Cancer epidemiology in Geneva’s canton
Incidence and mortality, 2016-2020
Introduction
Cancer registration in Switzerland
Since January 1, 2020, data collection and registration has been governed by the Law on the Registration of Oncological Diseases LEMO. This law stipulates that oncological diseases must be registered uniformly and comprehensively in Switzerland. It also requires doctors, laboratories, hospitals and other private or public institutions in the healthcare system to communicate certain data concerning oncological diseases. The aim of this obligation is the complete registration of oncological diseases in Switzerland.
Geneva’s cancer registry
The Geneva Tumor Registry was created in 1970. It is the oldest register in Switzerland and one of the oldest in Europe (FSO).
The aim of a population-based register such as the one in Geneva is to record all cancers diagnosed in the canton’s resident population. The objective is to produce comparable data over time on the cancer situation in Geneva, through the production of appropriate indicators (incidence, prevalence, mortality, survival, projections). In order to be exhaustive, it receives or actively seeks information from numerous sources, including hospitals, anatomopathology laboratories and referring physicians.
To learn more, visit the Registry website
Inclusions criteria
Included are all patients living in Geneva’s Canton and diagnosed with a malignant primary cancer, with the exception of non-melanomic skin cancers (C00-43, C45-97, ICD-10). Primary cancers are selected following the rules of the IARC/IACR rules .
The cause of death is based on death certificates indicating the causes of death which are completed by the physicians who declare the death. Are included all deaths caused by malignant cancer, that is to say underlying cause of death as coded by the Statistical Federal Office (SFO) (C00-C97, ICD-10). The mortality data presented were supplied by the FSO and were processed by the Registry.
Indicators definitions
This report is a compilation of the latest available cancer statistics in Geneva for the period 2016-2020, regarding incidence and mortality.
Both incidence and mortality are analysed using age-standardized rates (see definition below) computed with direct method. The use of a standard population is a very useful tool for comparisons of incidence and mortality rates. Age standardization is one of the key methods to control for different age distributions among populations, or over time. The European standard population in use for the interpretation of cancer burden is the Waterhouse reference population ( Waterhouse J. and Col. (Eds.). Cancer incidence in five continents. Lyon, IARC, 1976).
Table 1 shows the european reference population used in this document.
| Age category | Reference population 1976 |
|---|---|
| 0 to 4 years | 8,000 |
| 5 to 9 years | 7,000 |
| 10 to 14 years | 7,000 |
| 15 to 19 years | 7,000 |
| 20 to 24 years | 7,000 |
| 25 to 29 years | 7,000 |
| 30 to 34 years | 7,000 |
| 35 to 39 years | 7,000 |
| 40 to 44 years | 7,000 |
| 45 to 49 years | 7,000 |
| 50 to 54 years | 7,000 |
| 55 to 59 years | 6,000 |
| 60 to 64 years | 5,000 |
| 65 to 69 years | 4,000 |
| 70 to 74 years | 3,000 |
| 75 to 79 years | 2,000 |
| 80 to 84 years | 1,000 |
| 85 and older | 1,000 |
Crude incidence/mortality rate : The crude rate is the ratio of the number of new cases or deaths in a specified population and time period to the size of the population at risk during the same time period. Incidence and mortality rate are usually presented as an annual rate per 100,000 persons at risk.
Age-specific incidence/mortality rate: It is calculated by dividing the number of new cancers or cancer deaths observed in a given age category (generally five-year age groups, with highest group 85+) during a given time period by the corresponding number of person in the population at risk in the same age category and time period. It is expressed as the number of new cancer cases or deaths per 100,000 person at risk per year.
Age-standardized incidence/mortality rate (ASR). ASR is a summary measure of the rate that a given population would have if it had a standard age structure. Standardization is necessary when comparing several populations that differ with respect to age because age has a powerful influence on the risk of cancer. The ASR is a weighted mean of the age-specific rates; the weights are given by population distribution of a reference population. One frequently used reference population is the European Reference (or Standard) Population. The calculated incidence or mortality rate is then called age-standardized incidence or mortality rate (European reference). It is expressed per 100,000 person per year.
