Leader: An Estonian problem: Childhood cancer
Arvamus | 30 Dec 2003  | Tõnu NaelapeaEWR


The demographics of our readership are such that most of are the age where they have lost at least one parent. Many are aware of the debilitiating effects of fighting cancer However, one expects that few have been in the painful situation of losing an child in childhood to that disease.

It was thus quite stunning to read of the findings of EUROCARE-3 — the largest international cancer survival study to date, made public the week before Xmas. The EUROCARE study, which began in 1989 and is periodically updated, is funded by the European Union.

Children in Iceland and Finland appear to have the best chance in Europe of surviving childhood cancer, according to new research that tracks children’s cancer survival patterns across the region. The worst? Estonian children.

The aim of the report is to identify countries and areas where help is needed to enable children with cancer to live longer. “There is room for improvement. So large a gap in survival rates in not acceptable in Europe,” said the report’s lead author, Dr. Gemma Gatta of the National Tumor Institute in Milan, Italy.

The variations in overall cancer survival for children was indeed striking, ranging from a low of 45 percent in Estonia to a high of 90 percent in Iceland. The study was based on data from 45 cancer registries in 20 countries (Latvia and Lithuania did not participate). A total of 23,000 children, under the age of 15, diagnosed between 1990 and 1994 were monitored. Estonia reported 199 cases, Iceland 39, Finland 799.

Note the amazing disparity in the region — environmental impact, the legacy of Soviet ecocide must not be playing a role here, for Finns, with their 81% survival rate are in the same ecological biospace.

Dr. Peter Boyle, director of the European Oncology Institute in Milan and incoming chief of the U.N.’s International Agency for Research on Cancer, cautions against interpreting the results as a ranking of the performance of health care systems. However, there are questions that need to be asked, and answered, fast.

The majority of childhood cancers are curable or at least respond well to treatment. The main factors influencing survival are access to treatment and application of up-to-date resources. Early diagnosis and a sound referral system are key.

Is it really possible that Estonia’s health care system lags so far behind the Finns and the Icelanders? Even far below the European average — which is similar to North American one? Eastern Europe as a whole fares poorly in this study, but seeing Estonia at the bottom is an unpleasant surprise.

How can this gap be explained? Estonia does not have a Health ministry as we do in Canada, health care is the responsibility of the Ministry of Social Affairs. Could the minister responsible, Marko Pomerants, comment publicly on this report? The Nordic countries are setting the gold standard — Estonia should be following close behind, not lagging at the rear.

The low national birth rate is already a concern. Young people are delaying starting families, concentrating on careers. Families are usually small. The EUROCARE-3 report should be addressed in Estonia with the gravity that theses statistics demand.


 
Arvamus