Northern, and Central Europe, as well as in regions of Eastern and Southern Europe, the rates continue to rise.
“We need to look more closely at the reasons behind these worrying statistics and find ways to overcome the regional differences observed and reduce the growing burden of GI cancers,” said the President of UEG, Professor Michael Farthing. Similarly, the incidence or prevalence of GI disorders was proven to be higher in many countries of the Eastern Europe, compared to other regions. In addition, the mortality rates from GI disorders, other than cancer and infectious diseases, were highest in Eastern and North Eastern countries and lowest in parts of Scandinavia and the Mediterranean Islands.
Other new trends regarding the disease were revealed by the survey, including the incidence and prevalence of GI disorders. In several countries there was a clear increase of the incidence of the the major diseases like upper GI bleeding, inflammatory bowel disease (IBD), coeliac disease, alcoholic liver disease, gallstone disease, and colorectal and oesophageal cancer. Regarding these diseases, the researchers observed as well that the rate were higher among older patients.
“This extensive survey has highlighted major differences between countries in terms of both the risk of developing GI disorders and their long-term health outcomes,” stated Farthing. “We are particularly concerned about the increasing incidence of most major GI disorders across Europe and the clear differences in outcomes for patients between Eastern and Western nations.”
Healthcare provision is also not equal to all European patients, as, for example, colorectal cancer screening programs are not available to all patients since there is no standardized approach for screening even though programs are well established in most countries. Another difference identified is GI bleeding which is managed differently according to the country due to lack of consensus on the best practice. The researchers also reported that, not only are endoscopy services unequal, but they are also not seen as priorities by policymakers. In addition, medical training of students in gastroenterology is also different between countries and remains poorly documented.
“This survey was wide-ranging and has highlighted some areas of good practice, but many areas that require attention at both a national and European level,” explained the UEG president. “Our hope is that, ultimately, the survey and the reports generated will help to improve care and health outcomes and reduce inequalities across the continent.”
The survey was conducted with data pertaining to the spring of 2013 in response to a request from the Future Trends Committee. The researchers focused on both the clinical and economic burden of the disease, as well as healthcare provision in 28 countries from the European Union, Norway, Switzerland, Liechtenstein and Russia.
“Gastroenterology is a medical specialty that gets relatively little attention from a policy perspective compared with other specialties and attracts minimal independent research funding,” explained Professor Farthing about the purposes of the study. “We wanted to take a long, hard look at the situation today across Europe in order to ensure we prioritize our efforts where it is needed most.”
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