Cancer incidence and mortality in Serbia 1999-2009

Abstract

Background: Despite the increase in cancer incidence in the last years in Serbia, no nation-wide, population-based cancer epidemiology data have been reported. In this study cancer incidence and mortality rates for Serbia are presented using nation-wide data from two population-based cancer registries. These rates are additionally compared to European and global cancer epidemiology estimates. Finally, predictions on Serbian cancer incidence and mortality rates are provided.

Methods: Cancer incidence and mortality was collected from the cancer registries of Central Serbia and Vojvodina from 1999 to 2009. Using age-specific regression models, we estimated time trends and predictions for cancer incidence and mortality for the following five years (2010-2014). The comparison of Serbian with European and global cancer incidence/mortality rates, adjusted to the world population (ASR-W) was performed using Serbian population-based data and estimates from GLOBOCAN 2008.

Results: Increasing trends in both overall cancer incidence and mortality rates were identified for Serbia. In men, lung cancer showed the highest incidence (ASR-W 2009: 70.8/100,000), followed by colorectal (ASR-W 2009: 39.9/100,000), prostate (ASR-W 2009: 29.1/100,000) and bladder cancer (ASR-W 2009: 16.2/100,000). Breast cancer was the most common form of cancer in women (ASR-W 2009: 70.8/100,000) followed by cervical (ASR-W 2009: 25.5/100,000), colorectal (ASR-W 2009: 21.1/100,000) and lung cancer (ASR-W 2009: 19.4/100,000). Prostate and colorectal cancers have been significantly increasing over the last years in men, while this was also observed for breast cancer incidence and lung cancer mortality in women. In 2008 Serbia had the highest mortality rate from breast cancer (ASR-W 2008: 22.7/100,000), among all European countries while incidence and mortality of cervical, lung and colorectal cancer were well above European estimates.

Conclusion: Cancer incidence and mortality in Serbia has been generally increasing over the past years. For a number of cancer sites, incidence and mortality is alarmingly higher than in the majority of European regions. For this increasing trend to be controlled, the management of risk factors that are present among the Serbian population is necessary. Additionally, prevention and early diagnosis are areas where significant improvements could still be made.

Figure 1

Overall cancer incidence and mortality in Serbia - trends (1999–2009) and predictions (2010–2014). Legend: Red bold line – incidence, men. Red regular line – incidence, women. Black bold line – mortality, men. Black regular line, mortality, women. All dotted lines continuous to these are depicting predictions.

Figure 2

Trends in incidence and mortality from the four most common cancers in Serbia (1999–2009) and predictions (2010–2014). Legend: Blue line – lung cancer. Orange line – colorectal cancer. Turquoise line – prostate cancer. Green line – bladder cancer. Dark red line – stomach cancer. Pink line – breast cancer. Light green line – cervical cancer.

Figure 3

(A) Comparison of Serbian incidence ASR-Ws with the GLOBOCAN 2008 estimates – men; (B), Comparison of Serbian mortality ASR-Ws with the GLOBOCAN 2008 estimates – men. N Europe – Northern Europe, S Europe – Southern Europe, W Europe – Western Europe, CE Europe – Central Eastern Europe. * - Eureopan country with the lowest incidence/mortality ASR-W. ** - European country with the highest incidence/mortality ASR-W.

Figure 4

(A) Comparison of Serbian incidence ASR-Ws with the GLOBOCAN 2008 estimates –women; (B), Comparison of Serbian mortality ASR-Ws with the GLOBOCAN 2008 estimates – women. N Europe – Northern Europe, S Europe – Southern Europe, W Europe – Western Europe, CE Europe – Central Eastern Europe. B&H – Bosnia and Herzegovina. * - Eureopan country with the lowest incidence/mortality ASR-W. ** - European country with the highest incidence/mortality ASR-W.