Cancer

Please note that the following numbers should be interpreted in the context of COVID-19

1. Key messages

2. Cancer incidence

The number of registered new cancer cases increased from 68,967 in 2020 to 74,998 in 2021

In 2021, 74,998 new diagnoses of cancer (excluding non-melanoma skin cancer) were registered, including 40,615 new cases in men and 34,383 new cases in women.

Cancer incidence increases with age, with the highest incidence 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.

The number of new cases is the highest in the Flemish Region in 2021

Trends in unadjusted incidence in Belgium, show an overall increase between 2006 and 2021 for both men and women. After adjusting for age the trend patterns changed; the incidence increased from 486 per 100,000 in 2006 to 588 per 100,000 women in 2021 while the age-adjusted incidence decreased from 508 per 100,000 to 506 per 100,000 in men in the same period.

In men, unadjusted incidences are the highest in the Flemish Region followed by the Walloon Region, and the Brussels Capital Region. In women, unadjusted rates are similar in the Walloon Region and the Flemish Region, with lower rates in the Brussels Capital Region. This pattern is mainly driven by the age structure as the differences are greatly reduced once they are adjusted for age. A large drop in the unadjusted and age-adjusted incidence was observed in 2020, the first year of the COVID-19 pandemic. This drop may have more to do with reduced capacity for diagnosis rather than reflecting a true reduction in incidence and therefore, should be interpreted with caution.

From 2006 to 2021, the overall number of new cancer cases increased for both men and women in the Flemish Region and the Walloon Region, but decreased in the Brussels Capital Region. When considering age differences, the situation varies: In the Walloon Region, the Brussels Capital Region, and the Flemish Region, the age-adjusted incidence of cancer in men remained unchanged. However, in women, the age-adjusted incidence of cancer increased in the Flemish Region and the Walloon Region, while it remained stable in the Brussels Capital Region.

Prostate and breast cancer rank number one among men and women

In 2021, prostate cancer and breast cancer were the most frequently diagnosed cancers among men and women, respectively. The age-adjusted incidence of breast cancer in women was stable, while the age-adjusted incidence of prostate cancer decreased in men between 2006 and 2014, but has slightly increased since then.

Lung cancer has been the second most frequent cancer in men and since 2018 has also been the second most frequently diagnosed cancer in women. The age-adjusted incidence of lung cancer increased by 67% between 2006 and 2021 in women, while it decreased by 19% in men.

Colorectal cancer diagnoses decreased between 2006 and 2021 by 28% in men and 9.1% in women. When the colorectal screening program was introduced in the Flemish Region, a peak in age-adjusted incidence was observed in 2014.

The incidence of melanoma increased in both sexes. In men, the age-adjusted incidence increased by 130% between 2006 and 2021, while in women it increased by 107%, ranking melanoma 4th among the most frequently diagnosed cancers since 2010 ahead of cervical cancer. Greater awareness and more active screening can play some role in the observed increase in incidence, but these factors likely do not explain the entire increase.

The incidence of cancer is higher compared to the EU average in Belgium

Crude cancer incidence per 100,000 is higher in Belgium than the EU-14 average for men and women. Compared to the EU-14 average, the incidence per 100,000 in Belgium is 4.8% higher among men and 2.0% 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 levels of accuracy. Data for Greece and Spain are not available.

3. Cancer prevalence

4 in 100 people in Belgium are living with cancer

In 2021, 464,930 persons (4.0% of the total Belgian population) were living with cancer (including non-melanoma skin cancer) and had been diagnosed between 2012 and 2021. This number included 233,940 men and 230,990 women. The crude and age-adjusted prevalence per 100,000 was highest in the Flemish Region compared to the other Regions.

Prostate cancer was the most prevalent cancer type among men (71,231 cases, or 1.3% of the total male population in Belgium). Among women, breast cancer was the most prevalent cancer type (88,512 cases, or 1.5% of the total female population in Belgium). Another 49,010 patients with cancer were alive by the end of 2021 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 point in time, 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.

4. Read more

View the metadata for this indicator

View the prevalences in a dynamic application

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 causes 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 caused by carcinogenic agents related to behavioral, metabolic, and/or environmental factors.

Data on new cancer cases in Belgium are collected by the Belgian Cancer Registry Foundation. The data from the Belgian Cancer Registry are nationally representative and exhaustive. They collect and record 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 these cancers frequently occur, they are typically not clinically significant. In addition, there is large heterogeneity in the registration of these cancers, making comparisons and trend analyses very difficult.

Facts and figures about cancer are calculated and published every year by the Cancer Registry. These figures include the crude and age-standardized incidence, which refer to new cases; and prevalence, which refer to the number of people living with cancer at a given period after initial diagnosis. In this chapter, the presented cancer prevalence estimates from the year 2013 onwards have been calculated in the framework of the Belgian Burden of Disease project.

For information concerning cancer-related mortality, please consult the following pages: Causes of death and Causes of premature death.

Definitions

EU-14

The EU-14 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 and Sweden. We compare the Belgian health status to that of the EU-14 because these countries have similar socioeconomic conditions. Since the United Kingdom left the EU, the EU-15 was changed into the EU-14 group of countries.

Age-standardized incidence

The age-standardized incidence is a weighted average of the individual age-specific incidence 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.

Unadjusted incidence

The unadjusted incidence 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 unadjusted incidence 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 2021, representing people living in Belgium who were diagnosed with at least one invasive malignancy in the period from 1st January 2012 to 31st December 2021 and who were still alive at the end of 2021. Persons with more than one malignancy were included as prevalent cases in each cancer type but were counted only once in analysis regrouping multiple tumor 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. Gorasso, V., Silversmit, G., Arbyn, M., Cornez, A., De Pauw, R., De Smedt, D., ... & Speybroeck, N. (2022). The non-fatal burden of cancer in Belgium, 2004–2019: a nationwide registry-based study. BMC cancer. doi: https://doi.org/10.1186/s12885-021-09109-4

Please cite this page as: Sciensano. Non-Communicable Diseases: Cancer, Health Status Report, 06 Feb 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/non-communicable-diseases/cancer