Cancer in The Republic of Moldova

Preliminary data – for illustrative purposes only

1 Cancer Situation 2016 - 2023

1.1 Overall incidence and mortality

FIGURE 1.1 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender.

FIGURE 1.2 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender, with a 2-year forecast.

1.2 Incidence stratified by the affected system

FIGURE 2.1 New cancer cases and incidence (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population) in 2016–2023, stratified by the affected system in women (A and B) and men (C and D).

1.3 Mortality stratified by the affected system

FIGURE 3.1 Cancer deaths and mortality (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population) in 2016–2023, stratified by the affected system in women (A and B) and men (C and D).

2 Cancer Situation in 2023

Table 4.1 Number of new cancer cases, cancer deaths in 2023 and five-year relative survival of cancer patients.
New cases Cancer deaths 5-year relative survival
Female 6 222 2 471 65.7%
Male 6 584 3 484 48.4%
Total population 12 806 5 955 57.2%

2.1 Incidence

FIGURE 4.1 Number of new cancer cases among women and men in 2023, stratified by the most common cancer types.

FIGURE 4.2 Incidence of the most common cancer types in 2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population) among women and men.

FIGURE 4.3 Incidence of the most common cancer types in 2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population) among women and men aged under 20.

FIGURE 4.4 Incidence of the most common cancer types in 2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population) among women and men aged 20-69.

FIGURE 4.5 Incidence of the most common cancer types in 2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population) among women and men aged over 70.

2.2 Prevalence

FIGURE 5.1 Prevalence of the most common cancer types at the end of 2023.

2.3 Mortality

FIGURE 6.1 Number of cancer deaths among women and men in 2023, stratified by the most common cancer types.

FIGURE 6.2 Mortality from the most common cancer types in 2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population) among women and men.

FIGURE 6.3 Mortality from the most common cancer types in 2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population) among women and men aged 20-69.

FIGURE 6.4 Mortality from the most common cancer types in 2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population) among women and men aged over 70.
Table 6.5 Lifetime probability of developing and dying from cancer in men and women.
Lifetime risk of cancer Lifetime risk of cancer death
Female 26.2% 12.2%
Male 26.3% 16.2%

2.4 Relative survival

FIGURE 7.1 Five-year relative survival (%) for the most common cancer types among women and men followed up in 2021-2023 (excluding skin, non-melanoma).

FIGURE 7.2 Five-year relative survival (%) for the most common cancer types (excluding skin, non-melanoma) in female patients followed up in 2021-2023 by age group .

FIGURE 7.3 Five-year relative survival (%) for the most common cancer types (excluding skin, non-melanoma) in male patients followed up in 2021-2023 by age group.

2.5 Years of life lost due to cancer

FIGURE 8.1 Average age of diagnosis, life expectancy after diagnosis and years of life lost due to cancer for the most common cancer types in women diagnosed in 2016-2023 (excluding skin, non-melanoma).

FIGURE 8.2 Average age of diagnosis, life expectancy after diagnosis and years of life lost due to cancer for the most common cancer types in men diagnosed in 2016-2023 (excluding skin, non-melanoma).

2.6 Time series

FIGURE 9.1 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000–2025 Standard Population), stratified by gender – digestive system.

FIGURE 9.2 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender - respiratory system.

FIGURE 9.3 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender - genital system.

FIGURE 9.4 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender - urinary system.

FIGURE 9.5 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender - skin.

FIGURE 9.6 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender - central nervous system.

FIGURE 9.7 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender - thyroid gland.

FIGURE 9.8 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender - soft tissue.

FIGURE 9.9 Cancer incidence and mortality in 2016–2023 (per 100,000 person-years and age-standardized to the WHO 2000-2025 Standard Population), stratified by gender - hematolymphoid system.

2.7 Regional differences in cancer incidence and mortality

FIGURE 10.1 Relative regional differences in age-standardized overall cancer incidence and mortality in 2019–2023.

FIGURE 10.2 Relative regional differences in age-standardized breast cancer incidence and mortality in 2019–2023.

FIGURE 10.3 Relative regional differences in age-standardized prostate cancer incidence and mortality in 2019–2023.

FIGURE 10.4 Relative regional differences in age-standardized colorectal cancer incidence and mortality in 2019–2023.

FIGURE 10.5 Relative regional differences in age-standardized lung cancer incidence and mortality in 2019–2023.

2.8 Tables

3 Data

3.1 Data sources

The report is built from several independent sources. New cancer cases come from the database of the National Cancer Registry. Cancer deaths, and their underlying cause, come from the mortality database of the National Agency for Public Health (ANSP). Person-years and prevalence proportions are based on official national population estimates by calendar year, sex and five-year age group, and district. The life tables use national all-cause deaths together with mid-year population estimates. Age standardisation uses the WHO 2000–2025 World Standard Population.

3.2 Cancer types recorded and reported

The statistics cover cases diagnosed between 1 January 2016 and 31 December of the reporting year, with deaths occurring in the same years.

