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. Author manuscript; available in PMC: 2019 Mar 17.
Published in final edited form as: Lancet. 2018 Jan 31;391(10125):1023–1075. doi: 10.1016/S0140-6736(17)33326-3

Global surveillance of trends in cancer survival: analysis of individual records for 37,513,025 patients diagnosed with one of 18 cancers during 2000–2014 from 322 population-based registries in 71 countries (CONCORD-3)

Claudia Allemani 1, Tomohiro Matsuda 2, Veronica Di Carlo 1, Rhea Harewood 1, Melissa Matz 1, Maja Nikšić 1, Audrey Bonaventure 1, Mikhail Valkov 3, Christopher J Johnson 4, Jacques Estève 5, Olufemi J Ogunbiyi 6, Gulnar Azevedo e Silva 7, Wan-Qing Chen 8, Sultan Eser 9, Gerda Engholm 10, Charles Stiller 11, Alain Monnereau 12, Ryan Woods 13, Otto Visser 14, Gek Hsiang Lim 15, Joanne Aitken 16, Hannah K Weir 17, Michel P Coleman 1; CONCORD Working Group
PMCID: PMC5879496  NIHMSID: NIHMS940842  PMID: 29395269

Abstract

Background

In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival, as a metric of the effectiveness of health systems and to inform global policy on cancer control.

Methods

CONCORD-3 updates the world-wide surveillance of cancer survival to 2014, with individual data for 37.5 million patients diagnosed with cancer during the 15-year period 2000–2014. Data were provided by 322 population-based cancer registries in 71 countries and territories, of which 47 provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate and melanoma of the skin in adults, and brain tumours, leukaemias and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated five-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights.

Findings

For most cancers, five-year net survival remains among the highest in the world in the US and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas and lung. For women diagnosed during 2010–2014, the predicted five-year survival for breast cancer is now close to 90% in the US and in Australia, but international differences remain very wide, with levels as low as 40% in South Africa.

For gastrointestinal cancers, the highest levels of five-year survival are seen in South-East Asia, in Korea for cancers of the stomach (69%), colon (72%) and rectum (71%), in Japan for oesophageal cancer (36%) and in Taiwan for liver cancer (28%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (60% in Korea, 52% in Taiwan, 50% in China), and for both lymphoid malignancies (53% in Korea, 51% in Taiwan, 38% in China) and myeloid malignancies (46% in Korea, 33% in Taiwan, 25% in China). For children diagnosed during 2010–2014, five-year survival for acute lymphoblastic leukaemia ranged from 66% in Thailand to 95% in Finland. Five-year survival from brain tumours in children is higher than for adults, and the global range is very wide (from 45% in Thailand to 80% in Sweden and Denmark).

Interpretation

The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed world-wide every year. It contributes to the evidence base for global policy on cancer control. From 2017, the Organisation for Economic Co-operation and Development will use findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries world-wide. It is crucial for governments to recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer.

Keywords: population-based cancer registry, net survival, surveillance, global health

Introduction

The incidence of cancer continues to rise, both in high-income countries and, especially, in low- and middle-income countries. Prevention is crucial, but implementation has been slow and incomplete, even in high-income countries. Prevention is a long-term strategy, and not all cancers can be prevented.1 To reduce cancer mortality, it is necessary both to reduce cancer incidence and to improve cancer survival.

Many cancer patients will continue to be diagnosed every year for decades to come: an estimated 14 million patients a year world-wide around 2012,2 with a 50% projected increase to 21.6 million patients a year by 2030.3 Those patients will all need prompt diagnosis and optimal treatment, to improve their survival. Monitoring the effectiveness of national and regional health systems in treating and caring for these patients becomes ever more crucial.

In 2016, the WHO Executive Board recommended strengthening health systems to ensure early diagnosis and accessible, affordable, high-quality care for all cancer patients.3 The World Health Assembly followed up with a resolution on cancer control in May 2017. It included recommendations that national cancer control strategies should aim to reduce late presentation, ensure appropriate treatment and care for potentially curable malignancies such as acute leukaemia in children, “to increase survival, reduce mortality and improve quality of life.”4

President Tabaré Vázquez of Uruguay and WHO Director-General Tedros Ghebreyesus recently called for all countries “to provide universal health coverage, thereby ensuring all people can access needed preventive and curative health-care services, without falling into poverty.”5 Their call relates to all non-communicable diseases, including cancer. Population-based cancer survival is one metric that can help evaluate whether all people have access to effective treatment services.

In 2015, the CONCORD programme established global surveillance of cancer survival for the first time,6 with publication of trends in survival over the 15-year period 1995–2009 among patients diagnosed with cancer in 67 countries that were home to two-thirds (4.8 billion) of the world’s population. In 40 countries, the data had 100% national population coverage. CONCORD-2 incorporated centralised quality control and analysis of individual data for 25,676,887 patients diagnosed with one of 10 common cancers that represented 63% of the global cancer burden in 2009. The 279 population-based registries covered a combined total population of 896 million people.

The US National Cancer Institute, in an invited commentary7 for The Lancet, noted that the global analyses of cancer survival in CONCORD-2 provided insights from countries with successful cancer control initiatives that could be applied in other regions, and that the availability of better data “provides a clearer picture of the effect of cancer control programmes on the ultimate goal of improving survival and reducing the effect of cancer on the social and economic development of countries.”

The US Centers for Disease Control and Prevention (CDC) described CONCORD-2 as the start of global surveillance of cancer survival,a with survival estimates “that can be compared, so scientists can begin to determine why survival differs among countries. This could lead to improvements in cancer control programs.” The results from CONCORD-2 influenced national cancer control strategy in the UK in July 2015.8,9 In September 2015, the International Atomic Energy Agency’s Programme for Action on Cancer Therapy (PACT) used the results to launch a world-wide campaignb to highlight the global divide in cancer survival, and to raise awareness of persistent inequalities in access to life-saving cancer services.10 Further analysis of survival trends and disparities by race and stage at diagnosis in 37 US states are included in a forthcoming supplement to Cancer,11,12 designed to improve cancer control in the US.

CONCORD-3 updates world-wide surveillance of cancer survival trends to include patients diagnosed up to 2014, with follow-up to 31 December 2014. In countries that were already involved, more registries are participating, and 8 more countries have joined the programme. Follow-up for patients diagnosed during 2000–2009 with one of the 10 cancers included in CONCORD-2 has been updated. CONCORD-3 includes data for patients diagnosed during 2000–2014 with one of 18 malignancies that represent 75% of the global cancer burden (Table 1). In addition to information on stage at diagnosis, we have collected data on tumour grade and the first course of treatment. Findings are published within 3 years of the end of follow-up.

Table 1.

Estimated number of patients diagnosed with an index cancer* world-wide each year around 2012: by world region

Overall
More developed
Less developed
No. % No. % No. %
Oesophagus 455,784 3.2 86,144 1.4 369,640 4.6
Stomach 951,594 6.8 274,509 4.5 677,085 8.4
Colorectum 1,360,602 9.7 736,867 12.2 623,735 7.8

Liver 782,451 5.6 134,302 2.2 648,149 8.1
Pancreas 337,872 2.4 187,465 3.1 150,407 1.9
Lung 1,824,701 13.0 758,214 12.5 1,066,487 13.3

Melanoma 232,130 1.7 191,066 3.2 41,064 0.5
Breast (F) 1,671,149 11.9 788,200 13.0 882,949 11.0
Cervix 527,624 3.8 83,078 1.4 444,546 5.5

Ovary 238,719 1.7 99,752 1.6 138,967 1.7
Prostate 1,094,916 7.8 741,966 12.3 352,950 4.4
Brain and CNS 256,213 1.8 88,967 1.5 167,246 2.1

Lymphomas 451,691 3.2 219,255 3.6 232,436 2.9
Leukaemias 351,965 2.5 141,274 2.3 210,691 2.6
All index cancers 10,537,411 74.9 4,531,059 74.8 6,006,352 74.9

All cancers 14,067,894 100.0 6,053,621 100.0 8,014,273 100.0

Source: Globocan 201213

*

Index cancer: cancer or group of malignancies included in CONCORD-3.

“More developed”: Northern America, Europe, Australia, New Zealand and Japan; “Less developed”: other countries and regions.13 These are UN designations intended for statistical convenience and do not reflect a judgement about the stage reached by a particular country or area in the development process.24

ǂ

All cancers except non-melanoma skin cancer

Methods

Cancer registries

We contacted 412 cancer registries in 85 countries: 20 in Africa (13 countries), 45 in Central and South America (15 countries), 68 in North America (2 countries), 80 in Asia (20 countries), 189 in Europe (33 countries) and 10 in Oceania (2 countries).

When the data call for CONCORD-3 was issued in May 2016, 12 of the 279 cancer registries that had participated in CONCORD-2 were no longer operational. The registry in Benghazi (Libya) was disrupted by war, the registry in Macerata (Italy) ceased operating, the Department of Health ceased funding the UK National Registry of Childhood Tumours in 2013, and the 9 English regional cancer registries were replaced by a single cancer registry for England in 2013. Of the 267 remaining registries, nine could no longer provide up-to-date follow-up of all registered patients, while 13 did not reply to repeated approaches. Data from the Tirol (Austria) registry are no longer reported separately from the Austrian national estimates. In all, 244 (87%) of the 279 registries (63 of the 67 countries) that participated in CONCORD-2 submitted data.

Of the 133 registries that had not previously participated in the CONCORD programme, 108 agreed to do so. Of these, 85 (78%) registries in 12 countries submitted data, while 11 were unable to complete follow-up of registered cancer patients for their vital status, 9 made no further contact, and 3 signed up too late.

Of the 329 registries that submitted data, 7 were excluded because their data were not compliant with the protocol and could not be rectified in time. These exclusions affected the only participating registry or registries from several countries: Tunisia (Central Region), Bosnia Herzegovina (Republika Srpska), Saudi Arabia and Serbia (Central Region and Vojvodina). We analysed data provided by 322 cancer registries (81% of the 400 operational registries invited) in 71 countries and territories (text-figure 1), for patients diagnosed with cancer during the 15-year period 2000–2014, with data on their vital status at least five years after diagnosis, or at 31 December 2014.

Text-figure 1. Recruitment of cancer registries.

Text-figure 1

*Of the 400 operational registries invited; all other percentages refer to the number of registries at the top of each column. The number of countries excluded (black boxes) refers to those for which exclusions affected the only participating cancer registry or registries.

Eight countries are participating in the global surveillance of cancer survival for the first time: Africa: Morocco; Central and South America: Costa Rica (national), Mexico (children, national), and Peru; Asia: Iran, Kuwait (national) and Singapore (national), and Europe: Greece (children, national).

Protocol

The CONCORD-3 protocol defining the data structure, file transmission procedures and statistical analyses was expanded and updated from the CONCORD-2 protocol, with the addition of variables on five additional cancers or groups of malignancies, tumour grade, and the modality and date of the first course of treatment by surgery, radiotherapy or systemic therapy.

In a study of this scale, adherence to protocol is critical. The protocol and analytic approaches were discussed with CONCORD Working Group members from 27 countries at a one-day meeting in Marrakech, Morocco, in October 2016. The protocol was also discussed at workshops in China, the Russian Federation, Romania, Singapore and the USA (for North America), and in conference calls with Costa Rica, Hong Kong, Malaysia, Mauritius, Mexico and Mongolia.

English is still a barrier to communication in many countries, so the CONCORD-3 protocol was translated into eight other languages: Arabic, Chinese (Mandarin), French, Italian, Japanese, Portuguese, Russian and Spanish. Translations were done by native speakers in the CONCORD Central Analytic Team in London or the wider CONCORD Working Group, and checked against the English original by other native speakers. The protocol was made available to participants in all nine languages on the CONCORD web-site. The Central Analytic Team communicates with participants in six languages.

We examined survival for 18 cancers or groups of malignancies (“index cancers”): oesophagus, stomach, colon, rectum, liver, pancreas, lung, melanoma of the skin, breast (women), cervix, ovary and prostate in adults (15–99 years); brain tumours, myeloid and lymphoid malignancies in adults, and brain tumours, acute lymphoblastic leukaemia (ALL) and lymphomas in children (0–14 years). Collectively, these cancers accounted for about 75% of the estimated number of patients diagnosed with cancer world-wide each year around 2012 (10,537,411 of 14,067,894, excluding non-melanoma skin cancer; Table 1).13 The overall proportion is very similar in Northern America, Europe, Australia, New Zealand and Japan (“developed countries”) and in other world regions (“developing countries”), but it varies widely between cancers: prostate cancer is proportionately three times more common in developed countries, and cervical cancer four times more common in developing countries.

Solid tumours were defined by anatomic site (topography), and the leukaemias, lymphomas and melanoma of the skin by morphology (Table 2). Topography and morphology were coded to the International Classification of Diseases for Oncology (third edition, ICD-O-3),14 including its first revision.15 We restricted estimation of survival for melanomas to those arising in the skin, including the skin of the labia majora, vulva, penis and scrotum (ICD-O-3 C51.0, C51.9, C60.9, C63.2). Melanomas arising in internal organs were included with all other malignancies in those organs. For ovarian cancer, we included the fallopian tube, uterine ligaments and adnexa, as well as the peritoneum and retroperitoneum, where high-grade serous ovarian carcinomas are often detected.16 Registries were not asked to select cancers by sex, although some did so. Where data sets did include records for breast cancer in men, the proportion was consistently around 0.7%; these records were excluded. We also excluded small numbers of retroperitoneal malignancies in men, as well as Kaposi sarcoma, and tumours in solid organs with haematopoietic morphology.

Table 2.

Definition of malignancies, and number of contributing countries and registries*, by calendar period of diagnosis

Malignancy Topography and/or morphology codes Description Contributing countries and registries*
Any period
2000–2004 2005–2009 2010–2014 2000–2014
Oesophagus C15.0–C15.5; C15.8–C15.9 Oesophagus Countries 55 59 58 60
Registries 249 287 273 290

Stomach C16.0–C16.6; C16.8–C16.9 Stomach Countries 57 62 60 62
Registries 252 293 277 294

Colon C18.0–C18.9; C19.9 Colon and rectosigmoid junction Countries 57 64 64 65
Registries 251 294 280 296

Rectum C20.9; C21.0–C21.2; C21.8 Rectum, anus and anal canal Countries 56 63 63 64
Registries 250 292 278 294

Liver C22.0–C22.1 Liver and intrahepatic bile ducts Countries 56 60 60 61
Registries 250 289 275 291

Pancreas C25.0–C25.4; C25.7–C25.9 Pancreas Countries 55 58 58 59
Registries 249 288 274 290

Lung C34.0–C34.3; C34.8–C34.9 Lung and bronchus Countries 57 61 61 61
Registries 250 289 275 290

Melanoma of the skin 8720–8790 provided topography was C44.0– C44.9, C51.0, C51.9, C60.9 or C63.2 Melanoma of the skin, including skin of labia majora, vulva, penis and scrotum Countries 55 58 59 59
Registries 239 278 266 281

Breast (women) C50.0–C50.6; C50.8–C50.9 Breast Countries 59 64 65 66
Registries 255 295 282 298

Cervix C53.0–C53.1; C53.8–C53.9 Cervix uteri Countries 57 63 62 64
Registries 253 293 277 295

Ovary C48.0–C48.2; C56.9; C57.0–C57.4; C57.7–C57.9 Ovary, fallopian tube and uterine ligaments, other and unspecified female genital organs, peritoneum and retroperitoneum Countries 56 61 59 61
Registries 249 288 272 289

Prostate C61.9 Prostate gland Countries 58 62 62 62
Registries 249 289 275 290

Brain C71.0–C71.9 Brain (adults) Countries 55 58 58 59
Registries 247 283 269 286
Brain (children) Countries 54 58 60 60
Registries 219 257 245 260

Myeloid (adults)ǂ 9740; 9741; 9742; 9800; 9801; 9805; 9806; 9807; 9808; 9809; 9840; 9860; 9861; 9863; 9865; 9866; 9867; 9869; 9870; 9871; 9872; 9873; 9874; 9875; 9876; 9891; 9895; 9896; 9897; 9898; 9910; 9911; 9920; 9930; 9931; 9945; 9946; 9950; 9960; 9961; 9962; 9963; 9964; 9975; 9980; 9982; 9983; 9984; 9985; 9986; 9987; 9989; 9991; 9992 All myeloid malignancies Countries
Registries
56
249
59
280
60
268
61
286

Lymphoid (adults)ǂ 9590; 9591; 9596; 9597; 9650–9655; 9659; 9661– 9665; 9667; 9670; 9671; 9673; 9675; 9678; 9679; 9680; 9684; 9687–9691; 9695; 9698; 9699; 9700–9702; 9705; 9708; 9709; 9712; 9714; 9716– 9719; 9725–9729; 9731–9735; 9737; 9738; 9760– 9762; 9764; 9811–9818; 9820; 9823; 9826; 9827; 9831–9837; 9940; 9948 All lymphoid malignancies Countries
Registries
57
250
60
284
61
271
62
289

Acute lymphoblastic leukaemia (children) 9835–9837; plus 9811–9818 provided topography was C42.0, C42.1, C42.3, C42.4 or C80.9 Precursor-cell acute lymphoblastic leukaemia (ALL) Countries
Registries
56
214
60
247
61
233
61
254

Lymphoma (children) 9590; 9591; 9596; 9597; 9650–9655; 9659; 9661– 9665; 9667; 9670; 9671; 9673; 9675; 9678–9680; 9684; 9687–9691; 9695; 9698–9702; 9705; 9708; 9709; 9712; 9714; 9716–9719; 9725–9729; 9731– 9735; 9737; 9738; 9740–9742; 9750–9762; 9764– 9769; 9970; 9971; plus 9811–9818 provided topography was not C42.0, C42.1, C42.3, C42.4 or C80.9 All lymphomas Countries
Registries
55
214
60
253
62
235
62
257
*

Some registries contributed data for selected cancers and/or calendar periods, so the number of participating countries also varies by cancer and calendar period. The number of countries and registries that contributed data at some point during 2000–2014 (last column) is thus greater than or equal to the number in any five-year period.

