Cancer

1. Key messages

In 2017, 68,702 new diagnoses of cancer were made, including 36,977 new cases in men and 31,725 in women. The most frequently diagnosed cancers were prostate, lung and colorectal cancer in men, and breast, colorectal and lung cancer in women.
Since 2006, the number of new cancer diagnoses has increased for both men and women, partly due to the ageing of the population. After adjustment for age, incidence rates however only increased in women.
Age-adjusted incidence rates are highest in the Walloon Region.
Since 2006, the age-adjusted incidence of lung cancer has gone up with 46% in women, while it decreased by 13% in men. Over the same time period, the age-adjusted incidence of melanoma has increased by 103% in men and 83% in women.

2. Background

Cancer is a broad family of diseases that involve abnormal cell growth with the potential to invade or spread to other parts of the body. It is one of the most important disease groups in terms of premature mortality, ill health, and healthcare expenditure. Cancer can be caused by inherited genetic traits, but the vast majority is due to genetic mutations occasioned by carcinogenic agents related to lifestyle, and metabolic or environmental factors.

Data on new cancer cases in Belgium are collected by the Belgian Cancer Registry Foundation. The Belgian Cancer Registry is nationally representative and exhaustive. It collects and records both clinical and pathological data. The recording of data (topography and morphology) is done using the International Classification of Diseases for Oncology.

The total number of cancer cases is usually presented excluding non-melanoma skin cancers. Although frequently occurring, these cancers are typically not clinically significant. In addition, there is large heterogeneity in the registration of these cancers, impeding comparisons and trend analyses.

Incidence figures include crude and age-adjusted incidence rates. They are calculated and published yearly by the Cancer Registry. Prevalence data refer to the number of people living with cancer at a given period after initial diagnosis. Cancer prevalence for the year 2013 has been calculated by the Cancer Registry.

3. Cancer incidence

Belgium

In 2017, 68,702 new diagnoses of cancer (excluding non-melanoma skin cancer) were made, including 36,977 new cases in men and 31,725 new cases in women.

Cancer incidence shows a clear association with age, with the highest incidence rate in the 80-84 age group. Before the age of 55, cancers are more commonly diagnosed among women, while in the older age groups, cancer diagnoses become more common among men.

Cancer incidence by age and sex, Belgium, 2017
Source: Belgian Cancer Registry [1]

Trends and regional disparities

Crude incidence rates are highest in Flanders in men and in Wallonia in women, while age-adjusted incidence rates are highest in Wallonia in both genders. When adjusted for age, incidence rates in Flanders fall below the national average in both genders.

In Belgium, the crude incidence rate has increased between 2006 and 2017 in both men and women. When adjusted for age, the incidence rate only increased in women while it has decreased in men.

Between 2006 and 2017, crude incidence rates of cancer increased for both men and women in Flanders and Wallonia. In Brussels, however, a decreasing trend is observed. These evolutions are mainly driven by the ageing patterns of the populations, as evidenced by the age-adjusted incidence rates; in men, incidence rates were more or less stable in Wallonia and Brussels, while slightly decreasing in Flanders. In women, age-adjusted incidence rates increased in Flanders and Wallonia, while staying stable in Brussels.

  • Men
  • Women

Crude cancer incidence per 100,000 men in Belgium and its regions, 2006-2017
Source: Belgian Cancer Registry [1]

Crude cancer incidence per 100,000 women in Belgium and its regions, 2006-2017
Source: Belgian Cancer Registry [1]

  • Men
  • Women

Age-adjusted cancer incidence per 100,000 men in Belgium and its regions, 2006-2017
Source: Belgian Cancer Registry [1]; Age-adjustment based on European Standard Population.

Age-adjusted cancer incidence per 100,000 women in Belgium and its regions, 2006-2017
Source: Belgian Cancer Registry [1]; Age-adjustment based on European Standard Population.

Site-specific cancer incidence

In 2017, prostate cancer and breast cancer were the most frequently diagnosed cancers among men and women, respectively. The incidence of breast cancer in women is stable, while the age-adjusted incidence of prostate cancer has decreased in men between 2006 and 2017.

Lung cancer is the second most frequent cancer in men and third most frequent in women. The age-adjusted incidence of bronchus and lung cancer has gone up with 46% between 2006 and 2017 in women, while it decreased by 13% in men.

Colorectal cancer diagnoses remained stable between 2006 and 2017 in both men and women, and showed a peak in 2014, when a colorectal cancer screening program was introduced in Flanders.

The incidence of melanoma is increasing in both genders. In men, the age-adjusted incidence has increased by 103% between 2006 and 2017 while it has increased by 83% in women, ranking melanoma 4th among the most frequently diagnosed cancers since 2010, ahead of cervical cancer. A more active screening can have played some role in the apparent increase of incidence, but most probably does not account for the totality of the change.