Population at risk: The population which is susceptible to develop a specific cancer. It is defined on the basis of demographic data, such as place of residence, sex, age group, etc.
More information on ECIS (for reference population) and Nicer (for cancer registration).
Cancer incidence and mortality in Geneva, an overview
Over the period 2016-2020, a total of 6,769 and 6,358 new cases of invasive cancer were diagnosed respectively in men and in women in the canton of Geneva. Over the same period, 2,369 men and 2,245 women died from cancer. Figure 1 shows the proportion of men and women, for incidence and mortality
Figure 1: distribution of gender among incident cases and death cases
The age-standardized incidence rates (per 100,000 persons per year) were 456.4 for men and 358.9 for women. The standardized mortality rates (per 100,000 persons per year) were 144.4 for men and 101.9 for women.
Most common incident cancers
The most commonly occurring cancers in Geneva are shown in Figure 2. For the 2016-2020 period, the most frequent cancer among men was prostate, with a standardized incidence rate of 132.9 per 100 000 person per year. It was followed by lung and bronchus (51.1/100 000). The five most common cancer in men (prostate, lung and bronchus, colon and rectum, skin melanoma, urinary bladder) counted for 60.5% of all male cancer cases.
Among women, the most frequent cancer was breast, with an incidence rate of 130.1 per 100 000 person per year. The second most frequent cancer was lung and bronchus (35.7/100 000). The five most common cancer in women (breast, lung and bronchus, colon and rectum, skin melanoma, corpus uteri) counted for 63.4% of all female cancer cases.
More men than women developed cancer. The predominance of males was associated with prostate and tobacco-related cancers. It is to be noted the importance of lung and bronchus cancer among women, linked to the increase of tobacco consumption among women in the latter half of the 20th century.
Figure 2: Main incident cancer types by gender
Major cause of cancer death
Between 2016-2020 in Geneva, the most frequent cause of death (by cancer) among men was lung and bronchus, with an incidence rate of 33.3 per 100 000 person per year. The second most frequent cancer among men was prostate (14.8/100 000). The five most common cause of death by cancer in men (lung and bronchus, prostate, pancreas, colon and rectum, liver) counted for 58% of all male cancer cases.
The most frequent cause of death by cancer among women was breast, with an incidence rate of 20.4 per 100 000 person per year. The second most frequent cancer among women was lung and bronchus (20.2/100 000). The five most common cause of death by cancer in women (breast, lung and bronchus, colon and rectum, pancreas, ovary and other uterine adnexa) counted for 60.3% of all male cancer cases.
Figure 3 illustrates the main cancer cause of death by gender in Geneva for the period 2016-2020.
Figure 3: main cancer cause of death by gender in Geneva for the period 2016-2020
The difference in order of ranking between incidence and mortality reflects the differing survivorship of patients with different cancers. For example, lung cancer is both common and quickly fatal and, therefore, ranks highly in both new cancers and cancer deaths. Pancreatic cancer is not common but is usually rapidly lethal, so its mortality ranking is higher than its incidence ranking.
Age at incidence
The mean age at incidence was 67.6 years for men and 66.3 years for women. Incidence of cancer increases with age, reaching a pick after 80 years old in terms of incidence rate. Figure 4 shows age distribution according to gender and illustrates the distribution of specific incidence rates across age categories.
Figure 4: Age at incidence, specific incidence rates (represented by lines) and number of cancers by age (represented by bars)
Age at death
The mean age at death by cancer was 74.1 years for men and 75.2 years for women.
Figure 4 shows age distribution according to gender and illustrates the distribution of specific incidence rates across age categories.
Figure 5: Age at death, specific incidence rates (represented by lines) and number of cancers by age (represented by bars)
Incidence by cancer site
Table 2 and 3 show the number of cases diagnosed between 2016 and 2020 by cancer type for men and women, as well as crude and standardized rates.