International Classification of Diseases for Oncology (ICD-O-3),14 including its first revision.15

Lymphoid malignancies were defined by HAEMACARE17 groups 1–19 and myeloid malignancies by HAEMACARE groups 20–25, incorporating morphology codes from the first revision of ICD-O-3 (see text).

The International Classification of Childhood Cancer (3rd edition),20 incorporating morphology codes from the first revision of ICD-O-3,15 was used to define childhood ALL (group Ia1) and lymphoma in children (group II) (see text).

Registries provided data for all haematopoietic malignancies (ICD-O-3 morphology codes in the range 9590–9992) in adults and children, to minimise differences in the spectrum of leukaemias and lymphomas submitted for analysis. In consultation with specialists in the HAEMACARE17 and InterLymph18,19 groups, we agreed to analyse survival for adults in two broad groups: lymphoid malignancies (HAEMACARE groups 1–19) and myeloid malignancies (groups 20–25; Table 2, web-table 1).

For children, we agreed to present survival estimates separately for ALL and lymphomas, based on ICD-O-3 codes, grouped according to the third edition of the International Classification of Childhood Cancer (ICCC-3).20 The first revision of ICD-O-3, published in 2013,15 introduced eight new entities for acute lymphoblastic leukaemia/lymphoma (morphology codes 9811–9818). These new entities were not used at all by registries in 42 of the 58 countries that submitted data for children diagnosed with ALL during 2010–2014, and very rarely in eight countries (combined number of children coded to a new entity below 100), but the proportions ranged from 11% to 89% in large data sets from Australia, Belgium, Canada, the Netherlands, Puerto Rico, Singapore, Taiwan and the US. The overall proportion for all 58 countries combined during 2010–2014 was 29% (10,679 of 36,867 children). We therefore included the new entities in all analyses. They were included among the acute lymphoblastic leukaemias if the anatomic site was coded as blood, bone marrow, reticulo-endothelial or haematopoietic systems (not otherwise specified) (C42.0–42.1, C42.3–42.4), or unknown primary site (C80.9). Otherwise such malignancies were included with the lymphomas (web-table 1).

Survival analyses include only primary, invasive malignancies (ICD-O-3 behaviour code 3), except for the brain, where benign tumours (behaviour code 0) are also included. To facilitate quality control and comparison of the intensity of early diagnostic and screening activity, registries were asked to provide data for all registered malignancies at each index site, including those that were benign, of uncertain or borderline malignancy (1), in situ (2), metastatic (6) or uncertain whether primary or metastatic (9).

Registries were asked to provide full dates (day, month, year) of birth, diagnosis and death or last known vital status, both for quality control and to enable comparable estimation of survival.21 Where the day or month of birth, or the day of the date of diagnosis, or the day or month of the date of last known vital status was missing, we used an algorithm (details on request) to standardise the imputation of missing dates for all populations.

Participating registries completed a questionnaire on their methods of operation, including data definitions, data collection procedures, coding of anatomic site, morphology and behaviour, the tracing of registered cancer patients to ascertain their vital status, and how tumour records are linked with data on vital status.

Patients diagnosed with two or more primary cancers at different index sites during 2000–2014 were included in the analyses for each cancer, e.g. colon cancer in 2005 followed by a breast cancer in 2010. Survival was measured from the date of diagnosis until death, loss to follow-up or censoring. We retained the most complete record for patients with synchronous primary cancers in the same organ. If a patient was registered with two or more primary malignancies in the same index site during 2000–2014 (metachronous primaries), only the first was included in analyses.

North American registries define multiple primary cancers under the rules of the Surveillance Epidemiology and End Results (SEER) programme.22 Those rules accept more cancers as new primary cancers than the rules of the International Association of Cancer Registries (IACR),23 which are used by most cancer registries in other continents. The North American Association of Central Cancer Registries (NAACCR) kindly updated the program developed for CONCORD-2 to enable all North American registries to recode their entire incidence databases to the IACR multiple primary rules, before their data sets for 2000–2014 were extracted for CONCORD-3.

Countries and territories were defined by their UN name, continent and code as of 2015.24 The names of jurisdictions used in the text, tables, graphics, maps and web-appendix are those used for statistical purposes by the Statistics Division of the UN Secretariat; similarly, we use “national coverage” to contrast with “regional coverage” for statistical purposes. These designations and the presentation of data here do not imply any assumption regarding the political affiliation of countries or territories, or the expression of any opinion whatsoever on the part of the CONCORD programme concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Some names have been shortened for convenience (e.g. Korea for the Republic of Korea, Russia for Russian Federation): this does not carry any political significance.

Cyprus is a Member State of the European Union, but it is part of Asia. Costa Rica, Cuba, Guadeloupe, Martinique, Mexico and Puerto Rico (Caribbean and Central America) were grouped with South America as America (Central and South). World maps and 29 regional maps were prepared in ArcGIS® Release 10.3,25 using digital boundaries (shapefiles) from the Database of Global Administrative Areas (GADM 2.8).26

The population coverage of the data from participating registries is given as the proportion of the country or jurisdiction’s population, taken from the UN Population Division database for 2014,27 or from the authorities for Australia, Guadeloupe, Hong Kong, Poland, Portugal and Taiwan or the registries concerned. Belarus, Greece and Mexico provided data only for childhood cancers, so the populations used were for children (0–14 years), and Mali, Mongolia and Morocco only provided cancer data for women, so the female populations were used.

Quality control

As for the previous cycle of the CONCORD programme,6 we performed data quality checks in three phases: protocol adherence, exclusions, and editorial checks. After each phase, a detailed report was sent to each cancer registry for discussion, and correction of data where required.

First, registries were sent a report showing the percentage compliance with the protocol for each of 51 variables in each cancer file. Compliance less than 100% required correction and/or re-submission of data.

Next, we checked for logical inconsistencies between the variables in each tumour record. Exclusion criteria were defined a priori, based on experience from CONCORD-2, and extended to cover features of some of the five additional cancers such as Ann Arbor stage for the lymphomas, and 14 additional variables on tumour grade and treatment. The variables in each record were checked for logical coherence against 20 sets of criteria, including eligibility (e.g. age, tumour behaviour), definite errors (e.g. sex-site errors, invalid dates, impossible date sequence, missing vital status) and possible errors, including a wide range of inconsistencies between age, tumour site and morphology.6,28 Registries were sent ‘exclusion reports’ for each index cancer and each calendar period, summarising the number of tumour records with each type of definite or possible error, the number registered from a death certificate only (DCO) or detected at autopsy, and the number and proportion of eligible patients whose data could be included in survival analyses. Registries were invited to request details of tumour records in which errors had been detected. Many registries used this information to update their databases. Where errors in classification, coding or pathological assignment were identified, registries were asked to correct and re-submit their data.

Finally, we examined the proportion of tumour records with morphological verification of the diagnosis, whether from histology of a biopsy or surgical specimen, cytology of a smear or bone marrow aspirate, or from imaging or biomarkers, including tumours with a specific morphology code. We also examined the proportion of cases with non-specific morphology, the distributions of the day and month of the dates of birth, diagnosis and last known vital status, and the proportion of patients who died within 30 days, were lost to follow-up, or were censored within 5 years of diagnosis.

Follow-up for vital status

Cancer registries use various methods to determine the vital status (alive, dead, emigrated, lost to follow-up) of registered cancer patients.6 Among 243 registries that provided specific information on follow-up procedures, 242 (99%) determine the vital status of registered cancer patients using passive follow-up techniques, in which tumour registration records are regularly linked to a regional or national index of all death registrations, regardless of the cause of death. Linkages are usually based on a national identity or social security number that is stored in both records. Such linkages are increasingly done electronically, but manual scrutiny of printed lists is still required in places. Tumour records that match to a death record are updated with the date of death. Some registries routinely receive paper or electronic death certificates for their territory, but this is insufficient on its own, since death certificates that do not mention cancer are rarely included. Transcription errors can arise with identity numbers, so variables such as the name, sex and date of birth are often used to improve the probability of an accurate match between a cancer record and a death registration.

Many registries use electoral registers, hospital records or official databases, such as social insurance, health insurance and driving licences, to determine the date on which a patient was last known or believed to have been alive. Patients recorded as having migrated beyond the registry’s jurisdiction, or to another country, may be recorded as lost to follow-up, because the patient’s eventual death is unlikely to be recorded: they are censored from survival analysis on that date.

Active follow-up techniques are also used by 124 (51.0%) registries, which routinely contact the treating physician, GP or hospital administration to determine the vital status for each registered patient, often on a quarterly or annual basis. Some registries also determine the vital status by contact with the patient’s family, by telephone or home visit, or with the village administration.

Registries were asked to submit data with follow-up for at least 5 years or, for patients diagnosed during 2010–2014, until 31 December 2014. Registration and follow-up for patients diagnosed in 2000–2009 was updated, and new data sets were submitted.

Patients registered solely from a death certificate or diagnosed at autopsy were excluded from analyses, because their survival time is unknown.

Statistical methods

Most registries submitted data for patients diagnosed from 2000 to 2014, with follow-up to 2014, although some registries only began operation after 2000, or provided data for less than 15 years. The study design for examining survival trends among patients diagnosed in three consecutive five-year periods was cohort, cohort, period. This design was also used for CONCORD-2,6 so it enables us to examine global trends in survival over a 20-year period, by including the estimates for patients diagnosed during 1995–1999.

The cohort approach is considered the gold standard,29,30 because it provides a survival estimate for a group of patients who were diagnosed during the same year or period, are likely to have been treated in similar fashion, and who have all been followed up for at least the duration of survival required, such as 5 years. This approach to the estimation of survival is easy to interpret, but other approaches are required when some patients have been followed up for less than 5 years.

We used the cohort approach for patients diagnosed in 2000–2004 and 2005–2009, because in most data sets, all patients had been followed up for at least five years. We used the period approach31 for patients diagnosed during 2010–2014, because five years of follow-up data were not available for all patients. This combination of cohort and period approaches facilitates monitoring of cancer survival trends over an extended time span, from the earliest to the most recent years of cancer registration for which follow-up data are available (web-annex 1).32

To ensure comparability of survival trends from 1995,6 we estimated net survival up to five years after diagnosis for both adults and children. Net survival is the cumulative probability of surviving up to a given time since diagnosis (e.g. 5 years) after correcting for other causes of death (background mortality). We used the Pohar Perme estimator,33 which takes unbiased account of the higher competing risks of death in the elderly, implemented with the algorithm stns34 in Stata (version 14).35

To control for the wide differences in background mortality between participating jurisdictions and over time, we produced 8,790 life tables of all-cause mortality for each calendar year during 2000–2014 in the general population of each country or registry territory, by single year of age and sex, and by race/ethnicity in Australia (Northern Territory: Indigenous, non-Indigenous), Israel (Arab, Jewish), New Zealand (Māori, non-Māori) and Singapore (Chinese, Malay, Indian).

For 120 registries, we obtained complete life tables that did not require interpolation or smoothing, for each calendar year 2000–2014.

For 207 registries, the method of life table construction depended on whether we received raw data (numbers of deaths and populations) or mortality rates, and on whether the raw data or the mortality rates were by single year of age (“complete”) or by five-year age group (“abridged”).

For 109 registries, we obtained death and population counts from the registry, or the relevant national statistical authority. We derived life tables for 2001 and 2013 if possible, each centred on three calendar years of data (e.g. 2000–2002, 2012–2014) to increase the robustness of the rates. We constructed raw mortality rates from the death and population counts using a Poisson regression model with flexible functions,36 then smoothed and extended the rates to obtain complete life tables by sex and single year of age up to age 99 years. Life tables for each calendar year 2002–2012 were created by linear interpolation between the 2001 and 2010 life tables.37 Rather than extrapolate, we used the life table centred on 2001 for 2000, and the life table centred on 2013 for 2014.

For 64 registries that provided abridged mortality rates, or complete mortality rates that were not smoothed, we used the Ewbank relational model38 with 3 or 4 parameters to interpolate (if abridged) and smooth the mortality rates for the registry territory against a high-quality smooth life table for a country with a similar pattern of mortality by age.39

Each set of life tables was checked with a standardised statistical summary on the earliest and latest year of available data, showing the data source and the method of construction and smoothing. For each sex and, where relevant, each race or ethnicity, the reports show the life expectancy at birth, the probability of death in the age bands 15–59, 60–84 and 85–99 years, and semi-log plots of the age-mortality rates, showing both the raw data points and the final smoothed life-table curve, and the model residuals by age group (web-annex 2).

Collection of authoritative raw data on the numbers of deaths and populations by age, sex and calendar year or period in participating jurisdictions proved more difficult than in 2013–2014. For 34 registries, no reliable data on all-cause mortality could be obtained for the registry territory. We took national life tables published by the UN Population Division,27 and interpolated and extended them to age 99 years with the Elandt-Johnson method.40

For the 42 participating states in the US, we used life tables by state, race and socioeconomic status, provided by the US National Cancer Institute (Mariotto A, NCI, personal communication, 26 January 2016).

For each country, registry and calendar period, we present age-standardised net survival estimates for each cancer at five years after diagnosis. For adults, we used the International Cancer Survival Standard (ICSS) weights,41 in which age at diagnosis is categorised into 5 groups: 15–44, 45–54, 55–64, 65–74 and 75–99 years and, for prostate cancer, 15–54, 55–64, 65–74, 75–84 and 85–99 years. Of the three sets of ICSS weights, we used group 2 (cancers for which incidence does not increase steeply with age) for melanoma of the skin, cervix uteri and brain (adults), and group 1 (cancers for which incidence does increase steeply with age) for oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast, ovary and prostate, and both groups of haematopoietic malignancies. For children, we estimated survival for the age groups 0–4, 5–9 and 10–14 years; age-standardised estimates were obtained by assigning equal weights to the three age-specific estimates.41,42

Cumulative survival probabilities in the range 0–1 are presented for convenience as percentages in the range 0–100%. 95% confidence intervals for both unstandardised and age-standardised survival estimates were derived assuming a Normal distribution, truncated to the range 0–100. Standard errors to construct the confidence intervals were derived with the Greenwood method.43 If no death or censoring occurred within 5 years, or if all patients died within five years (survival probability 1 or zero) we obtained a binomial approximation for the lower and upper bound, respectively, of the confidence interval.29

Survival was not estimated if fewer than 10 patients were available for analysis. If 10–49 patients were available for analysis in a given calendar period, we only estimated survival for all ages combined. If 50 or more patients were available, we attempted survival estimation for each age group. If a single age-specific estimate could not be obtained, we merged the data for adjacent age groups and assigned the combined estimate to both age groups before standardisation for age. If two or more age-specific estimates could not be obtained, we present only the unstandardised estimate for all ages combined. We did not merge data between consecutive calendar periods.

The pooled estimates for countries with more than one registry do not include data from registries for which the estimates were less reliable. Less reliable estimates are reported with a flag when they are the only available information from a given country or territory.

Ethical approvals and confidentiality

We maintain approvals from the Ethics and Confidentiality Committee of the UK’s statutory Health Research Authority (HRA) (reference ECC 3–04(i)/2011, last update 3 March 2017) the National Health Service Research Ethics Service (11/LO/0331, 21 February 2017) and the London School of Hygiene and Tropical Medicine (12171, 6 September 2017). The HRA also approves the Cancer Survival Group’s System-Level Security Policy, governing data security. One investigator (MPC) maintains triennial certification with the Collaborative Institutional Training Initiative in Human Subjects Research for Biomedical Investigators (https://www.citiprogram.org, ID3327653, 2 May 2016). We maintain statutory and/or ethical approvals and data sharing agreements, usually with annual renewal, in 85 other jurisdictions participating in the CONCORD programme. Registries in all other jurisdictions obtain local approval. The data belong to the participating registries and are only used for purposes agreed in the CONCORD protocol.

Participants transmit data via a specially configured file transmission utility with 256-bit Advanced Encryption Security. The utility automatically generates a random, strong, one-time password for each data file at the time of transmission, and emails it to a different address. Neither the password nor the address are seen by the sender. This avoids the need for confirmation of passwords by email or telephone. Tumour records are effectively anonymised: they do not contain the patient’s name, address, postcode, or any national identity or social security number. All variables are numeric or alphanumeric codes. Each registry is sent a set of unique codes that must be used in naming each cancer data file, including distinct filenames for any re-transmission. The codes have no meaning outside the study. Data files thus contain no information that could be used to identify a person or a cancer registry, and neither the name nor the content of the file indicates that it even contains cancer data. This enhances security, as well as facilitating efficient handling of thousands of data files.

Role of the funding sources

The funding sources played no part in the design, data collection, quality control, analysis, interpretation of the findings, writing of the manuscript, or the decision to submit for publication. The corresponding author had full access to all data and responsibility for submission for publication.

