Cancer: Mortality Rates Expected to Decrease in 2025

Breast cancer mortality rates are projected to fall across all age groups in the EU in 2025—except for women aged over 80, for whom a 7% increase is expected compared to the 2015–2019 period.

These findings are part of a study estimating cancer mortality rates in the EU and the UK for 2025. The study, conducted by researchers at the University of Milan in collaboration with the University of Bologna, has been published today in the Annals of Oncology.

The team of epidemiologists, led by Carlo La Vecchia, Professor at the University of Milan, and Professor Eva Negri from the University of Bologna, attribute the projected rise in breast cancer mortality among the oldest age group to the lack of routine screening and timely diagnosis. Women over 80 are also less likely to receive the most advanced treatments currently available.

“Older women are not included in screening programmes and are less likely than younger women to benefit from major advances in the diagnosis and management of breast cancer. This includes developments in chemotherapy, hormone therapy, and immunotherapy—such as trastuzumab and similar agents—as well as in radiotherapy and surgery,” explains Professor La Vecchia.

The increasing prevalence of overweight and obesity observed in recent decades—now affecting over half of the population in many Northern and Central European countries—has led to a higher risk of breast cancer. This trend has not been sufficiently offset by improved diagnosis and treatment in older women and may therefore help explain the estimated rise in mortality rates in this group.

The researchers estimate that breast cancer mortality rates will fall by 3.6% across all age groups in the EU and by 0.8% in Italy in 2025 compared to 2020. The age-standardised mortality rate is projected at 13.3 per 100,000 women in the EU (equivalent to 90,100 deaths) and 14.0 per 100,000 in Italy (13,660 deaths).

“We estimate that between 1989 and 2025, 373,000 breast cancer deaths have been prevented in the EU. While most of these avoided deaths are the result of improved treatment and management, 25 to 30% are likely due to greater uptake of early diagnosis and screening programmes. As breast cancer is now treatable with highly effective, innovative approaches, it is essential that all patients are referred to cancer centres equipped to offer the full range of available therapies. Moreover, as shown by the concerning trends among women over eighty, tackling overweight and obesity remains a priority—not only in terms of cardiovascular health, but also for cancer prevention, including breast cancer,” adds La Vecchia.

Now in its fifteenth year, the research project examines cancer mortality trends in the EU and the UK, with separate analyses for men and women. It covers stomach, colorectal, pancreatic, lung, breast, uterine (including cervical), ovarian, prostate and bladder cancers, as well as leukaemia. Mortality data were drawn from the World Health Organization and United Nations databases, covering the period from 1970 to 2020. Over time, the estimates produced have proved to be robust and reliable.

A decline of around 3.5% in overall cancer mortality rates is expected across EU countries, with a drop from 125 to 121 deaths per 100,000 men, and from 80 to 79 per 100,000 women between 2020 and 2025. In total, approximately 1.28 million cancer deaths are projected in the EU in 2025, including around 176,000 in Italy. In Italy, mortality rates are expected to fall from 112 to 96 per 100,000 men and from 75 to 71 per 100,000 women.

The researchers estimate that 6.8 million cancer deaths will have been avoided in the EU between 1988 and 2025—4.7 million in men and 2.1 million in women—based on the assumption that mortality rates would otherwise have remained constant since 1988.

However, due to population ageing, the absolute number of cancer deaths is projected to rise—from 671,963 to 709,400 among men and from 537,866 to 570,500 among women in the EU. In Italy, the number of deaths is expected to decrease slightly among men (from 97,866 to 94,740) but rise among women (from 79,991 to 81,740).

While mortality rates for most cancer types are expected to decline in the EU in 2025, pancreatic cancer is an exception, with projected increases of 2% in men and 3% in women. Lung cancer mortality among women is also expected to rise by 4%, while bladder cancer mortality will increase by 2%.

In Italy, the only projected increases in cancer mortality concern pancreatic and bladder cancer in women. Mortality rates for all other cancer types are expected to decrease in both men and women.

“Smoking remains by far the leading known cause of pancreatic cancer, accounting for between 20% and 35% of cases depending on age group and smoking patterns. Diabetes and overweight—risk factors associated with metabolic syndrome—are responsible for around 5% of pancreatic cancer cases in Europe. The role of obesity is becoming increasingly important, but tobacco control remains the main priority for preventing pancreatic cancer,” explains Professor Eva Negri, who teaches Environmental Epidemiology and Occupational Medicine at the University of Bologna and co-led the study.

Lung cancer remains the leading cause of cancer-related death among men in both the EU (151,000 cases) and Italy (19,600 cases). In Italy, breast cancer is the leading cause of cancer death among women (13,660 cases). In the EU, breast cancer currently accounts for the highest number of cancer deaths in women, although by 2025, lung cancer is expected to overtake it. Mortality from lung cancer in women continues to rise, with a 3.8% increase forecast compared to 2020.

La Vecchia concludes: “Cancer mortality trends remain generally favourable across Europe. However, there are some worrying signs. One is the rise in colorectal cancer mortality among people under 50, now observed in the UK and several Northern and Central European countries. This is likely due to increased prevalence of overweight and obesity among younger people, who are not eligible for colorectal cancer screening based on age. Moreover, pancreatic cancer mortality remains high and shows no signs of declining in the EU, making it the fourth leading cause of cancer death after lung, colorectal and breast cancer. While lung cancer mortality rates are beginning to stabilise, they have not yet started to fall among women in the EU. These trends underscore the urgent need for stricter tobacco control policies across Europe.”

The project received support from AIRC Foundation; Claudia Santucci and Carlo La Vecchia also received funding from the Next Generation EU–MUR PNRR Extended Partnership Inf-Act initiative.