Inequity in Cancer Care

1. Inequity in Cancer Care Potential for improvement in European health care systems NiekKlazinga

2. Cancer • One of the major public health issues in OECD countries. • either the first or the second cause of death (after cardiovascular disease), accounting for more than a quarter of all deaths in many countries, • at least one-third of cancer can be prevented and • a further third can be either detected early or effectively treated.  • Cancer survival, diagnoses and treatment varies across European countries with potential for improvement.

3. Survival 5 year survival improves but differencesbetweencountriesremain

4. Breast cancer, five-year relative survival, 2001-06 and 2006-11 (or nearest period) 1. Period analysis, 2. Cohort analysis. Note: 95% confidence intervals represented by H. Source: OECD Health Statistics 2013, http://dx.doi.org/10.1787/health-data-en.

5. Colorectal cancer, five-year relative survival, 2001-06 and 2006-11 (or nearest period) 1. Period analysis, 2. Cohort analysis. Note: 95% confidence intervals represented by H. Source: OECD Health Statistics 2013, http://dx.doi.org/10.1787/health-data-en.

6. Expenditure Richercountries have bettercancerresults. But money does notexplaineverythingandexpenditure on cancerdifferslargelybetweencountries.

7. Percentage of total health expenditure spent on cancer care Note: Data from countries with an * come from OECD Disease Expenditure studies and data include expenditure for benign neoplasms. Data from other countries were collected through the OECD Questionnaire on Systems of Cancer Care 2010. Data for Sweden and Denmark refer to costs in hospitals only. Data for Finland do not include all costs related to medications. Further systematic efforts are needed to improve cross-national comparability of these data. Source: OECD Disease Expenditure studies and OECD Questionnaire on Systems of Cancer Care 2010.

8. Authorization of new drugs Timeliness of access to new drugs differsbetweencountries

9. Years of authorisation for ten selected innovative cancer drugs * Information on data for Israel: http//dx.doi.org/10.1787/888932315602. Source: OECD HCQI Questionnaire on Systems of Cancer Care

10. Radiotherapy Capacity of radiotherapydiffers

11. Radiotherapy equipment per million population, 2010 (or latest year available) Note: Data on radiotherapy equipment outside of hospital are not available for Belgium, France, Germany and Spain, leading to underreporting. * Information on data for Israel: http//dx.doi.org/10.1787/888932315602. Source: OECD Health Data 2012, doi: 10.1787/health-data-en.

12. screening use of screening differsbetweencountries

13. Mammography screening in women aged 50- 69, 2001 to 2011 (or nearest year) 1. Programme. 2. Survey. * Three-year average. Source: OECD Health Statistics 2013, http://dx.doi.org/10.1787/health-data-en.

14. screening Screening alsodiffersbysocio-economic status

15. Colorectal cancer screening test never taken (self-reported) by education level among people aged 50-74 (%), 2008 Source: Eurostat

16. Waitingtimes Waitingtimesdifferforreferralfrom GP to specialist andbetween diagnoses and treatment

17. Average referral time between GP and specialist visit, 2010 Note: Data for Australia and the Netherlands refer to 2008 and for Canada, Denmark, Israel, Korea and Latvia to 2009. For Germany, data for cervical cancer refer to 2010, while data for other cancers refer to 2009. Countries with an * refer to those in which experts provided estimated referral times. Data for Canada are the estimates for the waiting time between consultation to treat and the date of the radiation therapy procedure. 1. Information on data for Israel: http//dx.doi.org/10.1787/888932315602. Source: OECD HCQI Questionnaire on Systems of Cancer Care.

18. Average waiting time between cancer diagnosis and initial treatment (surgery, radiotherapy and/or chemotherapy), 2010 Note: Data for the Netherlands, Scotland and Sweden refer to 2008 and for Canada, Israel, Korea, Latvia and Poland to 2009. For Germany, data for cervical cancer refer to 2010 while data for other cancers refer to 2009. For French data, waiting time for breast cancer refers to 2007 while that for lung cancer refer to 2003. Countries with * refer to those in which experts provided estimated waiting times. Cancer diagnosis refers to the first day of cancer diagnosis in Korea. 1. Information on data for Israel: http//dx.doi.org/10.1787/888932315602. Source: OECD HCQI Questionnaire on Systems of Cancer Care.

19. National cancerprograms Countriesdiffer in the start and scope of theirnationalcancer programs

20. Introduction of NCCPs, national health policies or strategies with a focus on cancer care *. Information on data for Israel: http//dx.doi.org/10.1787/888932315602. Source: OECD HCQI Questionnaire on Systems of Cancer Care.

21. The route toimprovedcancer care in Europe Improvecomparability of cancerstatistics Enhancemutuallearningbynotonlyfocusing on inputs (professionals, technologies) but also on processandoutcomes Strengthenevidence-basedcancergovernance (screening, concentration of services, assuringtimely access) Strengtheningthe role of patients

22. More information www.oecd.org/health/health-systems/cancer-care.htm www.oecd.org/health/healthataglance www.oecd.org/els/health-systems/oecdhealthdata.htm