Results

The CONCORD database 2000–2014

Data were analysed for 322 cancer registries in 71 countries in Africa (8 registries, 6 countries), Central and South America (33 registries, 13 countries), North America (57 registries, 2 countries), Asia (66 registries, 17 countries), Europe (149 registries, 31 countries) and Oceania (9 registries, 2 countries) (Figure 1).

Figure 1. Participating countries and regions: world (adults).

Figure 1

Registries in smaller countries are shown in boxes, at different scales.

See web-figures 1.1–1.29 for regional maps, and web-figure 1.30 for world map for childhood cancers.

For 47 countries, data were provided with 100% coverage of the national population: 41 for both adults and children, and 6 for children only (Argentina, Belarus, France, Greece, Mexico and Switzerland) (Table 3). In the other countries, population coverage varied from less than 1% in India to 86% in the US. More than 80 cancer registries joined the CONCORD programme for the first time. The 322 participating registries cover a combined population of almost one billion people around 2014 (989,082,244; Table 4). Detailed maps of participating jurisdictions are shown in web-figures 1.1–1.30.

Table 3.

Data quality indicators, patients diagnosed during 2000–2014, by continent and country

Calendar
period
Patients
submitted
Ineligible (%)
Eligible
patients
Excluded (%)‖‖
Patients
included
Data quality indicators (%) ††
Incomplete
dates
In situ Other DCO Other MV Non-specific
morphology
Lost to
follow-up
Censored
AFRICA 46,627 9.6 0.4 1.1 41,447 0.9 2.1 40,197 91.6 14.1 7.6 37.7

 Algerian registries 2000–2014 18,157 7.6 0.1 1.8 16,434 1.8 3.3 15,602 98.4 10.2 0.0 31.5
 Mali (Bamako) 2010–2012 104 41.3 0.0 0.0 61 0.0 1.6 60 100.0 20.0 0.0 0.0
 Mauritius* 2005–2012 4,125 0.0 0.0 0.4 4,109 0.0 3.7 3,959 96.7 19.8 0.0 2.3
 Morocco (Casablanca) 2008–2012 4,840 1.4 0.0 0.1 4,769 0.0 1.8 4,683 100.0 2.4 33.0 35.6
 Nigeria (Ibadan) 2003–2014 11,726 25.4 1.4 1.2 8,443 0.9 1.1 8,274 98.7 2.0 0.0 65.3
 South Africa (Eastern Cape) 2000–2014 7,675 0.0 0.0 0.6 7,631 0.0 0.2 7,619 62.3 39.5 19.7 40.2

AMERICA (Central and South) 906,076 5.4 3.1 0.7 822,687 13.7 1.1 700,946 92.4 8.0 5.2 3.7

 Argentinian registries 2000–2014 75,167 1.7 1.5 0.5 72,366 10.8 0.6 64,151 96.5 5.7 0.0 2.3
 Brazilian registries 2000–2014 191,344 18.5 3.9 0.5 147,622 8.0 0.9 134,597 90.0 10.6 22.9 0.3
 Chilean registries 2000–2012 28,987 0.0 0.8 0.7 28,555 7.6 0.1 26,363 86.2 12.0 0.0 13.6
 Colombian registries 2000–2014 63,402 3.1 1.5 1.2 59,740 5.0 0.9 56,245 89.9 11.3 0.0 21.0
 Costa Rica* 2002–2014 72,900 0.0 4.1 1.4 68,900 8.4 0.8 62,536 90.1 13.0 0.0 0.0
 Cuba* 2000–2012 193,196 0.0 0.0 0.2 192,755 32.3 2.5 125,696 91.8 5.1 2.6 0.0
 Ecuadorian registries 2000–2014 71,798 7.7 8.2 0.8 59,892 9.8 1.6 53,043 92.0 9.9 0.3 2.7
 Guadeloupe* 2008–2013 8,896 0.0 12.0 0.3 7,802 0.0 0.2 7,787 99.1 2.1 0.0 57.7
 Martinique* 2000–2012 16,066 0.0 0.0 0.1 16,053 0.0 1.7 15,779 97.3 0.7 7.3 0.1
 Mexico (Childhood) 2008–2014 9,749 5.8 0.0 9.7 8,236 0.0 0.5 8,194 99.8 3.9 9.3 7.6
 Peru (Lima) 2010–2012 19,078 0.1 0.0 0.7 18,929 8.9 0.1 17,226 93.9 2.9 0.0 10.2
 Puerto Rico* 2000–2011 118,877 3.7 3.9 0.7 109,001 6.4 0.3 101,613 98.4 3.4 0.0 0.0
 Uruguay* 2008–2012 36,616 0.0 9.6 0.7 32,836 15.5 0.1 27,716 85.0 15.9 0.0 0.0

AMERICA (North) 15,925,870 0.7 6.8 0.7 14,622,183 1.8 0.3 14,320,034 97.7 3.0 1.4 0.0

 Canadian registries 2000–2014 1,519,461 0.1 4.9 0.7 1,431,975 1.2 0.4 1,409,413 94.8 5.5 0.0 0.0
 US registries 2000–2014 14,406,409 0.7 7.0 0.7 13,190,208 1.8 0.3 12,910,621 98.0 2.8 1.5 0.0

ASIA 6,595,363 0.6 3.4 0.4 6,298,518 4.7 0.4 5,976,959 88.6 11.5 0.4 1.0

 Chinese registries 2003–2013 610,729 0.8 0.2 0.2 603,861 1.4 0.1 594,533 66.2 41.8 3.2 0.1
 Cyprus* 2004–2014 25,086 1.4 2.6 0.8 23,880 9.0 0.5 21,610 98.9 1.8 0.0 34.8
 Hong Kong* 2005–2014 78,127 3.8 0.0 0.0 75,146 0.4 0.2 74,721 96.6 0.0 5.5 0.0
 Indian registries 2000–2014 5,048 3.2 0.0 0.0 4,882 1.7 0.6 4,774 82.1 25.1 1.8 0.1
 Iran (Golestan) 2006–2008 1,187 0.0 0.0 0.5 1,181 8.9 3.1 1,039 82.1 17.9 8.9 0.0
 Israel* 2000–2013 282,191 0.0 7.3 2.2 255,359 4.8 0.4 241,881 96.8 4.2 0.0 0.0
 Japanese registries 2000–2014 2,237,861 1.0 4.8 0.5 2,096,697 12.4 0.1 1,834,894 91.4 11.3 0.0 1.7
 Jordan* 2000–2014 43,442 0.2 1.2 1.5 42,179 0.2 1.6 41,433 99.1 3.0 5.9 0.0
 Korea* 2000–2014 1,770,463 0.5 0.0 0.0 1,762,176 0.0 0.1 1,760,804 93.1 7.8 0.0 0.0
 Kuwait* 2000–2013 8,931 0.0 1.4 1.1 8,710 2.3 0.3 8,484 99.8 0.4 1.2 0.0
 Malaysia (Penang) 2000–2013 19,612 0.3 0.0 0.1 19,527 1.6 2.1 18,805 94.2 9.5 0.0 13.0
 Mongolia* 2003–2014 1,025 0.0 1.1 0.0 1,014 0.3 1.2 999 77.0 4.1 7.6 0.0
 Qatar* 2000–2014 7,940 0.0 1.0 1.0 7,778 1.0 0.7 7,642 95.4 6.3 0.0 51.0
 Singapore* 2000–2014 122,461 0.0 7.0 1.9 111,495 1.1 0.3 109,992 91.7 1.9 0.0 0.0
 Taiwan* 2000–2014 941,313 0.1 8.6 0.1 859,169 0.0 0.1 858,683 86.6 0.5 0.0 0.0
 Thai registries 2000–2014 183,776 0.0 0.3 0.5 182,455 3.8 8.7 159,528 68.6 34.0 0.0 3.0
 Turkish registries 2000–2013 256,171 1.5 2.7 0.9 243,009 1.9 0.5 237,137 94.7 7.9 0.2 3.8

EUROPE 17,057,088 0.1 7.0 2.1 15,481,564 2.8 0.3 14,991,316 94.0 3.9 0.9 2.1

 Austria* 2000–2014 486,379 0.0 7.4 1.2 444,735 6.1 1.1 412,683 98.0 4.9 0.0 0.0
 Belarus (Childhood) 2000–2014 1,740 0.0 0.0 0.0 1,740 0.6 2.5 1,687 97.9 2.5 1.5 0.0
 Belgium* 2004–2014 616,737 0.0 11.4 0.2 545,373 0.0 0.2 544,110 98.4 2.0 1.1 0.0
 Bulgaria* 2000–2014 299,563 0.0 0.0 0.1 299,333 8.5 0.0 273,868 89.2 1.4 0.1 0.0
 Croatia* 2000–2014 246,883 0.0 3.5 0.2 237,793 6.2 0.1 222,776 82.9 0.5 0.0 0.0
 Czech Republic* 2000–2014 640,594 0.0 7.5 1.6 582,748 1.3 0.4 572,368 90.3 1.5 0.0 0.0
 Denmark* 2000–2014 366,310 0.0 0.0 0.2 365,525 0.0 0.1 365,105 96.3 6.8 0.2 0.0
 Estonia* 2000–2012 64,038 0.0 1.8 0.7 62,396 3.9 0.2 59,848 89.2 2.0 0.3 0.0
 Finland* 2000–2014 328,513 0.6 5.4 0.9 306,077 3.8 0.1 294,268 95.8 3.2 0.1 0.0
 French registries 2000–2012 466,020 0.2 0.0 0.3 463,588 0.0 0.6 460,927 96.1 0.6 1.8 0.1
 German registries 2000–2014 1,925,070 0.4 4.5 1.0 1,811,465 10.3 0.2 1,621,312 97.5 0.7 0.3 17.7
 Gibraltar* 2000–2010 732 13.0 11.7 1.1 543 0.2 1.7 533 99.6 0.8 0.0 41.7
 Greece (National Paediatric) 2000–2014 1,743 0.6 0.0 0.0 1,733 0.0 0.4 1,726 99.9 0.1 0.8 0.2
 Iceland* 2000–2014 15,245 0.0 1.4 0.8 14,918 0.8 0.1 14,782 96.5 3.9 0.0 0.0
 Ireland* 2000–2013 240,962 0.0 16.3 0.9 199,552 1.5 0.2 196,331 92.2 1.7 0.0 0.0
 Italian registries 2000–2014 1,452,003 0.0 1.8 0.8 1,414,476 0.7 0.3 1,400,117 87.5 14.1 0.7 0.8
 Latvia* 2000–2014 97,852 0.0 0.1 26.8 71,511 0.0 0.6 71,082 99.8 1.1 0.0 0.0
 Lithuania* 2000–2012 154,857 0.0 4.1 1.1 146,896 4.9 0.2 139,475 87.6 1.5 0.0 0.3
 Malta* 2000–2013 17,625 0.0 6.9 1.8 16,091 3.1 0.4 15,518 92.4 8.9 0.0 0.0
 Netherlands* 2000–2014 1,047,456 0.0 3.8 1.2 994,826 0.2 0.6 987,029 96.2 4.0 0.5 0.0
 Norway* 2000–2014 488,733 0.0 10.3 32.5 279,696 0.5 0.1 277,991 99.8 0.4 0.2 0.0
 Poland* 2000–2014 1,389,978 0.0 0.1 0.3 1,383,780 2.5 0.3 1,344,837 91.4 1.3 0.0 0.0
 Portugal* 2000–2014 408,523 0.7 2.7 1.5 388,199 0.1 0.2 386,853 96.7 2.7 1.7 0.0
 Romania (Cluj) 2006–2012 17,740 0.0 3.1 1.7 16,894 16.6 0.2 14,060 90.1 10.7 0.0 0.0
 Russian registries 2000–2014 252,171 0.0 0.5 0.4 249,928 0.8 1.0 245,591 85.4 4.1 2.0 1.3
 Slovakia* 2000–2010 180,029 0.0 4.1 1.3 170,269 8.2 0.1 156,122 94.0 6.7 0.0 0.0
 Slovenia* 2000–2013 124,213 0.0 13.0 2.4 105,052 2.0 0.0 102,970 93.5 0.3 0.1 0.0
 Spanish registries 2000–2014 417,865 0.3 6.8 0.9 384,586 1.9 0.2 376,759 91.7 2.2 0.5 0.5
 Sweden* 2000–2014 676,693 0.0 15.4 3.0 551,717 1.1 0.2 544,531 98.6 2.2 0.2 0.0
 Swiss registries 2000–2014 241,610 0.0 7.9 2.5 216,439 1.2 0.5 212,695 95.9 2.4 4.6 3.9
 United Kingdom* 2000–2014 4,389,211 0.1 13.0 1.4 3,753,685 1.8 0.3 3,673,362 94.9 4.5 1.9 0.0

OCEANIA 1,691,153 0.3 9.7 0.7 1,510,866 1.6 0.2 1,483,573 96.5 3.6 0.0 0.0

 Australia* 2000–2014 1,443,620 0.3 11.3 0.8 1,263,961 1.4 0.2 1,244,350 97.0 3.0 0.0 0.0
 New Zealand* 2000–2014 247,533 0.0 0.0 0.3 246,905 2.9 0.2 239,223 94.3 6.3 0.0 0.0

Total 42,222,177 0.5 6.4 1.2 38,777,265 2.9 0.3 37,513,025 94.6 4.9 1.0 1.1
*

Data with 100% coverage of the national population.

Data with 100% coverage of the national population for childhood malignancies only.

Korea: Republic of Korea; Russia: Russian Federation.

Incomplete dates: records in which the year of birth is unknown; or the month and/or year of diagnosis is unknown; or the year of last known vital status is unknown. In situ malignancy (ICD-O-3 behaviour code 2): some registries do not register in situ cancers; other registries did not submit them. Other: records with incomplete data, or for tumours that are benign (behaviour code 0, except brain tumours), of uncertain behaviour (1), metastatic from another organ (6), or unknown if primary or metastatic (9); or for patients with age outside the range 0–14 years (children) or 15–99 years (adults); or other conditions (see text).

ǁ

DCO: tumours registered from a death certificate only (DCO), or detected solely at autopsy. Sweden does not register DCOs; autopsy-detected cases were not submitted for CONCORD-2, but have been submitted for CONCORD-3. Other: vital status or sex unknown; invalid date or sequence of dates; inconsistency of sex-site, site-morphology, age-site, age-morphology, or age-site-morphology.

††

MV: microscopically verified. Non-specific morphology (solid tumours only): ICD-O-314,15 morphology code in the range 8000–8005. Censored: patients whose last known vital status is “alive” and who were censored within five years of diagnosis or, if diagnosed in 2010 or later, before 31 December 2014.

Table 4.

Population covered by participating registries (number of persons and % of national population) and number of patients diagnosed during 2000–2014 who were included in survival analyses, by continent and country

Population
covered
% of
national
Oesophagus Stomach Colon Rectum Liver Pancreas Lung Melanoma
of skin
Breast
(women)
Cervix Ovary Prostate Brain
(adults)
Brain
(children)
Myeloid
(adults)
Lymphoid
(adults)
ALL
(children)
Lymphoma
(children)
Total
AFRICA 10,533,762 3.4 3,057 1,731 2,172 1,487 869 379 2,734 368 15,117 5,017 1,010 2,726 592 179 425 2,042 64 228 40,197

 Algerian registries 2,447,075 6.3 104 1,129 1,331 827 244 272 1,852 248 5,196 885 423 764 392 109 290 1,376 45 115 15,602
 Mali (Bamako) 764,245 9.0 60 60
 Mauritius* 1,268,567 100.0 59 494 494 289 27 45 584 4 483 436 244 628 36 3 42 86 5 3,959
 Morocco (Casablanca) 2,178,083 12.7 4,683 4,683
 Nigeria (Ibadan) 2,797,220 1.6 230 266 333 69 3,962 1,578 225 833 148 45 76 412 12 85 8,274
 South Africa (Eastern Cape) 1,078,572 2.0 2,894 108 117 105 265 62 298 47 733 2,118 118 501 16 22 17 168 7 23 7,619

AMERICA (Central and South) 99,818,363 23.7 13,528 60,643 82,843 26,424 9,019 15,731 53,959 8,202 159,976 49,067 16,023 115,102 8,547 4,936 10,842 47,740 13,299 5,065 700,946

 Argentinian registries 3,973,922 9.2 1,152 2,686 6,076 1,959 968 1,657 5,195 1,084 15,282 2,467 1,688 7,115 1,217 2,662 1,588 4,281 5,119 1,955 64,151
 Brazilian registries 15,882,624 7.7 6,678 15,567 21,984 10,354 858 5,520 4,884 1,424 49,811 3,083 1,201 7,556 1,011 168 852 3,270 233 143 134,597
 Chilean registries 2,459,133 13.8 918 4,423 1,949 824 525 793 2,166 554 3,717 1,564 698 4,816 475 83 652 1,968 171 67 26,363
 Colombian registries 4,277,369 9.0 642 7,988 3,874 1,990 1,129 1,303 3,965 1,373 9,609 5,124 1,759 8,722 1,601 243 1,476 5,004 306 137 56,245
 Costa Rica* 4,757,606 100.0 528 8,577 5,438 1,926 1,239 1,188 2,688 1,432 12,019 7,466 1,408 11,345 1,067 153 857 4,646 456 103 62,536
 Cuba* 11,379,111 100.0 6,664 15,047 19,344 33,313 16,396 4,560 21,358 8,451 563 125,696
 Ecuadorian registries 6,398,546 40.2 486 7,210 3,203 1,622 1,502 1,069 2,641 1,080 8,283 5,453 1,732 7,939 1,481 324 1,489 6,330 859 340 53,043
 Guadeloupe* 450,273 100.0 119 521 724 210 82 167 308 52 1,266 160 110 3,389 55 14 115 480 9 6 7,787
 Martinique* 396,425 100.0 213 973 1,305 423 206 473 693 164 2,279 399 191 6,480 182 20 482 1,257 29 10 15,779
 Mexico (Childhood) 35,188,624 100.0 1,047 5,647 1,500 8,194
 Peru (Lima) 7,548,697 24.4 2,803 992 5,590 2,917 891 3,653 268 112 17,226
 Puerto Rico* 3,686,517 100.0 1,743 3,900 14,594 3,882 2,202 1,984 6,570 1,039 18,807 2,458 1,728 29,855 1,458 222 2,440 8,400 202 129 101,613
 Uruguay* 3,419,516 100.0 1,049 2,134 5,846 2,242 308 1,577 5,505 1,580 948 6,527 27,716