Tumours are identified from the ICD-10 diagnosis code recorded by the registry. The reported statistics cover the following neoplasms: all malignant tumours (ICD-10 C00–C97), together with in-situ tumours of the bladder and other urinary organs (D09.0–D09.1), benign and uncertain-behaviour tumours of the meninges, brain and other central nervous system (D32–D33, D42–D43), uncertain-behaviour tumours of the urinary organs (D41), the myelodysplastic and myeloproliferative neoplasms (D45–D47), and D76. Malignant codes that do not correspond to a specific site are reported together as “other and unspecified”.

All other diagnoses do not enter any analysis. These are principally in-situ carcinomas other than of the urinary tract (for example of the cervix uteri, breast and colon), benign tumours, and neoplasms of uncertain behaviour of the endocrine glands, soft tissue, skin and female genital organs.

Records from the Transnistrian region are excluded throughout, and records with missing sex or age are excluded from the corresponding sex- and age-specific analyses.

4 Statistical methods

4.1 Incidence and new cancer cases

Cancer incidence is the number of new cancer cases diagnosed in the population over a given period. The incidence rate expresses this as the number of new cases per 100,000 person-years. Person-years are derived from official national population estimates broken down by calendar year, sex and five-year age group.

Because the age structure of the population changes over time and differs between the groups being compared, incidence is also reported in age-standardised form. The age-standardised rate is the rate that would be observed if the population had the age structure of a fixed standard population, and it makes figures comparable with other countries. This report uses direct standardisation to the WHO 2000–2025 World Standard Population. New cases are presented as absolute numbers and as age-standardised rates, overall and by sex, cancer site, affected organ system and age group.

4.2 Cancer mortality

Cancer mortality is the number of deaths attributed to cancer over a given period, counted by the year of death from the national mortality database. As with incidence, the mortality rate is expressed per 100,000 person-years and is reported both crude and age-standardised, using direct standardisation to the WHO 2000–2025 World Standard Population in five-year age groups. Cancer deaths are presented as absolute numbers and age-standardised rates, overall and by sex, cancer site, organ system and age group.

4.3 Prevalence

Prevalence is the number of people who have been diagnosed with cancer and are still alive at a given point in time. Here, prevalence represents cases diagnosed beginning from 2016 and who were still alive by the end of the present reporting year. For site-specific estimates, a person is counted once for each different cancer site they have, so a person with cancer at two sites appears in both of those site rows. The overall estimate counts each living person only once, however many different cancers they have had. Persons who had emigrated, whose vital status was unknown, or who were recorded as deceased are not counted. Prevalence is reported as a number of living persons and as a proportion per 100,000 population.

4.4 Cancer patient survival

Patient survival is summarised by the relative survival ratio, which compares the survival observed in the patients with the survival expected in the general population of the same sex, age and calendar period. It is therefore interpreted as the survival that would be seen if cancer was the only possible cause of death. Five-year relative survival is reported for patients followed up during the reporting year and the two years preceding it, with expected survival obtained by the Ederer II method from the national life tables described below. Cases known to the registry only from a death certificate are excluded. Survival estimates based on fewer than ten persons at risk, estimates that increase over follow-up, and estimates with a standard error of 0.20 or more are treated as unreliable and are not reported (shown as “-”).

4.5 Years of life lost

The years of life lost to cancer measure how much shorter, on average, the life of a cancer patient is than that of a comparable person in the general population. For each cancer site and sex, they were obtained as the difference between the remaining life expectancy of the general population at the mean age of diagnosis and the remaining life expectancy actually observed in the patients, multiplied by the average annual number of new cases. Patients still alive five years after diagnosis were assumed to experience the same mortality as the general population of the same age. The general-population life expectancy was taken from the life tables described below.

4.6 Lifetime risk of cancer

The lifetime risk of cancer is the average probability, for a person in the population, of developing cancer at some point in life. The lifetime risk of cancer death is the corresponding probability of dying from cancer. Both are built from the age-specific cancer incidence or mortality and the all-cause mortality of the population.

4.7 Life tables

A life table, by sex and calendar year and in five-year age bands, was constructed from national all-cause deaths and mid-year population estimates.

4.9 Predictions

A short-term prediction of overall incidence and mortality, for the two years following the reporting period, was produced by fitting a linear trend to the most recent years and extrapolating it.

4.10 Regional differences

Incidence and mortality by district were examined for the pooled period including the reporting year and 4 years preceding it. Because the number of cases in any single district can be small, the analysis combines indirect standardisation with spatial smoothing. For each district, the observed number of cases is compared with the number that would be expected if the national age-specific rates applied to that district’s population, yielding a relative risk. These relative risks were then smoothed with a Bayesian hierarchical spatial model (BYM2 model), fitted by integrated nested Laplace approximation, which borrows strength from neighbouring districts and therefore reduces the random error that would otherwise be present in small district estimates.