Each year, 386 men are diagnosed with prostate cancer.
| Cancer category | Case number | Mean cases/year | Crude Rate (per 100 000) | Std Rate (per 100 000) | 95% Lower CI | 95% Upper CI |
|---|---|---|---|---|---|---|
| Lip, Oral Cavity, and Pharynx | 264 | 53 | 21.8 | 18.7 | 16.5 | 21.1 |
| Esophagus | 108 | 22 | 8.9 | 7.4 | 6.0 | 8.9 |
| Stomach | 156 | 31 | 12.9 | 10.2 | 8.6 | 12.0 |
| Small Intestine | 37 | 7 | 3.0 | 2.5 | 1.7 | 3.4 |
| Colon and Rectum | 593 | 119 | 48.9 | 39.1 | 36.0 | 42.5 |
| Anus and Anal Canal | 35 | 7 | 2.9 | 2.4 | 1.7 | 3.4 |
| Liver | 288 | 58 | 23.8 | 19.0 | 16.8 | 21.4 |
| Gallbladder and Extrahepatic Biliary Tract | 36 | 7 | 3.0 | 2.4 | 1.6 | 3.3 |
| Pancreas | 223 | 45 | 18.4 | 14.3 | 12.4 | 16.4 |
| Larynx | 68 | 14 | 5.6 | 4.7 | 3.6 | 5.9 |
| Lung and Bronchus | 771 | 154 | 63.6 | 51.1 | 47.5 | 55.0 |
| Pleura and Mesothelioma | 18 | 4 | 1.5 | 1.2 | 0.7 | 2.0 |
| Bone | 19 | 4 | 1.6 | 1.5 | 0.9 | 2.4 |
| Skin Melanoma | 433 | 87 | 35.7 | 29.5 | 26.7 | 32.4 |
| Soft Tissue | 56 | 11 | 4.6 | 3.9 | 2.9 | 5.2 |
| Breast | 17 | 3 | 1.4 | 1.2 | 0.7 | 2.0 |
| Prostate | 1931 | 386 | 159.3 | 132.9 | 126.9 | 139.1 |
| Testis | 98 | 20 | 8.1 | 7.6 | 6.2 | 9.3 |
| Kidney and Renal Pelvis | 238 | 48 | 19.6 | 16.2 | 14.2 | 18.5 |
| Urinary Bladder | 370 | 74 | 30.5 | 21.6 | 19.4 | 24.0 |
| Central Nervous System | 93 | 19 | 7.7 | 6.9 | 5.6 | 8.5 |
| Thyroid | 71 | 14 | 5.9 | 5.2 | 4.1 | 6.6 |
| Hodgkin Lymphoma | 47 | 9 | 3.9 | 3.6 | 2.6 | 4.8 |
| Non-Hodgkin Lymphoma | 263 | 53 | 21.7 | 17.7 | 15.6 | 20.1 |
| Multiple Myeloma | 98 | 20 | 8.1 | 6.8 | 5.5 | 8.3 |
| Chronic Lymphocytic Leukemia | 137 | 27 | 11.3 | 9.3 | 7.8 | 11.1 |
| Acute Myeloid Leukemia | 83 | 17 | 6.8 | 5.3 | 4.2 | 6.6 |
| Leukemia, Not otherwise specified | 6 | 1 | 0.5 | 0.4 | 0.1 | 0.8 |
| Other | 122 | 24 | 10.1 | 8.3 | 6.9 | 10.0 |
| Unknown Primary Site | 90 | 18 | 7.4 | 5.5 | 4.4 | 6.8 |
| Total | 6769 | 1354 | 558.5 | 456.4 | 445.4 | 467.7 |
In Geneva’s canton, 432 women are diagnosed every year with an invasive breast cancer.