AMERICA (North) 301,237,785 84.8 195,255 283,566 1,471,548 461,707 246,966 462,187 2,564,507 678,206 2,587,798 163,517 312,954 2,703,952 251,888 27,157 508,562 1,356,829 29,995 13,440 14,320,034

 Canadian registries 27,213,277 76.5 18,788 33,889 166,760 60,958 20,858 41,908 236,434 65,235 237,321 16,054 31,395 256,736 28,186 2,196 49,474 139,370 2,712 1,139 1,409,413
 US registries 274,024,508 85.8 176,467 249,677 1,304,788 400,749 226,108 420,279 2,328,073 612,971 2,350,477 147,463 281,559 2,447,216 223,702 24,961 459,088 1,217,459 27,283 12,301 12,910,621

ASIA 227,771,765 7.2 206,254 971,935 703,081 361,987 617,479 205,345 950,362 31,314 726,968 161,620 109,998 397,673 73,306 8,513 140,066 293,307 11,371 6,380 5,976,959

 Chinese registries 31,755,347 2.3 72,714 92,578 35,001 31,498 74,295 19,110 133,932 1,449 53,791 13,131 10,517 12,380 11,341 526 12,171 19,388 498 213 594,533
 Cyprus* 1,153,658 100.0 81 802 2,665 788 247 534 2,489 589 5,069 321 553 4,088 394 14 555 2,326 56 39 21,610
 Hong Kong* 7,241,700 100.0 28,797 12,856 28,956 4,112 74,721
 Indian registries 1,005,294 0.1 269 303 199 191 230 134 850 29 812 753 172 183 162 18 153 272 32 12 4,774
 Iran (Golestan) 1,893,646 2.4 412 353 216 58 1,039
 Israel* 7,939,483 100.0 1,691 9,737 33,938 9,401 2,310 8,083 25,347 12,265 51,125 2,942 5,663 32,503 5,235 843 8,375 30,911 754 758 241,881
 Japanese registries 51,445,407 40.6 63,631 381,457 247,682 102,776 122,792 79,636 276,444 4,018 184,372 30,606 31,244 168,505 15,007 1,293 37,845 85,640 1,438 508 1,834,894
 Jordan* 7,416,083 100.0 352 1,955 5,116 1,775 606 952 4,282 214 11,584 579 2,457 1,483 489 1,917 6,511 681 480 41,433
 Korea* 50,074,400 100.0 30,627 396,213 187,078 121,053 214,821 59,357 257,345 5,771 179,520 58,663 28,076 83,892 17,701 2,333 42,322 70,594 3,389 2,049 1,760,804
 Kuwait* 3,753,121 100.0 90 207 908 330 261 240 559 18 2,568 163 221 509 230 49 346 1,405 251 129 8,484
 Malaysia (Penang) 1,543,500 5.2 290 1,061 2,285 1,126 927 539 2,863 4,606 1,046 805 915 289 84 504 1,244 156 65 18,805
 Mongolia* 1,468,823 100.0 999 999
 Qatar* 2,172,065 100.0 98 361 784 283 438 186 587 55 1,861 196 214 586 287 33 489 1,042 71 71 7,642
 Singapore* 3,870,700 100.0 1,434 6,822 17,225 6,241 7,101 3,481 17,921 367 22,473 2,943 3,514 7,991 1,202 196 3,339 7,187 388 167 109,992
 Taiwan* 23,123,866 100.0 27,680 54,983 108,844 57,163 158,157 22,283 141,108 2,988 116,929 29,214 16,872 52,681 8,410 1,211 17,813 39,704 1,811 832 858,683
 Thai registries 13,738,188 20.3 3,344 5,321 13,801 6,679 30,814 3,284 28,865 695 25,001 12,737 5,469 5,869 2,779 385 5,177 8,486 605 217 159,528
 Turkish registries 18,176,484 23.4 3,541 19,782 18,542 9,769 4,480 7,526 57,770 2,856 37,302 4,214 6,678 25,114 8,786 1,039 9,060 18,597 1,241 840 237,137

EUROPE 321,767,598 50.1 294,606 668,096 1,764,170 801,387 283,720 506,723 2,317,434 647,507 2,700,348 267,986 399,675 2,355,249 297,032 24,316 436,684 1,182,009 29,544 14,830 14,991,316

 Austria* 8,516,916 100.0 5,324 19,308 46,127 23,360 10,570 18,371 56,130 19,150 74,818 6,455 11,567 75,082 7,615 7,223 31,583 412,683
 Belarus (Childhood) 1,498,163 100.0 580 740 367 1,687
 Belgium* 11,226,322 100.0 10,191 15,222 63,540 27,614 7,026 15,015 83,551 21,905 111,685 6,929 10,447 97,316 9,057 781 19,790 42,772 720 549 544,110
 Bulgaria* 7,201,308 100.0 21,404 37,854 22,511 5,704 50,210 5,875 53,605 16,329 12,206 26,190 6,226 14,919 537 298 273,868
 Croatia* 4,255,853 100.0 3,007 14,589 27,382 15,309 5,456 8,596 41,744 7,848 35,323 5,279 7,138 22,066 7,515 403 5,026 15,421 443 231 222,776
 Czech Republic* 10,542,666 100.0 7,764 24,157 83,481 34,838 12,056 27,622 93,241 27,800 89,989 14,950 18,875 78,581 11,007 489 9,734 36,974 531 279 572,368
 Denmark* 5,646,899 100.0 6,556 8,022 40,495 22,384 4,708 13,279 62,402 24,630 65,840 5,755 9,024 55,052 8,951 493 8,951 27,756 574 233 365,105
 Estonia* 1,316,203 100.0 786 5,212 6,523 3,062 903 2,698 9,201 1,983 8,149 2,232 2,122 9,734 1,295 103 1,512 4,193 93 47 59,848
 Finland* 5,479,660 100.0 3,686 9,871 25,374 12,847 5,096 12,851 31,950 14,949 62,282 2,318 8,101 66,706 5,953 503 5,573 25,395 572 241 294,268
 French registries 13,891,552 21.7 9,958 13,770 53,149 20,018 14,818 15,328 51,989 13,677 82,538 5,125 8,658 91,806 7,532 4,477 18,897 41,784 4,830 2,573 460,927
 German registries 29,655,933 36.8 27,208 75,378 191,396 99,791 28,301 57,498 212,897 78,713 300,626 24,302 38,064 284,771 27,683 691 45,934 126,594 1,019 446 1,621,312
 Gibraltar* 31,997 100.0 12 29 81 21 5 13 63 31 169 10 14 62 11 4 8 533
 Greece (National Paediatric) 1,610,335 100.0 237 1,092 397 1,726
 Iceland* 327,318 100.0 271 473 1,433 580 165 481 2,314 713 2,743 225 276 3,083 348 35 433 1,167 31 11 14,782
 Ireland* 4,675,164 100.0 4,899 6,801 21,724 9,085 2,178 5,931 26,838 9,470 34,632 3,573 4,952 37,536 4,605 396 6,250 16,806 461 194 196,331
 Italian registries 34,881,955 58.3 12,219 80,686 188,983 53,226 63,084 56,698 203,548 46,607 250,204 13,394 31,025 196,256 28,325 1,613 49,653 121,301 2,022 1,273 1,400,117
 Latvia* 1,989,354 100.0 1,294 6,878 7,658 4,748 464 1,072 9,691 2,503 13,020 3,148 3,842 10,674 1,415 100 1,749 2,679 147 71,082
 Lithuania* 2,916,798 100.0 2,130 11,840 11,148 7,694 1,776 5,421 18,499 3,317 17,699 6,318 5,452 30,156 2,942 136 4,850 9,741 250 106 139,475
 Malta* 417,723 100.0 184 656 1,908 781 152 709 2,043 541 3,523 136 547 2,069 315 24 492 1,383 35 20 15,518
 Netherlands* 16,868,020 100.0 25,342 29,585 126,237 51,839 6,397 28,717 159,895 59,088 198,074 10,317 19,252 142,578 17,261 1,428 30,256 78,420 1,588 755 987,029
 Norway* 5,147,970 100.0 3,021 7,548 36,646 16,306 1,916 6,671 33,558 19,994 43,349 4,458 7,207 57,657 5,647 484 8,374 24,389 511 255 277,991
 Poland* 38,483,957 100.0 18,959 79,466 140,075 83,669 20,764 47,635 306,136 35,834 220,036 48,857 53,462 131,099 37,794 2,071 21,008 94,159 2,505 1,308 1,344,837
 Portugal* 10,566,132 100.0 6,122 33,865 57,219 25,989 5,107 8,303 40,422 9,358 69,599 9,013 6,532 64,886 7,348 549 9,414 32,024 627 476 386,853
 Romania (Cluj) 983,525 5.0 216 1,201 1,552 657 547 563 2,126 436 2,205 1,004 460 1,301 291 19 482 969 21 10 14,060
 Russian registries 8,081,400 5.6 6,000 31,711 28,946 16,305 3,757 10,048 42,434 4,914 41,903 10,897 10,628 20,346 4,449 327 3,190 9,209 320 207 245,591
 Slovakia* 5,422,861 100.0 2,794 9,604 23,694 11,066 2,741 6,624 22,971 6,389 23,698 6,170 5,207 14,376 3,695 323 4,466 11,821 304 179 156,122
 Slovenia* 2,066,068 100.0 1,202 6,443 12,376 6,682 1,964 4,073 16,051 5,603 15,822 2,281 2,750 14,932 1,943 114 3,026 7,498 122 88 102,970
 Spanish registries 9,396,745 20.3 5,637 17,844 54,250 18,245 11,848 12,438 54,237 11,028 56,759 5,023 7,710 63,237 8,685 1,521 13,483 31,782 1,917 1,115 376,759
 Sweden* 9,703,247 100.0 6,233 13,463 55,664 29,777 7,242 14,240 51,122 36,921 102,483 6,816 12,132 139,051 9,327 761 14,280 43,784 926 309 544,531
 Swiss registries 4,368,854 53.2 3,583 6,135 21,137 8,633 5,070 7,694 27,116 14,893 39,262 1,858 4,964 40,528 4,102 565 7,175 18,923 733 324 212,695
 United Kingdom* 64,596,700 100.0 120,008 116,935 398,118 174,350 53,905 118,134 605,055 163,337 680,313 44,814 97,061 578,118 71,921 5,093 129,233 308,555 5,873 2,539 3,673,362

OCEANIA 27,952,971 100.0 21,728 33,411 174,823 67,496 20,311 39,014 162,266 187,512 232,346 13,537 25,841 290,176 25,294 1,713 54,647 129,127 3,078 1,253 1,483,573

 Australia* 23,457,489 100.0 17,877 27,952 144,382 56,260 17,281 33,319 136,318 156,302 193,134 11,065 21,124 247,000 21,569 1,484 46,955 108,727 2,565 1,036 1,244,350
 New Zealand* 4,495,482 100.0 3,851 5,459 30,441 11,236 3,030 5,695 25,948 31,210 39,212 2,472 4,717 43,176 3,725 229 7,692 20,400 513 217 239,223

Total 989,082,244 20.2 734,428 2,019,382 4,198,637 1,720,488 1,178,364 1,229,379 6,051,262 1,553,109 6,422,553 660,744 865,501 5,864,878 656,659 66,814 1,151,226 3,011,054 87,351 41,196 37,513,025

Populations in 2014 or nearest available year (see text).

*

Data with 100% coverage of the national population.

Data with 100% coverage of the national population for childhood malignancies only.

Korea: Republic of Korea; Russia: Russian Federation.

Populations for 2014 are from the UN Population Division,27 or national authorities in Australia, Guadeloupe, Hong Kong, Poland, Portugal and Taiwan (2010). Sub-national populations were provided by the registry concerned. Belarus, Greece and Mexico only provided data for childhood cancers: national populations shown are for children (0–14 years). Mali, Mongolia and Morocco only provided cancer data for women: national populations shown are for women. Population shown for France excludes Guadeloupe and Martinique.

Coverage is now national in Australia, and contributions from additional registries increased the population coverage in another 14 of the 25 countries that participated in CONCORD-2 with sub-national coverage: Africa: Algeria (from 1.6% to 6.0%); Central and South America: Brazil (5.7%, 7.7%), Chile (5.5%, 13.8%), Colombia (6.9%, 9.0%), Ecuador (33.8%, 40.2%); North America: the USA (83.2%, 85.8%); Asia: Japan (29.2%, 40.6%), Thailand (5.9%, 20.3%), Turkey (5.4%, 23.4%); Europe: France (18.4%, 21.7%), Italy (38.6%, 58.3%), Romania (3.1%, 5.0%), Russia (0.9%, 5.6%), Switzerland (47.4%, 54.7%); Oceania: Australia (90.8%, 100%). International coverage has been reduced by the loss of data from Indonesia (Jakarta) and from four countries in Africa: Gambia, Lesotho, Libya and Tunisia.

Three of the Polish registries that participated in CONCORD-2 now use a different or anglicised name, changing the alphabetical order in web-tables: Holy Cross (formerly Kielce), Lower Silesia (Wrocław) and Subcarpathia (Podkarpackie). All 16 voivodships of Poland are now included.

Four registries submitted data with wider territorial coverage than before. The Burgundy (Digestive) registry in France submitted data for both the Saône-et-Loire and the Côte-d’Or départements; the Biella registry (Italy) now covers the Provincia di Vercelli as well as Biella; the Milano (Italy) registry now covers Provincia di Milano and Lodi as well as the city of Milan, and the Cluj (Romania) registry expanded coverage from Cluj county to include Bistrița-Năsăud county.

We received more than 4,700 data sets.

We examined individual cancer registrations for 42,218,671 patients diagnosed with an index cancer during the period 2000–2014 (Table 3). Of these, 2,701,998 (6.4%) were for an in situ cancer, mostly of the cervix (54.6% of 1,708,084 women), breast (10.6% of 7,377,462 women), colon (4.4% of 4,619,536 adults) or prostate (0.6% of 6,069,630 men) (web-table 2). The proportions of in situ cancer are not directly comparable between countries, because some registries still do not record in situ malignancies, while others did not submit data for cancers where in situ malignancy is common. The variation between continents is still of interest: for cervical cancer, it ranged from 2.3% in African registries to 24% in Central and South American registries, 37.4% in Asian registries and 82% in Oceania; US registries did not submit data for in situ cervical cancers, and only three Canadian provinces did so. The proportion of in situ breast cancers varied from 0.3% in African registries to 4–6% in Asia, Europe and Oceania and 17% in North America.

Patients with in situ cancer were not included in survival analyses. We excluded a further 506,625 (1.7%) patients because the year of birth, the month or year of diagnosis, or the year of last vital status was unknown, or because the tumour was not a primary, invasive malignancy (behaviour code 3), or the morphology was that of Kaposi sarcoma or lymphoma in a solid organ, or for other reasons (Table 3). The proportion of records excluded for these reasons is shown for each cancer and each cancer registry in web-table 2.

Of the 38,771,959 patients otherwise eligible for inclusion in survival analyses, the records for 1,124,388 (2.9%) were excluded because the cancer was registered only from a death certificate or discovered at autopsy (Table 3), and 116,316 (0.3%) for other reasons. These included definite errors (unknown vital status, unknown sex, sex-site error, invalid date(s) or sequence of dates) and possible errors, such as apparent inconsistencies between age, cancer site and morphology (details on request). For example, we excluded hepatoblastomas in children older than 6 years, and multiple myeloma in persons aged less than 20 years, unless the record was confirmed as correct by the registry concerned.

Among the 37,507,799 patients available for survival analyses for all cancers combined (97% of those eligible for inclusion), pathological evidence of malignancy (histology, cytology or haematology) was available for 35,482,420 (94.6%) (Table 3). This proportion ranged from 88.6% in Asia, 90.1% in Africa and 92.4% in Central and South America, up to 94–98% in Europe, Oceania and North America. Continental variation was much wider for some cancers (web-table 2).

Countries marked in the text with an asterisk are those for which survival estimates are based on data with national population coverage (100%). Survival estimates that are considered less reliable are flagged (§) in tables and graphics. These are data sets in which 15% or more of patients were lost to follow-up or censored alive within five years of diagnosis. For patients diagnosed in 2010 or later, this criterion was applied for patients censored alive before 31 December 2014, the study closure date. Estimates are also flagged as less reliable if 15% or more of patients were registered only from a death certificate or at autopsy and excluded from analysis, since their survival is unknown. Finally, estimates are also flagged if 15% or more of patients were excluded from analysis because one or more dates was incomplete: unknown year of birth, unknown month or year of diagnosis, or unknown year of last vital status.