  • Crude
  • Age-adjusted

Crude incidence of the six most commonly diagnosed cancers (excluding non-melanoma skin cancer) in men, Belgium, 2006-2017
Source: Belgian Cancer Registry [1]

Age-adjusted incidence of the six most commonly diagnosed cancers (excluding non-melanoma skin cancer) in men, Belgium, 2006-2017
Source: Belgian Cancer Registry [1]; Age-adjustment based on European Standard Population.

  • Crude
  • Age-adjusted

Crude incidence of the six most commonly diagnosed cancers (excluding non-melanoma skin cancer) in women, Belgium, 2006-2017
Source: Belgian Cancer Registry [1]

Age-adjusted incidence of the six most commonly diagnosed cancers (excluding non-melanoma skin cancer) in women, Belgium, 2006-2017
Source: Belgian Cancer Registry [1]; Age-adjustment based on European Standard Population.

International comparison

Crude cancer incidence per 100,000 is higher in Belgium than the EU-15 average, both for men and women. Compared to the countries with the lowest incidence rates, the incidence per 100,000 in Belgium is 35% higher among men and 46% higher among women.

International comparisons should be interpreted with caution, given the various methods of data collection in different countries (registers versus routine reporting systems), with different level of accuracy. Data for Greece and Spain were not available.

  • Men
  • Women

Cancer incidence per 100,000 men, EU-15 countries, 2015 or nearest year
Source: WHO-EURO Health For All Database [2]

Cancer incidence per 100,000 women, EU-15 countries, 2015 or nearest year
Source: WHO-EURO Health For All Database [2]

4. Cancer prevalence

331,776 persons (3% of the total Belgian population) were alive by the end of 2013 after having been diagnosed with cancer (excluding non-melanoma skin cancer) between 2004 and 2013. This number included 161,166 men and 170,610 women. The crude prevalence per 100,000 was highest in the Flemish Region, while the age-adjusted prevalence per 100,000 was highest in the Walloon Region.

Prostate cancer was the most prevalent cancer type among men (67,892 cases, or 1.2% of the total male population in Belgium). Among women, breast cancer was the most prevalent cancer type (80,099 cases, or 1.4% of the total female population in Belgium). Another 31,370 Belgians were alive by the end of 2013 after having been diagnosed with colon cancer in the past 10 years.

Information on the prevalence of cancer yields a different picture than the information on the incidence of cancer. Indeed, cancer prevalence is a function of cancer incidence and survival, and the latter may be very different from one cancer to another. Lung cancer, for instance, has a low survival rate, such that few survivors will be alive at a given moment, despite the high incidence. On the other hand, prostate and breast cancer have both high incidence and survival rates, explaining their predominance in prevalence estimates.

  • Men
  • Women

Ten-year prevalence (absolute numbers) of the most common cancer types among men, Belgium, 2013
Source: Cancer burden in Belgium [3]

Ten-year prevalence (absolute numbers) of the most common cancer types among women, Belgium, 2013
Source: Cancer burden in Belgium [3]

5. Read more

View the metadata for this indicator

Definitions

EU-15
The EU-15 corresponds to all countries that belonged to the European Union between 1995 and 2004: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden and the United Kingdom. We compare the Belgian health status to that of the EU-15 because these countries have similar socioeconomic conditions.
Age-adjusted incidence
The age-adjusted incidence rate is a weighted average of the individual age-specific rates using an external standard population. Here, the European Standard Population is used as standard population. It is the incidence that would be observed if the population had the age structure of the standard population. Since age has a powerful influence on the risk of cancer, this standardization is necessary when comparing several populations that differ with respect to their age structure.
Crude incidence
The crude incidence rate is calculated by dividing the number of new cases observed during a given time period by the corresponding number of people in the population at risk. The crude rate is expressed as the number of new cases per 100,000 person years.
Ten-year prevalence
Ten-year prevalence data were estimated with an index date of 31st December 2013, representing people living in Belgium who were diagnosed with at least one invasive malignancy in the period from 1st January 2004 to 31st December 2013 and who were still alive at the end of 2013. Persons with more than one malignancy were included as prevalent cases in each cancer type, but were counted only once in analysis regrouping multiple tumour sites.

References

  1. Belgian Cancer Registry. https://kankerregister.org/
  2. Health For All Database. WHO EURO. https://gateway.euro.who.int/en/datasets/european-health-for-all-database/
  3. Cancer burden in Belgium 2004-2013, Belgian Cancer Registry, Brussels 2015. https://kankerregister.org/media/docs/publications/BCR_publicatieCancerBurden2016_web160616.pdf