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The burden of non-acute dying on society: dying of cancer and chronic disease in the European Union
  1. Jeroen Hasselaar1,
  2. Yvonne Engels1,
  3. Johan Menten2,
  4. Birgit Jaspers3,4 and
  5. Kris Vissers1
  1. 1Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
  2. 2Department of Radiotherapy-Oncology and Palliative care, University Hospital Gasthuisberg Leuven, Leuven, Belgium
  3. 3Department of Palliative Medicine, University of Bonn, Palliative Care Centre, Malteser Hospital Bonn/Rhein-Sieg, Germany
  4. 4Department of Palliative Medicine, University of Goettingen, Germany
  1. Correspondence to Jeroen Hasselaar, Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Geert Grote Plein Zuid, Nijmegen 6500, The Netherlands; j.hasselaar{at}


Objectives Due to the ageing of the European population, the burden of non-acute dying on society is expected to increase. The aim of this study is to estimate the number of persons dying of cancer and chronic disease in Europe, including regional differences.

Methods Death certificates of deceased persons in the European Union (EU)-27 countries in 2007 (some countries 2006 or 2004) were analysed and primary death causes were listed. These data were prepared for the general population and for the population of 65 years and older. Crude death rates (CDRs) were calculated for both groups and for all included countries.

Results Of 480 million deceased European people, 202 million died of cancer and chronic disease in 2007 (42%). The CDR of the EU-27 countries was 409 (95% CI 370 to 451) for cancer and other chronic diseases per 100 000 inhabitants in 2007. For the 65+ population, the CDR for the EU-27 was 1783 (95% CI 1701 to 1868) for cancer and chronic disease. Large differences across countries appeared. An inverse relationship was shown for country-specific CDRs for cancer and chronic disease versus CDRs for other death causes (R=−0.41; p=0.04).

Conclusions Dying of cancer and chronic diseases involves a considerable burden on the European society. Future research should relate this information to the prevalence of symptoms and the use of palliative care services. European policy makers should take into account regional variations in developing long- and short-term palliative care strategies.

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  • Funding European Agency of Health and Consumers (EAHC). The funding body was not involved in the study design; in the collection, analysis and interpretation data; in the writing of the report; or in the decision to submit the paper for publication.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Statistical data are available at Eurostat Luxembourg.