In what follows, we present results in a similar structure for each group of cancers. Where possible, we also present graphics of national trends in cancer survival over the 20-year period 1995–2014. Estimates for patients diagnosed during 1995–99 are for countries that provided data for one of the 10 cancers included in CONCORD-2.6

Gastrointestinal cancers

Oesophagus

Results are available for 734,428 adults from 290 registries in 60 countries (Tables 2 and 4).

In 2010–2014, 5-year age-standardised net survival was in the range 10–30% in most countries, with a much wider range in Asia (web-figure 4). Most survival estimates were considered reliable (Table 5, web-table 4).

Table 5.

Five-year age-standardised net survival (NS, %): adults (15–99 years) diagnosed with one of 15 common malignancies and children (0–14 years) diagnosed with one of 3 common malignancies by calendar period of diagnosis (2000–2004, 2005–2009, 2010–2014)

Period of
diagnosis
Oesophagus
Stomach
Colon
Rectum
Liver
Pancreas
Lung
Melanoma of the skin
Breast
Cervix
Ovary
Prostate
Brain (adults)
Brain (children)
Myeloid (adults)
Lymphoid (adults)
ALL (children)
Lymphoma (children)
NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI NS (%) 95% CI
AFRICA
Algeria
(3 registries)
2000–2004 20.7§ 14.3 – 27.1 88.1§ 80.1 – 96.0 63.4§ 48.3 – 78.5 6.2§ 0.0 – 13.7 8.3§ 0.0 – 20.3 18.0§ 14.0 – 22.0 6.9§ 0.0 – 18.5 38.9§ 29.1 – 48.7 61.1§ 55.5 – 66.7 50.7§ 35.6 – 65.8 89.9§ 77.8 – 100.0 21.1§ 6.0 – 36.2 23.3§ 13.8 – 32.8 30.9§ 10.1 – 51.6 6.0§ 0.0 – 15.1
2005–2009 554§ 36.4 – 74.5 42.4§ 36.4 – 48.4 76.7§ 69.6 – 83.9 64.5§ 56.4 – 72.7 13.9§ 8.6 – 19.2 30.2§ 21.3 – 39.2 30.2§ 25.7 – 34.8 63.4§ 59.4 – 67.3 55.6§ 47.4 – 63.8 70.7§ 64.5 – 77.0 54.3§ 44.7 – 63.8 50.3§ 41.0 – 59.6 51.9§ 43.4 – 60.4 43.3§ 29.4 – 57.2 17.1§ 0.1 – 34.1 47.8§ 39.9 – 55.8 100.0§ 100.0 – 100.0 78.9§ 62.5 – 95.3
2010–2014 37.3§ 23.4 – 51.1 41.6§ 35.5 – 47.7 74.2§ 65.7 – 82.7 67.3§ 58.0 – 76.5 13.5§ 6.9 – 20.1 29.8§ 18.7 – 40.9 33.7§ 28.5 – 38.9 54.9§ 47.3 – 62.6 77.0§ 68.5 – 85.6 72.4§ 66.0 – 78.7 66.5§ 53.5 – 79.5 64.1§ 56.6 – 71.6 46.5§ 37.5 – 55.5 54.1§ 39.2 – 69.0 17.9§ 5.3 – 30.6 59.1§ 49.9 – 68.3 77.5§ 65.4 – 89.7

Mali (Bamako) 2000–2004
2005–2009
2010–2014 0.0§ 0.0 – 0.0

Mauritius* 2000–2004
2005–2009 44.3 36.8 – 51.7 65.9 56.7 – 75.1 83.6§ 75.0 – 92.1 31.7 25.9 – 37.6 83.6 75.9 – 91.3 80.8 76.0 – 85.6 79.7 69.6 – 89.8 61.8 54.1 – 69.4
2010–2014 28.1 14.641.5 25.7 18.0 – 33.3 57.9 48.5 – 67.2 72.9§ 62.7 – 83.0 17.0 2.631.3 24.5 11.437.6 20.4 13.2 – 27.7 63.5 54.7 – 72.4 43.7 25.5 – 61.9 50.1 34.4 – 65.8 65.9 53.4 – 78.4

Morocco (Casablanca) 2000–2004
2005–2009 86.7§ 71.7 – 100.0
2010–2014 99.7§ 95.8 – 100.0

Nigeria (Ibadan) 2000–2004
2005–2009 41.2§ 16.965.6 25.9§ 0.053.7 100.0§ 100.0 – 100.0 98.8§ 95.6 – 100.0 58.6§ 46.5 – 70.7 59.4§ 24.9 – 93.9 73.9§ 50.2 – 97.6 88.6§ 60.4 – 100.0 57.4§ 29.0 – 85.8 86.8§ 54.9 – 100.0 51.0§ 31.5 – 70.6
2010–2014 17.4§ 0.134.8 16.9§ 0.037.8 97.7§ 74.6 – 100.0 97.5§ 89.9 – 100.0 49.8§ 36.5 – 63.1 49.1§ 33.8 – 64.4 58.7§ 40.1 – 77.2 54.9§ 19.7 – 90.0 28.4§ 3.0 – 53.7 56.4§ 32.2 – 80.5 6.0§ 0.0 – 13.6

South Africa (Eastern Cape) 2000–2004 12.1§ 0.027.0 27.1§ 0.057.1 53.0§ 23.4 – 82.7 70.7§ 56.7 – 84.7 82.5§ 42.5 – 100.0 77.6§ 55.0 – 100.0
2005–2009 19.2§ 12.0 – 26.4 25.0§ 6.144.0 31.9§ 10.753.1 19.9§ 0.046.4 16.7§ 0.8 – 32.5 32.0§ 23.3 – 40.7 40.2§ 32.2 – 48.1 81.0§ 58.8 – 100.0 38.6§ 25.1 – 52.0 29.5§ 10.8 – 48.2
2010–2014 18.0§ 12.6 – 23.4 25.6§ 7.243.9 12.3§ 4.3 – 20.2 9.1§ 0.021.5 0.0§ 0.00.0 21.8§ 0.049.5 15.0§ 6.1 – 24.0 16.7§ 0.0 – 41.0 40.1§ 30.7 – 49.6 37.1§ 31.4 – 42.9 67.8§ 47.4 – 88.2 37.8§ 25.5 – 50.1 51.6§ 0.6 – 100.0 47.7§ 31.1 – 64.4

AMERICA (CENTRAL AND SOUTH)
Argentina 2000–2004 18.7§ 12.7 – 24.8 21.7§ 17.1 – 26.2 54.2§ 49.7 – 58.7 48.9 41.5 – 56.3 14.1§ 6.0 – 22.1 9.6§ 5.5 – 13.6 19.5§ 15.5 – 23.5 68.4 60.6 – 76.3 82.3 79.4 – 85.2 58.3 52.6 – 64.0 40.4 32.4 – 48.4 83.5 78.5 – 88.6 29.8§ 22.6 – 37.0 45.1 41.8 – 48.3 47.9 39.4 – 56.3 54.5 49.1 – 59.8 65.0 62.7 – 67.3 79.9 76.7 – 83.0
(5 registries) 2005–2009 15.0§ 11.4 –18.6 19.3§ 16.9 – 21.7 51.2§ 49.0 – 53.5 47.5 43.3 – 51.7 11.4§ 8.2 – 14.5 8.3§ 6.0 – 10.7 12.4§ 10.9 – 14.0 68.1 63.4 – 72.9 82.0 80.4 – 83.6 55.6 52.0 – 59.1 43.2 38.6 – 47.9 83.6 81.2 – 86.0 27.7§ 24.4 – 31.0 56.1 52.9 – 59.3 39.5 34.5 – 44.6 48.8 45.9 – 51.6 72.0 69.7 – 74.2 76.9 73.5 – 80.3
2010–2014 16.4§ 11.9 – 21.0 21.5§ 18.5 – 24.4 54.4§ 51.8 – 57.1 49.9 45.3 – 54.4 12.6§ 8.7 – 16.6 11.4§ 8.1 – 14.6 13.1§ 11.2 – 15.1 71.0 65.6 – 76.4 84.4 82.6 – 86.2 52.7 48.7 – 56.7 38.6 34.3 – 42.9 87.6 84.9 – 90.4 30.7§ 26.8 – 34.6 62.9§ 59.4 – 66.4 37.4 32.1 – 42.6 48.2 45.0 – 51.5 76.1§ 73.7 – 78.4 83.4 80.1 – 86.6

Brazil 2000–2004 10.7§ 9.0 – 12.4 19.1§ 17.9 – 20.3 44.5§ 42.9 – 46.0 37.7§ 35.7 – 39.6 15.4§ 10.4 – 20.5 3.9§ 3.0 – 4.9 10.7 8.3 – 13.1 76.7 71.5 – 81.8 68.7§ 67.5 – 69.8 69.3 66.1 – 72.6 42.1 36.0 – 48.1 90.0 87.2 – 92.8 31.3§ 26.2 – 36.4 55.7 44.7 – 66.6 31.1 7.3 – 54.9 48.2 43.7 – 52.6 67.7 57.8 – 77.6 69.2 57.3 – 81.1
(6 registries) 2005–2009 12.5§ 10.6 – 14.5 24.7§ 23.2 – 26.2 50.6§ 49.3 – 52.0 45.7§ 43.7 – 47.8 9.6§ 6.5 – 12.8 9.1§ 7.3 – 10.9 7.8 5.8 – 9.8 75.9 71.7 – 80.1 76.9§ 75.7 – 78.0 63.2 59.9 – 66.5 34.1 29.4 – 38.9 92.5 90.2 – 94.8 28.2§ 24.4 – 32.1 34.7 21.9 – 47.5 41.6 31.4 – 51.8 49.4 45.6 – 53.2 69.8 60.0 – 79.6 86.3 77.1 – 95.5
2010–2014 9.7§ 7.9 – 11.4 20.6§ 18.9 – 22.2 48.3§ 46.7 – 49.9 42.4§ 40.1 – 44.6 11.2§ 7.6 – 14.7 9.5§ 7.4 – 11.5 8.5 5.3 – 11.6 70.0 65.4 – 74.7 75.2§ 73.9 – 76.5 60.3 56.3 – 64.3 34.9 29.5 – 40.3 91.6 89.1 – 94.1 28.1§ 23.7 – 32.6 28.9 15.8 – 41.9 39.1 28.7 – 49.5 46.2 42.2 – 50.2 66.0 53.3 – 78.8 88.2 78.2 – 98.3

Chile 2000–2004 7.0 3.1 – 10.9 14.5 11.7 – 17.4 35.5 28.6 – 42.3 35.9 26.3 – 45.5 3.6§ 0.07.4 2.2 0.2 – 4.2 7.1§ 4.4 – 9.8 57.4 46.6 – 68.1 74.6 68.2 – 81.1 58.2 52.3 – 64.0 25.8 18.5 – 33.1 82.6 77.2 – 88.0 12.4 0.0 – 26.7 46.7 22.7 – 70.7 29.1 19.1 – 39.1 28.9 23.4 – 34.3 76.7 65.6 – 87.7 70.1 43.3 – 96.9
(4 registries) 2005–2009 10.8 7.5 – 14.1 16.3 14.7 – 18.0 47.1 43.1 – 51.0 39.5 33.9 – 45.0 2.7§ 1.0 – 4.4 3.6 1.9 – 5.4 6.3§ 4.7 – 7.8 64.4 54.4 – 74.4 73.5 68.4 – 78.6 57.2 51.6 – 62.9 29.0 23.3 – 34.7 84.4 80.7 – 88.1 21.8 14.3 – 29.3 56.7 37.0 – 76.4 25.8 20.8 – 30.8 37.1 33.7 – 40.5 67.4 57.3 – 77.4 69.7 51.4 – 88.0
2010–2014 8.7 0.3 – 17.0 16.7 14.2 – 19.3 43.9§ 39.3 – 48.5 32.7§ 26.6 – 38.8 3.7§ 0.7 – 6.8 4.4 1.07.8 4.6§ 3.0 – 6.2 59.7§ 49.4 – 69.9 75.5§ 69.4 – 81.5 56.7§ 50.0 – 63.4 28.0§ 21.3 – 34.7 82.0§ 78.4 – 85.5 24.2 15.2 – 33.2 16.5 11.4 –21.6 32.5 23.8 – 41.2 63.9 48.5 – 79.3

Colombia 2000–2004 10.7§ 5.6 – 15.8 18.4 16.0 – 20.9 45.0 40.6 – 49.4 38.3 32.9 – 43.7 4.8§ 1.8 – 7.9 6.4§ 3.5 – 9.4 9.4 7.2 – 11.5 63.1§ 57.0 – 69.1 72.3 68.9 – 75.7 56.6§ 53.5 – 59.8 33.5 28.0 – 39.0 83.6 80.7 – 86.5 23.8 20.1 – 27.5 44.9§ 32.9 – 57.0 16.3 11.4 –21.2 37.2 33.4 – 40.9 52.3 43.5 – 61.2 68.4§ 55.3 – 81.6
(4 registries) 2005–2009 9.5 4.6 – 14.4 17.7 16.2 – 19.3 41.3 37.9 – 44.7 37.2 32.7 – 41.7 5.4 3.1 – 7.7 3.4 1.6 – 5.2 10.5 8.5 – 12.5 71.3§ 66.2 – 76.5 79.1 76.1 – 82.0 55.4 52.6 – 58.1 35.4 30.3 – 40.6 87.8 85.4 – 90.3 27.4 23.5 – 31.4 33.9§ 23.4 – 44.5 30.7 25.7 – 35.7 42.3 39.2 – 45.4 57.3 47.8 – 66.9 85.0§ 76.1 – 93.9
2010–2014 10.5§ 3.9 – 17.1 17.1§ 15.4 – 18.8 34.5§ 31.2 – 37.9 38.0§ 33.2 – 42.8 5.2§ 2.7 – 7.8 5.3§ 2.8 – 7.8 8.7§ 6.7 – 10.6 65.1§ 59.2 – 71.1 72.1§ 69.0 – 75.2 49.4§ 46.5 – 52.3 33.3§ 28.2 – 38.4 80.3§ 77.6 – 83.1 20.8§ 17.1 – 24.4 46.9§ 35.9 – 57.9 31.8§ 26.6 – 37.1 40.3§ 37.0 – 43.6 68.9 51.6 – 86.3

Costa Rica* 2000–2004 35.7§ 26.3 – 45.1 48.4 45.5 – 51.2 63.8 59.5 – 68.1 48.4 41.3 – 55.6 39.0§ 32.4 – 45.6 38.1§ 31.3 – 44.8 36.2§ 31.0 – 41.5 82.6 77.2 – 88.1 87.0 83.6 – 90.3 84.9§ 81.2 – 88.6 54.3 43.7 – 64.9 94.0 92.0 – 96.1 30.8§ 24.9 – 36.7 77.1 55.1 – 99.0 35.0 25.4 – 44.6 50.0 45.2 – 54.8 97.8 93.2 – 100.0
2005–2009 19.2§ 11.3 – 27.1 38.4 36.3 – 40.5 55.1 52.2 – 58.0 50.2 45.2 – 55.2 23.6§ 18.5 – 28.7 23.8§ 19.1 – 28.6 22.0§ 19.0 – 25.1 76.2 71.5 – 80.8 86.4 84.0 – 88.7 78.3§ 75.3 – 81.3 47.1 40.5 – 53.7 92.6 90.9 – 94.2 18.9§ 15.1 – 22.8 71.2 61.2 – 81.3 21.2 15.7 – 26.7 50.4 46.9 – 53.9 87.4 82.8 – 91.9 93.0 86.7 – 99.3
2010–2014 20.9§ 14.3 – 27.6 40.6 38.5 – 42.7 60.1 57.4 – 62.8 53.9 49.2 – 58.5 24.1§ 19.7 – 28.5 24.5§ 19.5 – 29.5 20.1§ 17.1 – 23.1 77.2 72.7 – 81.7 86.7 84.6 – 88.9 78.0§ 74.8 – 81.2 56.9 49.1 – 64.7 93.2 91.5 – 94.9 21.5§ 17.5 – 25.6 69.8 57.8 – 81.8 29.4 23.3 – 35.4 52.4 49.1 – 55.7 80.0 69.3 – 90.7 93.5 86.2 – 100.0

Cuba* 2000–2004 17.2§ 15.7 – 18.7 39.8§ 38.3 – 41.2 4.5§ 3.8 – 5.1 73.7 72.2 – 75.1 64.1 62.3 – 65.9 29.5 26.7 – 32.3 26.1§ 24.6 – 27.6 44.0§ 41.6 – 46.5 72.4§ 67.1 – 77.8
2005–2009 25.6§ 23.6 – 27.5 48.5§ 46.9 – 50.1 23.2§ 22.1 – 24.2 81.8 80.5 – 83.0 68.8 67.0 – 70.7 38.4 35.6 – 41.3 53.8§ 52.1 – 55.6 49.4§ 46.7 – 52.0 77.4§ 71.5 – 83.3
2010–2014 35.7§ 32.8 – 38.6 63.9§ 61.6 – 66.2 30.1§ 28.4 – 31.8 75.1 73.7 – 76.5 72.9 70.5 – 75.2 49.3§ 45.0 – 53.5 71.4§ 68.9 – 74.0 60.1§ 56.3 – 63.8 78.5§ 70.5 – 86.6