| Cancer category | Case number | Mean cases/year | Crude Rate (per 100 000) | Std Rate (per 100 000) | 95% Lower CI | 95% Upper CI |
|---|---|---|---|---|---|---|
| Lip, Oral Cavity, and Pharynx | 114 | 23 | 8.8 | 6.5 | 5.3 | 7.8 |
| Esophagus | 60 | 12 | 4.7 | 2.9 | 2.1 | 3.8 |
| Stomach | 101 | 20 | 7.8 | 5.6 | 4.5 | 6.8 |
| Small Intestine | 33 | 7 | 2.6 | 1.8 | 1.2 | 2.6 |
| Colon and Rectum | 577 | 115 | 44.8 | 29.3 | 26.7 | 32.0 |
| Anus and Anal Canal | 85 | 17 | 6.6 | 4.7 | 3.7 | 5.9 |
| Liver | 80 | 16 | 6.2 | 4.0 | 3.1 | 5.0 |
| Gallbladder and Extrahepatic Biliary Tract | 51 | 10 | 4.0 | 2.2 | 1.6 | 3.0 |
| Pancreas | 232 | 46 | 18.0 | 10.8 | 9.3 | 12.4 |
| Larynx | 13 | 3 | 1.0 | 0.8 | 0.4 | 1.4 |
| Lung and Bronchus | 641 | 128 | 49.8 | 35.7 | 32.8 | 38.7 |
| Pleura and Mesothelioma | 12 | 2 | 0.9 | 0.5 | 0.2 | 0.9 |
| Bone | 12 | 2 | 0.9 | 0.8 | 0.4 | 1.5 |
| Skin Melanoma | 362 | 72 | 28.1 | 21.3 | 19.1 | 23.8 |
| Soft Tissue | 50 | 10 | 3.9 | 3.1 | 2.2 | 4.1 |
| Breast | 2162 | 432 | 167.8 | 130.1 | 124.4 | 135.9 |
| Cervix Uteri | 67 | 13 | 5.2 | 4.2 | 3.2 | 5.4 |
| Corpus Uteri | 286 | 57 | 22.2 | 15.7 | 13.8 | 17.8 |
| Ovary and Other Uterine Adnexa | 219 | 44 | 17.0 | 11.9 | 10.3 | 13.8 |
| Kidney and Renal Pelvis | 113 | 23 | 8.8 | 6.5 | 5.3 | 7.9 |
| Urinary Bladder | 90 | 18 | 7.0 | 4.1 | 3.2 | 5.1 |
| Central Nervous System | 63 | 13 | 4.9 | 4.0 | 3.0 | 5.2 |
| Thyroid | 202 | 40 | 15.7 | 14.2 | 12.2 | 16.3 |
| Hodgkin Lymphoma | 40 | 8 | 3.1 | 2.9 | 2.1 | 4.0 |
| Non-Hodgkin Lymphoma | 223 | 45 | 17.3 | 12.4 | 10.7 | 14.2 |
| Multiple Myeloma | 86 | 17 | 6.7 | 4.0 | 3.1 | 5.0 |
| Chronic Lymphocytic Leukemia | 84 | 17 | 6.5 | 4.5 | 3.5 | 5.7 |
| Acute Myeloid Leukemia | 73 | 15 | 5.7 | 3.8 | 2.9 | 4.9 |
| Leukemia, Not otherwise specified | 7 | 1 | 0.5 | 0.4 | 0.1 | 0.9 |
| Other | 126 | 25 | 9.8 | 6.8 | 5.6 | 8.2 |
| Unknown Primary Site | 94 | 19 | 7.3 | 3.6 | 2.8 | 4.5 |
| Total | 6358 | 1272 | 493.6 | 358.9 | 349.6 | 368.4 |
Mortality by cancer site
Table 4 and 5 show the number of death by cancer diagnosed between 2016 and 2020 among men and women in the Canton.
