Background: Cancer mortality rates, though not absolute numbers of deaths, have been decreasing over the last three decades in Europe. Materials and methods: We estimated projections and the number of avoided deaths for total cancer mortality and 10 major cancer sites, between 1989 and 2022, for the European Union (EU), the UK, France, Germany, Italy, Poland and Spain using cancer death certification and population data since 1970 from the World Health Organization and Eurostat. Results: In the EU, we predict 1 269 200 cancer deaths in 2022; corresponding age-standardized rates (world) fall 6% to 126.9 deaths/100 000 in men and 4% to 80.2/100 000 women since 2017. Male lung cancer is expected to fall 10% reaching 30.9/100 000. The rise in female lung cancer mortality slowed (+2% to 13.8/100 000). We estimated 369 000 (23%) avoided deaths in 2022 alone and a total of 5 394 000 (12%) deaths since the peak rate in 1988. Stomach, colorectal, breast and prostate cancers showed substantial declines, between 5% and 16% over the past 5 years. Pancreatic cancer remained stable in men (8.1/100 000) and rose 3% in women (5.9/100 000), becoming the third cause of cancer mortality in the EU (87 300 deaths), overtaking breast cancer (86 300 deaths). The fall in uterine cancers slowed down (−4%) to 4.7/100 000. Bladder cancer fell 9% in men, but was stable in women. Leukaemias fell more than 10%. Ovarian cancer mortality declined over the past decade in all considered countries. EU predicted rates were 4.3/100 000 (−13%) all ages, 1.2/100 000 (−26%) at 20-49, 15.3/100 000 (−11%) at 50-69 and 32.3/100 000 (−11%) at 70-79 years. Conclusions: We predicted additional declines in cancer mortality rates for 2022. The slowdown in female lung cancer mortality reflects some levelling of smoking in women. Favourable ovarian cancer trends are likely to continue and are largely attributable to the spreading oral contraceptive use and some impact of improved diagnosis and management.
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