Ecuador 2000–2004 20.9 9.931.9 17.8 12.3 – 23.3 47.7 41.0 – 54.4 38.7 30.4 – 47.1 8.1§ 4.6 – 11.5 8.4§ 4.7 – 12.2 10.1§ 7.2 – 13.0 59.0 50.9 – 67.1 72.1 67.3 – 76.9 47.4 44.1 – 50.7 34.5 26.5 – 42.5 85.7 82.0 – 89.5 24.2 19.4 – 28.9 48.0§ 35.2 – 60.8 20.5 12.6 – 28.4 33.1 29.1 – 37.0 48.3§ 40.3 – 56.4 73.4§ 62.7 – 84.1
(5 registries) 2005–2009 7.7 3.5 – 11.9 17.4 12.0 – 22.7 46.7 42.9 – 50.5 43.5 38.8 – 48.2 6.3§ 4.1 – 8.6 9.0§ 6.2 – 11.8 10.5§ 8.5 – 12.4 60.5 54.5 – 66.5 75.7 72.7 – 78.7 50.4 47.8 – 52.9 38.8 33.1 – 44.5 80.7 78.0 – 83.5 20.9 17.6 – 24.2 31.2 20.9 – 41.5 20.3 15.5 – 25.0 39.4 36.7 – 42.0 51.5 44.9 – 58.0 72.2 63.7 – 80.7
2010–2014 12.7 6.7 – 18.7 19.1 13.1 – 25.1 47.8 43.9 – 51.6 44.5 39.2 – 49.8 5.9§ 3.9 – 7.8 8.4§ 5.7 – 11.2 12.2§ 10.0 – 14.4 57.9 51.6 – 64.1 75.5 72.4 – 78.7 52.0 49.3 – 54.7 37.9 32.1 – 43.7 82.2 79.4 – 85.0 25.8 22.0 – 29.6 48.2 35.9 – 60.5 24.4 18.9 – 29.9 40.1 37.4 – 42.8 49.8 42.7 – 56.9 67.3 57.4 – 77.2

Guadeloupe* 2000–2004
2005–2009 0.0 0.00.1 11.7§ 5.7 – 17.7 30.9§ 23.1 – 38.7 21.3§ 8.8 – 33.8 9.5§ 0.020.3 11.2§ 1.720.8 6.8 2.3 – 11.2 86.2§ 53.0 – 100.0 69.8§ 60.0 – 79.7 20.9§ 3.3 – 38.5 24.2§ 8.9 – 39.5 82.8§ 78.2 – 87.5 0.2§ 0.0 – 0.6 37.5§ 9.8 – 65.3 25.7§ 17.3 – 34.0
2010–2014 11.7§ 6.8 – 16.6 26.8§ 19.5 – 34.0 35.6§ 22.4 – 48.8 3.7§ 0.09.2 4.0§ 0.2 – 7.7 14.1§ 0.0 – 36.7 50.2§ 39.6 – 60.8 19.4§ 9.0 – 29.9 29.5§ 13.8 – 45.2 71.4§ 65.5 – 77.2 9.6§ 0.0 – 19.5 32.3§ 21.4 – 43.2 36.0§ 27.3 – 44.6

Martinique* 2000–2004 4.2 0.48.1 29.7 24.2 – 35.2 57.0 50.4 – 63.6 44.1 35.1 – 53.1 12.0 5.6 – 18.4 13.4 7.8 – 19.1 12.5 7.6 – 17.4 81.8§ 68.5 – 95.1 78.9 73.5 – 84.3 69.7 62.5 – 76.9 29.5 17.8 – 41.1 93.2 90.5 – 95.8 32.6 22.4 – 42.8 46.2 36.8 – 55.6 49.8 44.1 – 55.5 77.5 55.9 – 99.2
2005–2009 4.9 1.1 – 8.7 33.0 27.5 – 38.5 54.9 49.5 – 60.3 54.0 46.0 – 62.1 12.4 5.6 – 19.1 6.9 3.2 – 10.5 14.7 10.4 – 18.9 86.4§ 74.7 – 98.2 87.8 83.5 – 92.1 57.6 48.9 – 66.3 34.0 24.6 – 43.4 97.8 95.7 – 99.9 28.1 19.9 – 36.2 49.7 41.8 – 57.6 48.7 43.9 – 53.6
2010–2014 4.0 1.86.3 32.1 24.5 – 39.6 53.6 46.9 – 60.3 52.0 42.2 – 61.7 15.6 7.2 – 23.9 11.9 6.5 – 17.3 11.8 6.4 – 17.2 77.8§ 61.3 – 94.3 89.8 84.5 – 95.1 57.5 46.2 – 68.8 35.7§ 23.4 – 48.0 97.9 95.1 – 100.0 35.8 26.4 – 45.3 47.9 39.4 – 56.5 49.4 43.3 – 55.4

Mexico (Childhood) 2000–2004
2005–2009 41.2 35.1 – 47.4 52.5 49.8 – 55.2 75.1§ 70.7 – 79.5
2010–2014 36.5 30.0 – 43.0 52.7 49.4 – 56.1 72.0§ 66.4 – 77.7

Peru (Lima) 2000–2004
2005–2009
2010–2014 59.0 55.8 – 62.1 54.8 50.0 – 59.5 84.0 81.4 – 86.7 57.2 54.8 – 59.6 36.3§ 29.5 – 43.0 46.2§ 42.9 – 49.6 60.4 53.4 – 67.3 73.4§ 64.8 – 82.1

Puerto Rico* 2000–2004 10.9 8.5 – 13.4 26.6 24.1 – 29.1 60.9 59.3 – 62.5 53.9 50.9 – 57.0 11.8§ 9.0 – 14.6 8.8§ 6.3 – 11.2 14.7§ 13.1 – 16.3 73.3 68.2 – 78.4 83.4 81.9 – 84.9 60.6 56.9 – 64.4 34.9 30.8 – 39.0 98.7 97.6 – 99.7 31.7§ 28.0 – 35.4 71.2 62.1 – 80.3 25.6§ 21.4 – 29.8 49.1 46.8 – 51.4 79.3 70.2 – 88.4 94.5 90.1 – 98.8
2005–2009 13.0 10.1 – 15.9 29.9 27.3 – 32.5 62.1 60.6 – 63.5 59.4 56.6 – 62.3 8.7§ 6.9 – 10.5 9.0§ 6.9 – 11.1 16.0 14.5 – 17.5 75.4 70.6 – 80.1 83.0 81.6 – 84.4 58.8 55.3 – 62.4 37.2 33.4 – 41.0 99.0 98.1 – 99.9 34.8 31.5 – 38.0 76.1 67.6 – 84.6 38.8 35.6 – 42.0 53.5 51.6 – 55.4 86.2 78.1 – 94.4 90.9 83.1 – 98.7
2010–2014 20.4 14.8 – 25.9 34.6 30.3 – 39.0 63.4 61.1 – 65.7 59.0 54.6 – 63.4 14.2§ 10.4 – 18.0 10.2§ 7.1 – 13.3 17.6 14.9 – 20.3 75.1 68.2 – 81.9 84.1 82.0 – 86.3 63.5 57.9 – 69.1 37.3 32.0 – 42.6 98.4 97.0 – 99.8 36.3 31.2 – 41.4 70.5 56.3 – 84.7 44.9 39.6 – 50.1 60.3 57.2 – 63.4 93.1 83.6 – 100.0 96.3 89.9 – 100.0

Uruguay* 2000–2004
2005–2009 12.0§ 8.4 – 15.6 20.5 17.5 – 23.5 57.7 55.0 – 60.4 50.5 46.3 – 54.6 12.0§ 4.4 – 19.7 4.3§ 2.3 – 6.3 9.9§ 8.3 – 11.5 55.7 51.6 – 59.8 37.4 31.9 – 42.8 84.7 82.1 – 87.3
2010–2014 8.0§ 5.3 – 10.7 18.5§ 15.4 – 21.5 53.5 49.2 – 57.7 50.1 44.8 – 55.4 14.3§ 8.0 – 20.6 4.4§ 3.0 – 5.8 9.0§ 7.4 – 10.6 56.5 51.8 – 61.1 37.4§ 31.4 – 43.4 86.5 83.7 – 89.3

AMERICA (NORTH)

Canada 2000–2004 14.5 13.4 – 15.6 25.1 24.2 – 26.0 61.6 61.1 – 62.1 61.9 61.1 – 62.8 17.4 16.2 – 18.5 7.9 7.3 – 8.5 16.3 15.9 – 16.6 87.9 87.3 – 88.6 85.9 85.5 – 86.4 67.9 66.4 – 69.5 37.6 36.6 – 38.6 93.0 92.6 – 93.3 24.7 23.4 – 26.0 73.3 68.2 – 78.4 47.5 46.1 – 48.8 60.1 59.5 – 60.7 91.0 88.8 – 93.3 89.4 85.9 – 92.9
(9 registries) 2005–2009 14.7 13.7 – 15.7 26.6 25.7 – 27.5 65.7 65.2 – 66.2 65.5 64.7 – 66.3 19.2 18.2 – 20.2 9.4 8.8 – 10.0 18.5 18.1 – 18.8 88.5 88.0 – 89.1 87.6 87.2 – 88.0 66.9 65.3 – 68.5 41.0 40.0 – 42.0 94.2 93.9 – 94.5 29.8 28.5 – 31.1 72.5 67.7 – 77.2 49.2 47.9 – 50.5 66.0 65.4 – 66.5 92.1 90.0 – 94.3 88.5 84.4 – 92.5
2010–2014 16.1 15.1 – 17.1 29.6 28.6 – 30.5 67.0 66.5 – 67.5 66.8 66.0 – 67.5 18.7 17.8 – 19.7 10.8 10.2 – 11.4 20.6 20.2 – 20.9 89.1 88.6 – 89.6 88.2 87.8 – 88.6 66.6 65.1 – 68.1 40.9 39.9 – 41.8 93.6 93.3 – 94.0 29.9 28.6 – 31.1 72.7 68.0 – 77.4 50.4 49.2 – 51.6 68.6 68.1 – 69.1 92.6 90.7 – 94.6 92.3 89.1 – 95.6

United States 2000–2004 16.5 16.1 – 16.8 26.2 25.8 – 26.5 64.7 64.5 – 64.9 63.9 63.5 – 64.2 12.5 12.2 – 12.8 7.2 7.0 – 7.4 17.0 16.9 – 17.1 88.9 88.7 – 89.1 88.9 88.7 – 89.0 64.3 63.7 – 64.8 40.4 40.0 – 40.7 97.5 97.3 – 97.6 26.8 26.5 – 27.1 72.1 71.1 – 73.2 41.0 40.7 – 41.3 61.2 61.0 – 61.4 86.7 85.8 – 87.5 88.5 87.4 – 89.6
(48 registries) 2005–2009 18.7 18.4 – 19.1 30.1 29.7 – 30.4 65.5 65.3 – 65.7 64.5 64.1 – 64.8 15.6 15.3 – 15.9 8.9 8.7 – 9.1 19.4 19.3 – 19.5 90.4 90.2 – 90.6 89.8 89.6 – 89.9 63.0 62.5 – 63.5 42.0 41.7 – 42.4 98.1 98.0 – 98.2 35.1 34.8 – 35.4 76.8 75.9 – 77.7 45.9 45.6 – 46.2 66.1 66.0 – 66.3 88.1 87.3 – 88.9 90.2 89.2 – 91.3
2010–2014 20.0 19.6 – 20.4 33.1 32.7 – 33.4 64.9 64.7 – 65.1 64.1 63.7 – 64.4 17.4 17.1 – 17.7 11.5 11.3 – 11.7 21.2 21.1 – 21.3 90.8 90.6 – 91.0 90.2 90.1 – 90.4 62.6 62.0 – 63.1 43.4 43.1 – 43.8 97.4 97.3 – 97.5 36.5 36.1 – 36.8 78.2 77.3 – 79.2 46.7 46.4 – 47.0 68.1 67.9 – 68.3 89.5 88.8 – 90.3 94.3 93.6 – 95.1

ASIA

China 2000–2004 22.9 22.0 – 23.9 30.2 29.3 – 31.1 51.4 49.6 – 53.3 49.5 47.5 – 51.4 11.7 10.9 – 12.5 14.4 12.8 – 16.0 18.7 18.0 – 19.4 35.6 25.8 – 45.4 75.9 70.9 – 80.9 53.3 48.1 – 58.5 42.4 38.2 – 46.6 57.7 52.3 – 63.0 22.7 20.5 – 25.0 32.7 21.0 – 44.4 18.6 15.8 – 21.5 33.9 31.6 – 36.2 61.8 46.5 – 77.2 44.2 29.7 – 58.8
(21 registries) 2005–2009 27.1 26.5 – 27.7 33.2 32.7 – 33.7 55.6 54.6 – 56.5 52.5 51.5 – 53.6 11.6 11.1 – 12.0 10.2 9.4 – 11.0 17.7 17.4 – 18.1 45.5 40.8 – 50.2 80.4 79.3 – 81.5 63.0 61.2 – 64.9 40.6 38.8 – 42.5 62.5 59.9 – 65.1 26.4 25.2 – 27.7 39.1 31.2 – 47.0 20.1 18.7 – 21.4 35.4 34.2 – 36.6 53.5 44.6 – 62.4 52.3 39.5 – 65.0
2010–2014 29.7 29.0 – 30.4 35.9 35.3 – 36.5 57.6 56.6 – 58.6 56.9 55.8 – 58.0 14.1 13.6 – 14.7 9.9 9.1 – 10.7 19.8 19.4 – 20.2 49.6 44.5 – 54.6 83.2 82.1 – 84.3 67.6 65.8 – 69.5 41.8 39.8 – 43.7 69.2 66.4 – 72.0 32.0 30.6 – 33.5 41.1 32.0 – 50.1 24.8 23.2 – 26.4 38.3 37.0 – 39.5 57.7 46.6 – 68.7 61.1 47.5 – 74.8

Cyprus* 2000–2004 36.6 22.251.1 70.7§ 61.8 – 79.6 61.9§ 43.080.8 8.4§ 0.021.0 12.8§ 1.723.9 18.3 12.2 – 24.3 89.0§ 73.6 – 100.0 89.3§ 80.8 – 97.8 60.4§ 41.0 – 79.8 42.6§ 24.6 – 60.6 91.0§ 84.0 – 97.9 32.1§ 13.4 – 50.8 60.0§ 39.1 – 80.9 61.4§ 52.2 – 70.6
2005–2009 47.2§ 30.563.8 28.1§ 22.9 – 33.3 67.6§ 63.9 – 71.4 78.3§ 71.3 – 85.4 13.3§ 6.320.2 8.0§ 4.5 – 11.6 18.2 15.6 – 20.8 82.1§ 75.8 – 88.4 92.0§ 88.7 – 95.4 66.9§ 60.0 – 73.8 46.2§ 39.9 – 52.4 98.3§ 95.4 – 100.0 24.6§ 18.6 – 30.7 39.8§ 33.3 – 46.2 69.4§ 65.1 – 73.7 85.2§ 72.1 – 98.3 100.0§ 86.3 – 100.0
2010–2014 39.0§ 21.856.3 35.6§ 30.0 – 41.2 72.1§ 68.5 – 75.8 75.9§ 69.6 – 82.2 10.6§ 5.8 – 15.5 11.6§ 7.7 – 15.5 18.7 16.2 – 21.2 79.0§ 73.1 – 85.0 92.8§ 89.7 – 95.9 73.3§ 65.1 – 81.6 46.4§ 40.0 – 52.7 99.2§ 96.4 – 100.0 25.2§ 19.5 – 31.0 36.0§ 30.2 – 41.9 65.7§ 61.8 – 69.6 86.6§ 78.2 – 95.0

Hong Kong* 2000–2004
2005–2009 56.1 55.1 – 57.1 57.3 55.8 – 58.7 82.2 80.9 – 83.5 66.7 64.5 – 69.0
2010–2014 56.4 55.4 – 57.3 58.0 56.6 – 59.4 83.3 82.1 – 84.6 65.8 63.6 – 68.1

India 2000–2004 2.9 0.06.4 6.4 2.5 – 10.3 46.9 31.961.8 36.9 16.157.8 2.4 0.06.0 4.2 0.010.5 6.9 2.3 – 11.5 57.6 48.1 – 67.1 45.2 34.8 – 55.6 25.6 12.2 – 39.1 24.8 6.3 – 43.3 22.4§ 8.3 – 36.5 19.7 6.3 – 33.1 40.6 28.1 – 53.1 54.0 28.3 – 79.8
(2 registries) 2005–2009 3.4 0.7 – 6.0 9.8 3.4 – 16.3 33.8 21.146.4 33.6 20.8 – 46.3 3.7 0.0 – 7.7 5.3 0.011.4 3.5 1.4 –5.7 59.1 46.6 – 71.6 51.6 40.5 – 62.6 13.2 7.7 – 18.7 33.2 16.3 – 50.0 16.7 10.4 – 23.0 6.1 2.5 – 9.6 45.4 34.2 – 56.6 75.5 52.1 – 99.0
2010–2014 4.1 0.0 – 8.5 8.9 4.0 – 13.9 38.9 24.6 – 53.3 30.0 20.5 – 39.5 6.3 0.611.9 5.6 0.011.6 3.7 1.6 –5.7 61.5 27.3 – 95.8 66.1 51.5 – 80.8 59.0 47.5 – 70.5 15.6 10.2 – 21.1 44.3 32.1 – 56.6 30.0 17.5 – 42.6 29.0 16.8 – 41.3 45.6 33.0 – 58.1