Each year, 103 men die with lung cancer. It is the major cause of death in men.
| Cancer category | Case number | Mean cases/year | Crude Rate (per 100 000) | Std Rate (per 100 000) | 95% Lower CI | 95% Upper CI |
|---|---|---|---|---|---|---|
| Lip, Oral Cavity, and Pharynx | 115 | 23 | 9.5 | 7.7 | 6.3 | 9.3 |
| Esophagus | 79 | 16 | 6.5 | 5.0 | 4.0 | 6.3 |
| Stomach | 76 | 15 | 6.3 | 4.9 | 3.9 | 6.2 |
| Small Intestine | 6 | 1 | 0.5 | 0.3 | 0.1 | 0.8 |
| Colon and Rectum | 204 | 41 | 16.8 | 12.2 | 10.5 | 14.1 |
| Anus and Anal Canal | 10 | 2 | 0.8 | 0.7 | 0.3 | 1.3 |
| Liver | 167 | 33 | 13.8 | 10.5 | 8.9 | 12.2 |
| Gallbladder and Extrahepatic Biliary Tract | 26 | 5 | 2.1 | 1.5 | 1.0 | 2.3 |
| Pancreas | 203 | 41 | 16.8 | 12.6 | 10.9 | 14.5 |
| Larynx | 16 | 3 | 1.3 | 1.0 | 0.6 | 1.7 |
| Lung and Bronchus | 517 | 103 | 42.6 | 33.3 | 30.4 | 36.4 |
| Pleura and Mesothelioma | 17 | 3 | 1.4 | 1.1 | 0.6 | 1.8 |
| Bone | 7 | 1 | 0.6 | 0.6 | 0.2 | 1.2 |
| Skin Melanoma | 38 | 8 | 3.1 | 2.4 | 1.6 | 3.3 |
| Soft Tissue | 16 | 3 | 1.3 | 1.1 | 0.6 | 1.9 |
| Breast | 2 | 0 | 0.2 | 0.1 | 0.0 | 0.5 |
| Prostate | 283 | 57 | 23.4 | 14.8 | 13.0 | 16.6 |
| Testis | 1 | 0 | 0.1 | 0.1 | 0.0 | 0.5 |
| Kidney and Renal Pelvis | 63 | 13 | 5.2 | 3.8 | 2.9 | 4.9 |
| Urinary Bladder | 128 | 26 | 10.6 | 6.9 | 5.7 | 8.2 |
| Central Nervous System | 72 | 14 | 5.9 | 5.2 | 4.0 | 6.5 |
| Thyroid | 8 | 2 | 0.7 | 0.5 | 0.2 | 1.0 |
| Hodgkin Lymphoma | 6 | 1 | 0.5 | 0.3 | 0.1 | 0.7 |
| Non-Hodgkin Lymphoma | 76 | 15 | 6.3 | 4.5 | 3.5 | 5.7 |
| Multiple Myeloma | 42 | 8 | 3.5 | 2.6 | 1.8 | 3.5 |
| Chronic Lymphocytic Leukemia | 23 | 5 | 1.9 | 1.3 | 0.8 | 1.9 |
| Acute Myeloid Leukemia | 49 | 10 | 4.0 | 2.7 | 2.0 | 3.5 |
| Leukemia, Not otherwise specified | 18 | 4 | 1.5 | 1.0 | 0.6 | 1.6 |
| Other | 28 | 6 | 2.3 | 1.7 | 1.1 | 2.5 |
| Unknown Primary Site | 73 | 15 | 6.0 | 4.0 | 3.1 | 5.1 |
| Total | 2369 | 474 | 195.4 | 144.4 | 138.4 | 150.5 |
In Geneva’s canton, 86 women die with an invasive breast cancer every year. It is nearly equal to the number of death recorded for lung cancer (81).
