Cancer in Estonia: incidence 2021, survival 2017–2021 and cancer cases diagnosed in screening

Estonian cancer incidence data are available for more than 50 years – since 1968. Over the years, the annual number of new cancer cases has increased significantly. In 2021, 8224 new cancer cases were registered in Estonia, of which 4084 were diagnosed in men and 4140 in women. Excluding non-melanoma skin cancer, the overall number of cancer cases was 6978. Leading cancer sites in men were similar to previous years – the prostate (26% of all cancers in men) and lung (13%). In women, the leading sites were
the breast and non-melanoma skin (both 19% of all cancers in women).

The increase in cancer cases in the long term is partly caused by the ageing of the population – more than a third of all cases in 2021 were diagnosed in patients older than 75 years. Among 54-year-old and younger women, cancer incidence was lower than among men in the same age, however, from the age 55, cancer incidence in men was remarkably higher than in women. The most frequent cancer sites vary across age groups. Cancer is quite rare in children – in 2021 20 cases of malignant tumours were diagnosed in children aged 0–14 of which leukaemia was the most frequent. In the age group 15–34, the leading cancer sites were testis, non-melanoma skin and brain in men and the breast, non-melanoma skin and thyroid in women. In the age group 35–54, the most common cancer sites in men were non-melanoma skin, the prostate and lung and the breast, non-melanoma skin and cervix uteri in women. In patients aged older than 55, the leading sites were the same as in the general population – the prostate, lung and non-melanoma skin in men and non-melanoma skin and the breast in women.

In 2021, the proportion of microscopically verified cancer cases was 90%, indicating a rather good quality of diagnosis. 3,4% of cancer cases were death certificate initiated (DCI) while ca 2% of cases were registered as death certificate only (DCO) cases, which is rather low, but nevertheless refers to incomplete notification of cancer cases to the ECR.

It is important to diagnose and treat cancer as early as possible, to enable more effective treatment. Half of the new cancer cases diagnosed in 2021 were localized at the time of diagnosis, but ca 20% of men and 15% of women already had distant metastasis. The highest proportion of distant metastasis at diagnosis was seen in pancreatic cancer both in men (60%) and women (50%). For more than 40% of patients, distant metastasis was found in lung cancer in both men and women.