Iran (Golestan) 2000–2004 -
2005–2009 7.4 4.8 – 10.0 5.7 3.3 – 8.0 29.1 20.2 – 38.0 26.2 14.138.3
2010–2014

Israel* 2000–2004 17.9 14.3 – 21.5 29.3 27.6 – 31.1 66.5 65.4 – 67.6 62.7 60.6 – 64.7 15.1§ 12.2 – 17.9 7.6§ 6.4 – 8.8 20.8 19.8 – 21.8 85.6 84.2 – 87.0 85.1 84.2 – 86.1 65.0 61.6 – 68.5 40.1 37.8 – 42.4 92.5 91.4 – 93.6 29.7 27.8 – 31.7 74.5 69.3 – 79.6 51.3 49.1 – 53.5 63.7 62.5 – 64.9 86.4 81.6 – 91.2 89.1 84.6 – 93.5
2005–2009 22.4 18.6 – 26.2 29.8 28.1 – 31.5 71.4 70.3 – 72.4 67.3 65.3 – 69.3 15.6§ 13.1 – 18.2 9.2§ 8.0 – 10.5 23.8 22.8 – 24.8 88.4 87.2 – 89.7 87.8 86.8 – 88.7 65.9 62.7 – 69.1 43.5 41.1 – 45.9 95.7 94.7 – 96.6 32.3 30.4 – 34.3 72.0 67.2 – 76.9 43.9 41.9 – 46.0 65.2 64.1 – 66.3 86.7 82.2 – 91.2 90.8 87.3 – 94.3
2010–2014 25.8 21.4 – 30.2 32.3 30.4 – 34.3 71.7 70.6 – 72.9 67.8 65.6 – 70.0 18.9§ 15.6 – 22.2 12.4§ 10.8 – 14.0 26.6 25.4 – 27.7 87.4 86.1 – 88.8 88.0 87.0 – 89.0 66.6 63.2 – 70.1 45.0 42.3 – 47.7 95.6 94.5 – 96.7 32.8 30.6 – 34.9 77.6 72.6 – 82.6 39.7 37.6 – 41.9 65.5 64.2 – 66.7 87.9 83.1 – 92.6 92.3 89.0 – 95.6

Japan (16 registries) 2000–2004 27.7 26.4 – 29.0 50.5 50.0 – 50.9 63.4 62.7 – 64.0 58.6 57.6 – 59.5 25.7§ 25.1 – 26.3 6.9§ 6.4 – 7.4 29.3 28.1 – 30.5 68.9 65.1 – 72.8 85.9 85.2 – 86.6 67.5 66.3 – 68.7 35.5 33.8 – 37.2 85.9 84.9 – 87.0 27.9§ 26.3 – 29.5 65.3 59.2 – 71.5 24.8 23.4 – 26.1 47.5 46.3 – 48.7 79.7 74.9 – 84.4 86.0 80.2 – 91.7
2005–2009 33.3 32.3 – 34.2 57.6 57.3 – 57.9 66.8 66.3 – 67.3 64.0 63.3 – 64.6 28.6§ 28.1 – 29.1 7.6§ 7.2 – 7.9 29.3 28.9 – 29.7 68.3 65.6 – 71.0 88.9 88.4 – 89.3 69.2 68.3 – 70.1 43.9 42.8 – 45.1 91.4 90.8 – 92.0 38.5§ 37.2 – 39.7 62.5 58.1 – 66.8 27.5 26.7 – 28.3 52.0 51.4 – 52.6 83.7 80.6 – 86.9 84.7 79.5 – 89.9
2010–2014 36.0 34.8 – 37.3 60.3 59.9 – 60.7 67.8 67.3 – 68.4 64.8 64.0 – 65.7 30.1§ 29.5 – 30.6 8.3§ 7.8 – 8.7 32.9 32.3 – 33.4 69.0 66.0 – 72.0 89.4 88.9 – 89.9 71.4 70.4 – 72.3 46.3 44.9 – 47.7 93.0 92.4 – 93.6 46.3§ 44.9 – 47.7 69.6 64.4 – 74.7 33.3 32.4 – 34.3 57.3 56.5 – 58.0 87.6 84.2 – 91.0 89.6 84.2 – 95.0

Jordan* 2000–2004 52.6§ 41.3 – 63.9 76.1§ 69.7 – 82.5 86.0§ 81.6 – 90.5 79.9§ 71.1 – 88.8 71.5§ 58.1 – 84.9 66.9§ 52.0 – 81.8 42.9§ 38.3 – 47.4 68.5§ 56.4 – 80.6 87.6§ 83.5 – 91.7 75.6§ 66.8 – 84.3 88.5§ 83.7 – 93.3 55.8§ 49.0 – 62.6 73.5§ 65.7 – 81.3 57.1§ 48.1 – 66.1 76.0§ 69.4 – 82.6 75.4§ 69.7 – 81.2 92.4§ 88.1 – 96.6
2005–2009 53.9§ 43.0 – 64.8 64.8§ 58.4 – 71.3 80.8§ 77.0 – 84.7 76.2§ 67.1 – 85.3 64.3§ 54.5 – 74.1 32.5§ 25.6 – 39.4 44.1§ 39.4 – 48.7 63.1§ 49.3 – 76.9 86.6§ 83.2 – 90.0 70.6§ 63.9 – 77.4 88.6§ 83.3 – 93.9 46.7§ 41.1 – 52.4 66.0§ 58.6 – 73.3 56.5§ 46.9 – 66.1 74.6§ 68.3 – 80.9 89.2§ 84.8 – 93.6 91.1§ 86.4 – 95.8
2010–2014 41.1§ 30.4 – 51.9 55.7§ 48.7 – 62.6 76.1§ 72.1 – 80.1 73.2§ 65.0 – 81.4 40.0§ 28.6 – 51.3 24.0§ 18.7 – 29.3 28.3§ 24.9 – 31.6 55.9§ 41.5 – 70.4 84.4§ 80.9 – 88.0 56.4§ 48.2 – 64.6 86.1§ 81.1 – 91.0 32.9§ 26.8 – 39.0 57.3§ 49.9 – 64.8 42.5§ 35.3 – 49.6 65.1§ 60.3 – 69.9 88.0§ 83.1 – 92.8 87.0§ 81.4 – 92.6

Korea* 2000–2004 18.6 17.6 – 19.6 48.6 48.2 – 48.9 60.5 59.9 – 61.2 60.8 60.0 – 61.6 15.3 15.0 – 15.7 7.6 7.2 – 8.1 15.3 15.0 – 15.6 51.4 48.3 – 54.4 79.5 78.0 – 81.0 76.0 75.3 – 76.7 43.0 41.2 – 44.7 76.0 74.6 – 77.5 27.6 26.4 – 28.9 54.2 50.8 – 57.6 31.7 30.4 – 33.0 39.8 38.8 – 40.8 73.1 70.4 – 75.8 82.4 79.3 – 85.4
2005–2009 26.9 25.8 – 28.0 61.1 60.8 – 61.5 68.1 67.6 – 68.6 68.1 67.5 – 68.7 22.4 22.1 – 22.8 8.4 8.0 – 8.9 19.9 19.6 – 20.2 55.3 52.8 – 57.7 84.0 83.0 – 85.0 77.0 76.4 – 77.7 44.1 42.7 – 45.5 87.3 86.5 – 88.1 31.9 30.8 – 33.0 61.4 58.1 – 64.7 41.5 40.5 – 42.5 47.5 46.7 – 48.4 78.6 76.1 – 81.0 83.0 80.0 – 85.9
2010–2014 31.3 30.3 – 32.4 68.9 68.6 – 69.2 71.8 71.4 – 72.2 71.1 70.6 – 71.7 27.2 26.8 – 27.6 10.5 10.0 – 10.9 25.1 24.8 – 25.4 59.9 57.5 – 62.2 86.6 85.8 – 87.5 77.3 76.6 – 78.0 47.5 46.2 – 48.9 89.9 89.2 – 90.5 33.7 32.6 – 34.7 60.3 56.9 – 63.8 45.9 44.9 – 46.8 52.5 51.8 – 53.3 84.4 82.1 – 86.7 91.0 88.9 – 93.1

Kuwait* 2000–2004 17.6§ 2.932.4 15.0 7.1 – 22.9 64.8 53.1 – 76.5 59.3 48.1 – 70.4 11.4§ 3.519.2 11.2§ 3.119.3 13.3 8.9 – 17.7 68.3 58.0 – 78.7 54.8 45.2 – 64.3 38.9 26.3 – 51.5 78.8 66.7 – 90.9 30.3§ 19.1 –41.5 47.1 24.4 – 69.8 38.6 27.1 – 50.0 52.1 42.9 – 61.2 76.1§ 65.7 – 86.5 93.0 86.2 – 99.8
2005–2009 9.5 0.020.6 13.4 7.1 – 19.7 50.2 42.7 – 57.7 53.3 42.4 – 64.2 12.4 5.819.1 7.0 3.0 – 11.0 16.3 11.1 –21.5 71.0 63.8 – 78.2 73.8 61.7 – 86.0 35.4 25.2 – 45.6 71.9 63.7 – 80.0 24.9 17.3 – 32.6 59.2 39.2 – 79.1 24.0 15.9 – 32.0 63.2 55.8 – 70.7 74.9 65.6 – 84.1 90.7 83.2 – 98.2
2010–2014 25.4 10.540.4 22.4 12.6 – 32.3 58.5 49.4 – 67.7 58.2 48.5 – 67.9 18.6 9.8 – 27.3 23.6 12.0 – 35.2 13.4 8.8 – 18.0 75.2 66.4 – 83.9 56.6 44.2 – 69.0 35.1 25.6 – 44.7 84.0 74.1 – 94.0 31.8 23.2 – 40.4 25.6 17.7 – 33.6 68.2 59.5 – 76.9 88.4 80.6 – 96.2 96.3 91.4 – 100.0

Malaysia (Penang) 2000–2004
2005–2009 13.2 6.5 – 19.9 23.2 17.5 – 29.0 54.9 49.2 – 60.6 37.3 30.1 – 44.5 6.4 3.7 – 9.1 8.9 4.5 – 13.3 6.8 4.9 – 8.7 74.4§ 66.3 – 82.4 56.3§ 49.5 – 63.0 36.4§ 27.3 – 45.6 74.9 67.5 – 82.3 20.5 10.7 – 30.4 41.3§ 19.0 – 63.6 20.3 11.5 –29.1 31.4 24.7 – 38.1 72.8§ 62.4 – 83.3 95.3§ 89.2 – 100.0
2010–2014 13.7 3.823.6 30.0 22.9 – 37.0 55.9 46.1 – 65.8 58.0 46.6 – 69.4 9.6 3.915.2 19.0 12.0 – 26.0 10.1 7.1 – 13.2 65.0§ 52.1 – 78.0 57.1§ 48.3 – 65.9 46.8§ 34.5 – 59.0 87.7 80.8 – 94.5 28.3 14.7 – 42.0 63.4§ 45.7 – 81.2 29.6 21.2 – 38.0 51.3 39.6 – 63.1 82.3§ 72.0 – 92.5 85.0§ 66.2 – 100.0

Mongolia* 2000–2004
2005–2009 76.7 60.0 – 93.4
2010–2014 76.1 63.8 – 88.4

Qatar* 2000–2004 36.1§ 10.361.9 15.0§ 2.0 – 28.0 62.1§ 50.1 – 74.1 67.8§ 48.786.9 7.1§ 2.6 – 11.5 9.9§ 0.021.2 7.4§ 0.8 – 14.1 77.5§ 48.0 – 100.0 59.2§ 48.7 – 69.7 83.9§ 68.5 – 99.2 47.1§ 25.1 – 69.0 81.5§ 60.7 – 100.0 52.9§ 34.0 – 71.9 11.1§ 0.0 – 27.1 63.8§ 49.8 – 77.7 46.5§ 34.5 – 58.4 67.3§ 44.3 – 90.3 69.0§ 52.6 – 85.4
2005–2009 33.4§ 9.457.5 22.0§ 12.2 – 31.7 64.3§ 47.6 – 80.9 60.5§ 46.7 – 74.3 10.3§ 3.217.3 4.2§ 0.010.4 14.3§ 7.4 – 21.2 30.1§ 0.0 – 65.3 73.3§ 63.0 – 83.7 55.6§ 35.3 – 76.0 62.6§ 47.5 – 77.6 98.2§ 87.1 – 100.0 32.4§ 19.0 – 45.8 52.1§ 39.7 – 64.6 60.3§ 45.9 – 74.7 82.6§ 61.2 – 100.0 88.5§ 73.8 – 100.0
2010–2014 42.2§ 9.475.0 17.5§ 9.7 – 25.3 63.5§ 51.7 – 75.2 43.6§ 31.2 – 56.1 27.2§ 12.9 – 41.5 16.6§ 7.2 – 26.1 17.2§ 10.3 – 24.2 99.7§ 84.7 – 100.0 71.9§ 58.4 – 85.5 63.5§ 44.2 – 82.8 39.2§ 26.3 – 52.1 89.6§ 79.0 – 100.0 36.1§ 20.5 – 51.7 65.5§ 34.5 – 96.5 56.9§ 42.0 – 71.9 75.0§ 58.8 – 91.2 100.0§ 100.0 – 100.0 95.3§ 87.3 – 100.0

Singapore* 2000–2004 9.0 6.2 – 11.8 25.4 23.3 – 27.4 56.1 54.4 – 57.8 51.4 48.5 – 54.2 13.2 11.6 – 14.9 5.3 3.6 – 7.0 10.3 9.4 – 11.2 62.8 51.0 – 74.6 76.3 73.9 – 78.7 68.3 65.2 – 71.5 42.5 37.9 – 47.0 83.4 80.3 – 86.5 26.2 21.5 – 30.9 60.9 48.0 – 73.8 39.2 35.1 – 43.3 46.0 43.0 – 48.9 79.8 72.3 – 87.2 86.9 77.5 – 96.3
2005–2009 10.5 7.4 – 13.5 27.1 25.0 – 29.2 60.3 58.7 – 61.8 59.0 56.3 – 61.8 20.4 18.6 – 22.2 6.7 5.1 – 8.3 13.0 12.0 – 13.9 59.0 50.5 – 67.5 80.3 78.3 – 82.3 63.3 60.1 – 66.6 46.8 42.8 – 50.7 86.7 84.5 – 88.9 30.3 26.2 – 34.4 57.5 45.9 – 69.0 43.7 40.1 – 47.4 55.3 52.7 – 57.9 90.4 84.2 – 96.6 73.8 61.6 – 86.0
2010–2014 14.8 11.1 – 18.4 30.3 28.2 – 32.4 61.7 60.2 – 63.2 60.5 58.0 – 63.0 24.7 22.8 – 26.6 9.4 7.6 – 11.2 15.5 14.5 – 16.5 60.0 51.7 – 68.2 80.3 78.4 – 82.2 63.4 60.2 – 66.6 43.9 40.7 – 47.0 87.8 85.8 – 89.8 34.4 30.6 – 38.2 62.0 51.4 – 72.5 44.1 41.1 – 47.1 58.7 56.4 – 61.1 88.6 81.8 – 95.4 92.1 85.2 – 99.1

Taiwan* 2000–2004 13.0 12.0 – 13.9 35.6 34.8 – 36.4 56.8 56.0 – 57.5 57.7 56.8 – 58.7 19.5 19.1 – 19.9 7.0 6.3 – 7.7 11.6 11.2 –12.0 48.6 44.6 – 52.6 80.2 78.9 – 81.6 74.3 73.4 – 75.2 44.1 41.8 – 46.4 75.5 73.8 – 77.2 26.5 24.8 – 28.1 57.1 52.4 – 61.8 23.1 21.6 – 24.6 40.3 39.2 – 41.4 72.1 68.2 – 75.9 80.1 75.6 – 84.7
2005–2009 13.2 12.3 – 14.1 36.7 35.9 – 37.5 60.4 59.8 – 61.0 61.5 60.6 – 62.3 24.4 24.0 – 24.8 6.5 5.9 – 7.1 16.0 15.6 – 16.4 53.3 49.7 – 56.9 82.2 81.2 – 83.2 73.2 72.2 – 74.2 47.5 45.5 – 49.5 79.8 78.7 – 81.0 27.6 26.0 – 29.2 58.8 54.1 – 63.5 30.4 29.1 – 31.7 46.8 45.8 – 47.8 78.8 75.3 – 82.3 84.0 79.6 – 88.4
2010–2014 15.5 14.6 – 16.4 38.6 37.8 – 39.4 62.6 62.0 – 63.1 62.5 61.7 – 63.3 27.9 27.5 – 28.4 7.7 7.0 – 8.3 20.6 20.2 – 21.0 52.1 48.5 – 55.6 84.2 83.3 – 85.1 70.0 68.9 – 71.1 48.8 46.9 – 50.8 83.0 81.9 – 84.0 28.4 26.9 – 29.9 54.8 49.9 – 59.6 33.4 32.2 – 34.6 50.5 49.6 – 51.5 76.5 72.8 – 80.1 86.7 82.5 – 90.8