| Cancer category | Case number | Mean cases/year | Crude Rate (per 100 000) | Std Rate (per 100 000) | 95% Lower CI | 95% Upper CI |
|---|---|---|---|---|---|---|
| Lip, Oral Cavity, and Pharynx | 46 | 9 | 3.6 | 2.4 | 1.7 | 3.2 |
| Esophagus | 47 | 9 | 3.6 | 2.1 | 1.5 | 2.9 |
| Stomach | 50 | 10 | 3.9 | 2.2 | 1.6 | 3.0 |
| Small Intestine | 2 | 0 | 0.2 | 0.1 | 0.0 | 0.3 |
| Colon and Rectum | 193 | 39 | 15.0 | 8.0 | 6.8 | 9.3 |
| Anus and Anal Canal | 18 | 4 | 1.4 | 0.9 | 0.5 | 1.4 |
| Liver | 81 | 16 | 6.3 | 3.7 | 2.8 | 4.7 |
| Gallbladder and Extrahepatic Biliary Tract | 33 | 7 | 2.6 | 1.3 | 0.8 | 1.9 |
| Pancreas | 191 | 38 | 14.8 | 7.9 | 6.8 | 9.3 |
| Larynx | 2 | 0 | 0.2 | 0.1 | 0.0 | 0.3 |
| Lung and Bronchus | 403 | 81 | 31.3 | 20.2 | 18.2 | 22.5 |
| Pleura and Mesothelioma | 12 | 2 | 0.9 | 0.5 | 0.2 | 1.0 |
| Bone | 7 | 1 | 0.5 | 0.4 | 0.2 | 0.9 |
| Skin Melanoma | 26 | 5 | 2.0 | 1.2 | 0.7 | 1.8 |
| Soft Tissue | 13 | 3 | 1.0 | 0.6 | 0.3 | 1.0 |
| Breast | 431 | 86 | 33.5 | 20.4 | 18.4 | 22.6 |
| Cervix Uteri | 15 | 3 | 1.2 | 0.7 | 0.4 | 1.2 |
| Corpus Uteri | 52 | 10 | 4.0 | 2.4 | 1.7 | 3.2 |
| Ovary and Other Uterine Adnexa | 135 | 27 | 10.5 | 6.4 | 5.3 | 7.7 |
| Kidney and Renal Pelvis | 38 | 8 | 3.0 | 1.6 | 1.1 | 2.2 |
| Urinary Bladder | 48 | 10 | 3.7 | 1.8 | 1.3 | 2.5 |
| Central Nervous System | 57 | 11 | 4.4 | 3.2 | 2.4 | 4.3 |
| Thyroid | 7 | 1 | 0.5 | 0.2 | 0.1 | 0.5 |
| Hodgkin Lymphoma | 2 | 0 | 0.2 | 0.0 | 0.0 | 0.2 |
| Non-Hodgkin Lymphoma | 65 | 13 | 5.0 | 2.2 | 1.7 | 3.0 |
| Multiple Myeloma | 49 | 10 | 3.8 | 1.9 | 1.3 | 2.5 |
| Chronic Lymphocytic Leukemia | 21 | 4 | 1.6 | 0.9 | 0.5 | 1.5 |
| Acute Myeloid Leukemia | 41 | 8 | 3.2 | 2.1 | 1.4 | 2.9 |
| Leukemia, Not otherwise specified | 17 | 3 | 1.3 | 0.7 | 0.4 | 1.1 |
| Other | 49 | 10 | 3.8 | 2.2 | 1.6 | 3.0 |
| Unknown Primary Site | 94 | 19 | 7.3 | 3.6 | 2.8 | 4.5 |
| Total | 2245 | 449 | 174.3 | 101.9 | 97.3 | 106.7 |
Conclusions
This reports aimed at describing the epidemiology of cancer in Geneva’s canton for the period 2016-2020. It shows that the main cancer for men is prostate cancer while it is breast for women. For both gender, lung and bronchus, colon and rectum and skin melanoma cancers are the four other major cancer types.
The analysis presented in this document are not finished and the results are not considered as validated.
Acknowledgments
We would like to thank all the patients who make their data available to us, so that we can better represent the burden of cancer and improve cancer care in the canton in the future, for the trust they place in us.
This document is the fruit of work or collaboration with numerous individuals and agencies, to whom the Registry would like to extend its warmest thanks:
Doctors and other cancer notifiers from hospitals, radiotherapy centers and private practices
Public and private anatomopathology laboratories
The Geneva Cancer Screening Foundation
Other Swiss cancer registries
National Cancer Registry ONEC
Wildsorf Foundation
Geneva Cancer League
Swiss Cancer League
Swiss Federal Statistical Office (FSO)
Office Cantonal de la Population (OCP)
The IT services of the University of Geneva, in particular the IT Service of the Faculty of Medicine
The various tumor registries