Thailand (6 registries) 2000–2004 8.8§ 6.6 – 11.1 22.3§ 18.7 – 25.8 39.8§ 37.2 – 42.5 43.0§ 38.5 – 47.4 7.7§ 6.9 – 8.6 6.9§ 5.1 – 8.7 10.2§ 9.3 – 11.1 44.7§ 34.4 – 55.0 56.6§ 52.0 – 61.3 53.5§ 51.3 – 55.7 41.8§ 34.8 – 48.7 52.1§ 46.6 – 57.6 11.7§ 9.2 – 14.3 23.4§ 15.2 – 31.5 9.4§ 7.2 – 11.6 30.3§ 26.7 – 34.0 54.5§ 46.7 – 62.4 43.9§ 27.1 – 60.8
2005–2009 7.8 5.9 – 9.7 16.1 13.9 – 18.3 42.8 41.1 – 44.6 38.6 36.0 – 41.1 7.9 7.3 – 8.6 9.6 7.7 – 11.5 10.3 9.6 – 11.1 37.9§ 30.6 – 45.2 64.8§ 62.5 – 67.0 55.8§ 54.0 – 57.7 35.8 32.3 – 39.3 71.8 69.0 – 74.7 17.6 15.2 – 20.0 38.4 30.6 – 46.3 18.2 16.0 – 20.4 36.1 33.7 – 38.4 60.6 54.2 – 67.1 63.7§ 52.3 – 75.0
2010–2014 7.1 5.1 – 9.1 12.5 10.7 – 14.3 47.0 45.2 – 48.8 44.4 41.8 – 47.1 6.9 6.3 – 7.5 6.8 5.3 – 8.2 8.6 7.9 – 9.2 29.9§ 23.7 – 36.1 68.7§ 66.6 – 70.8 53.9§ 52.1 – 55.8 37.2 34.0 – 40.5 68.0 65.2 – 70.8 14.7 12.6 – 16.9 44.5§ 35.9 – 53.1 25.4 22.8 – 28.0 35.0 32.8 – 37.1 65.9§ 59.2 – 72.6 73.9§ 65.0 – 82.7

Turkey 2000–2004 14.8§ 9.2 – 20.4 21.9§ 18.5 – 25.4 52.9§ 49.1 – 56.7 48.5 43.9 – 53.0 20.1§ 15.0 – 25.2 10.9§ 7.8 – 14.1 11.9§ 10.6 – 13.3 60.9§ 53.2 – 68.6 84.8 81.5 – 88.0 64.8 59.7 – 69.9 46.1§ 38.3 – 53.8 83.4§ 79.3 – 87.5 32.1§ 27.9 – 36.2 56.8 46.3 – 67.2 35.9§ 30.6 – 41.2 54.3§ 49.6 – 58.9 72.4 64.3 – 80.6 79.9 70.9 – 88.9
(9 registries) 2005–2009 14.7 12.9 – 16.5 21.4 20.3 – 22.4 52.7 51.3 – 54.2 49.3 47.3 – 51.3 14.9 12.9 – 17.0 9.5 8.4 – 10.7 12.7 12.2 – 13.2 57.7 54.6 – 60.9 80.6 79.2 – 82.1 59.2 56.5 – 61.9 40.0 37.4 – 42.6 81.2 79.9 – 82.6 34.0 32.4 – 35.6 61.1 56.2 – 66.0 49.0 46.8 – 51.2 50.3 48.7 – 51.8 78.7 74.9 – 82.6 85.0 81.4 – 88.7
2010–2014 19.0 16.9 – 21.1 24.6 23.6 – 25.6 55.2 53.8 – 56.6 52.6 50.6 – 54.5 15.9 14.0 – 17.8 10.4 9.3 – 11.5 14.9 14.3 – 15.4 60.7 57.6 – 63.7 82.1 80.7 – 83.5 60.7 58.1 – 63.3 39.7 37.3 – 42.0 83.8 82.5 – 85.1 35.6 34.1 – 37.0 62.5 58.4 – 66.7 54.0 51.8 – 56.1 54.5 53.0 – 56.1 80.9 77.2 – 84.6 82.9 79.1 – 86.7

EUROPE
Austria*
2000–2004 16.2 14.2 – 18.3 30.0 28.7 – 31.3 60.7 59.7 – 61.7 60.2 58.9 – 61.5 11.2 10.0 – 12.4 6.7§ 5.9 – 7.5 15.4 14.8 – 16.0 83.4 82.2 – 84.7 81.7 80.9 – 82.4 65.4 63.4 – 67.4 40.9 39.4 – 42.5 90.1 89.3 – 90.8 24.2 22.6 – 25.9 25.0 23.1 – 26.8 57.6 56.5 – 58.7
2005–2009 16.8 15.0 – 18.7 34.2 32.9 – 35.6 63.5 62.5 – 64.4 63.5 62.2 – 64.8 14.2§ 12.9 – 15.6 8.5 7.7 – 9.4 18.0 17.4 – 18.6 84.6 83.5 – 85.8 83.9 83.2 – 84.6 66.0 63.7 – 68.2 41.2 39.6 – 42.8 90.8 90.1 – 91.5 28.5 26.9 – 30.1 29.6 27.7 – 31.5 62.2 61.1 – 63.3
2010–2014 18.6 16.6 – 20.6 35.4 34.0 – 36.9 63.7 62.7 – 64.7 64.2 62.9 – 65.6 14.8§ 13.4 – 16.2 10.5§ 9.5 – 11.4 19.7 19.1 – 20.4 87.8 86.7 – 88.8 84.8 84.1 – 85.5 63.9 61.6 – 66.2 41.0 39.4 – 42.7 90.2 89.5 – 90.9 26.3 24.7 – 27.9 32.0 30.1 – 34.0 63.3 62.3 – 64.4

Belarus (Childhood) 2000–2004 66.1 59.8 – 72.3 78.5 73.0 – 83.9 86.5 80.7 – 92.3
2005–2009 70.4 64.0 – 76.8 87.0 81.9 – 92.2 84.6 77.0 – 92.2
2010–2014 68.5 61.6 – 75.5 86.6 81.7 – 91.5 85.2 78.0 – 92.4

Belgium* 2000–2004 16.6 13.8 – 19.4 29.3 26.4 – 32.2 64.3 62.7 – 66.0 62.9 60.4 – 65.4 21.3 16.8 – 25.8 8.9 6.9 – 10.8 15.4 14.4 – 16.4 86.3 83.9 – 88.7 84.8 83.5 – 86.0 65.1 61.1 – 69.0 42.7 39.4 – 45.9 92.1 90.8 – 93.4 31.5 28.5 – 34.5 84.1 75.6 – 92.6 49.7 46.7 – 52.7 65.5 63.6 – 67.4 80.4 69.8 – 91.0 94.2 87.9 – 100.0
2005–2009 23.2 21.7 – 24.7 35.8 34.4 – 37.1 65.0 64.3 – 65.7 65.3 64.3 – 66.4 20.6 19.0 – 22.3 10.5 9.6 – 11.4 17.0 16.5 – 17.4 88.9 87.9 – 89.8 85.3 84.7 – 85.8 65.7 63.8 – 67.6 42.8 41.3 – 44.3 93.2 92.6 – 93.7 31.9 30.6 – 33.2 75.2 70.3 – 80.1 53.2 51.9 – 54.5 68.0 67.2 – 68.8 90.5 87.0 – 94.1 95.6 92.9 – 98.2
2010–2014 23.6 22.1 – 25.0 37.5 36.2 – 38.9 67.9 67.2 – 68.6 66.6 65.6 – 67.6 20.7 19.2 – 22.2 12.4 11.4 –13.3 18.2 17.7 – 18.6 91.0 90.1 – 91.8 86.4 85.9 – 86.9 65.4 63.5 – 67.2 43.1 41.6 – 44.6 93.8 93.2 – 94.3 31.2 29.9 – 32.5 74.5 70.2 – 78.9 55.4 54.2 – 56.5 70.6 69.8 – 71.4 90.8 87.3 – 94.3 95.4 92.7 – 98.1

Bulgaria* 2000–2004 11.2§ 10.3 – 12.0 43.9 42.7 – 45.2 37.0 35.6 – 38.4 4.0§ 2.9 – 5.1 5.8 5.3 – 6.3 50.8 47.9 – 53.8 70.9 69.7 – 72.1 49.2 47.6 – 50.7 32.9 30.9 – 34.9 49.4 47.1 – 51.7 29.9§ 27.2 – 32.6 38.1 36.1 – 40.0 63.5 55.5 – 71.5 70.7 62.2 – 79.2
2005–2009 13.9 13.0 – 14.9 48.5 47.4 – 49.6 42.1 40.7 – 43.5 4.6§ 3.5 – 5.6 7.0 6.5 – 7.6 56.0 53.3 – 58.6 75.9 74.8 – 77.0 53.2 51.7 – 54.7 33.9 32.2 – 35.5 54.8 52.7 – 56.9 40.1 37.6 – 42.6 39.9 38.1 – 41.6 74.8 68.4 – 81.1 74.3 64.9 – 83.7
2010–2014 16.0 14.9 – 17.0 52.4 51.3 – 53.6 45.9 44.4 – 47.4 6.5§ 5.1 – 7.9 7.7 7.1 – 8.2 61.2 58.8 – 63.7 78.3 77.2 – 79.4 54.8 53.3 – 56.3 37.3 35.4 – 39.1 68.3 66.2 – 70.5 41.6§ 39.2 – 44.1 43.5 41.8 – 45.2 78.3 71.7 – 84.9 87.7 80.6 – 94.9

Croatia* 2000–2004 6.8 4.9 – 8.7 19.7 18.4 – 20.9 47.3 45.9 – 48.7 44.4 42.7 – 46.1 9.2§ 7.6 – 10.7 9.1 7.9 – 10.4 11.2 10.5 – 11.9 66.4 64.0 – 68.8 73.6 72.2 – 75.0 63.2 60.6 – 65.8 36.9 34.6 – 39.2 65.7 63.6 – 67.9 37.0 35.1 – 38.8 65.7 58.3 – 73.1 31.1 28.6 – 33.6 42.7 41.0 – 44.4 81.7 74.3 – 89.1 76.6 66.8 – 86.3
2005–2009 9.1 6.9 – 11.2 18.9 17.6 – 20.2 49.5 48.2 – 50.8 47.1 45.5 – 48.7 9.2§ 7.7 – 10.8 8.2 7.0 – 9.4 10.6 10.0 – 11.3 74.7 72.7 – 76.7 78.2 77.0 – 79.4 64.3 61.9 – 66.7 33.4 31.3 – 35.5 78.3 76.7 – 79.9 39.6 37.8 – 41.5 75.2 67.9 – 82.5 29.2 26.8 – 31.6 51.0 49.3 – 52.6 86.7 81.1 – 92.3 84.6 76.2 – 93.0
2010–2014 8.7 6.6 – 10.8 20.0 18.6 – 21.3 51.1 49.9 – 52.4 48.2 46.5 – 49.8 9.3§ 7.7 – 10.9 8.4§ 7.1 – 9.7 10.0 9.3 – 10.6 77.2 75.3 – 79.1 78.6 77.4 – 79.7 63.2 60.8 – 65.6 36.0 33.9 – 38.2 80.9 79.3 – 82.4 42.2 40.4 – 44.0 73.4 65.6 – 81.3 32.2 29.7 – 34.7 52.7 51.1 – 54.3 85.2 79.1 – 91.3 94.5 89.1 – 99.9

Czech Republic* 2000–2004 7.3 6.0 – 8.6 18.7 17.7 – 19.7 48.0 47.3 – 48.8 43.8 42.6 – 44.9 3.0 2.3 – 3.6 3.6 3.0 – 4.1 8.6 8.2 – 9.0 80.7 79.5 – 81.8 75.7 74.8 – 76.5 60.4 58.9 – 61.9 34.3 33.0 – 35.5 71.0 69.9 – 72.2 19.5 18.2 – 20.8 55.6 47.9 – 63.3 19.9 18.2 – 21.7 49.9 48.8 – 51.0 88.0 82.9 – 93.1 89.0 82.7 – 95.3
2005–2009 9.0 7.5 – 10.5 19.3 18.3 – 20.3 52.0 51.3 – 52.7 47.9 46.8 – 49.0 5.3 4.5 – 6.2 4.7 4.1 – 5.3 9.8 9.4 – 10.3 84.6 83.7 – 85.6 79.1 78.4 – 79.9 62.7 61.2 – 64.1 35.3 34.0 – 36.5 81.5 80.7 – 82.3 22.1 20.8 – 23.4 64.3 57.4 – 71.3 33.5 31.8 – 35.1 53.2 52.2 – 54.3 90.3 85.6 – 95.0 82.9 73.2 – 92.5
2010–2014 9.8 8.3 – 11.4 20.6 19.6 – 21.6 56.1 55.4 – 56.9 52.3 51.2 – 53.4 6.7 5.6 – 7.7 6.1 5.4 – 6.7 10.6 10.2 – 11.1 85.7 84.8 – 86.6 81.4 80.7 – 82.1 61.0 59.5 – 62.4 36.5 35.2 – 37.8 85.3 84.6 – 86.0 21.4 20.1 – 22.7 69.7 63.2 – 76.2 36.8 35.2 – 38.5 57.2 56.1 – 58.2 88.2 82.1 – 94.3 89.6 82.5 – 96.6

Denmark* 2000–2004 8.4 6.9 – 9.8 14.7 13.2 – 16.3 51.5 50.4 – 52.6 53.2 51.7 – 54.7 4.4 3.1 – 5.8 3.8 3.0 – 4.5 9.5 9.0 – 10.1 87.3 86.0 – 88.5 80.3 79.4 – 81.2 63.0 60.6 – 65.4 33.1 31.4 – 34.8 63.6 62.1 – 65.1 30.5 28.8 – 32.2 68.8 62.1 – 75.5 35.7 33.6 – 37.8 57.7 56.4 – 59.0 84.3 78.6 – 90.0 90.2 82.2 – 98.2
2005–2009 10.4 8.9 – 11.9 15.4 13.9 – 16.9 56.5 55.5 – 57.6 59.8 58.4 – 61.1 5.6 4.2 – 7.0 5.6 4.7 – 6.4 12.3 11.7 –12.8 89.1 88.1 – 90.0 84.0 83.2 – 84.8 66.7 64.3 – 69.1 37.4 35.7 – 39.2 82.5 81.6 – 83.4 35.1 33.4 – 36.7 79.4 72.9 – 85.8 45.0 43.0 – 47.0 66.9 65.7 – 68.0 93.1 88.4 – 97.7 90.0 83.1 – 97.0
2010–2014 13.7 12.0 – 15.4 19.9 18.1 – 21.6 61.6 60.6 – 62.7 64.8 63.4 – 66.1 7.5 5.9 – 9.1 8.0 7.0 – 9.1 16.6 16.0 – 17.3 91.1 90.2 – 91.9 86.1 85.4 – 86.9 69.5 67.0 – 72.0 39.7 37.8 – 41.6 85.6 84.7 – 86.4 38.9 37.3 – 40.6 79.5 73.3 – 85.6 47.6 45.7 – 49.6 70.9 69.8 – 72.1 94.0 90.1 – 97.9 93.8 89.0 – 98.7

Estonia* 2000–2004 5.7 2.8 – 8.6 22.3 20.2 – 24.4 48.9 46.2 – 51.5 46.4 42.9 – 49.9 5.5§ 2.8 – 8.3 4.8 3.2 – 6.5 10.8 9.5 – 12.2 71.4 67.0 – 75.8 70.9 68.2 – 73.6 62.3 58.5 – 66.1 31.2 27.7 – 34.6 67.9 64.5 – 71.3 25.2 21.4 – 29.0 81.2 69.9 – 92.5 36.6 31.6 – 41.6 48.8 45.6 – 52.0 63.7 51.0 – 76.4 88.3 73.4 – 100.0
2005–2009 6.0 3.5 – 8.5 24.2 22.1 – 26.4 53.8 51.3 – 56.3 50.5 46.9 – 54.1 6.5 3.9 – 9.2 5.4 3.8 – 7.0 14.3 12.6 – 15.9 75.2 71.7 – 78.8 75.4 73.1 – 77.6 66.9 63.4 – 70.4 37.2 33.8 – 40.7 83.2 80.9 – 85.6 26.1 22.6 – 29.6 72.3 57.9 – 86.7 42.4 38.1 – 46.8 53.5 50.6 – 56.4 85.4 73.6 – 97.1 85.8 68.1 – 100.0
2010–2014 5.4 2.3 – 8.5 29.2 26.1 – 32.3 58.4 55.2 – 61.6 54.8 50.1 – 59.5 4.2 1.8 –6.6 10.2 7.0 – 13.4 16.9 14.9 – 19.0 81.8 77.6 – 86.0 76.6 73.8 – 79.3 66.5 62.2 – 70.7 42.3 37.4 – 47.1 86.3 83.5 – 89.0 31.0 26.1 – 36.0 64.5 47.3 – 81.8 37.8 32.1 – 43.5 53.8 50.2 – 57.4 87.7 76.4 – 98.9 88.0 73.1 – 100.0

Finland* 2000–2004 11.8 9.5 – 14.1 26.0 24.3 – 27.6 61.3 59.9 – 62.8 59.9 58.0 – 61.9 7.1 5.5 – 8.8 4.1 3.2 – 4.9 11.9 11.0 –12.7 84.8 83.3 – 86.4 86.5 85.5 – 87.5 67.8 64.3 – 71.3 41.2 39.2 – 43.1 90.0 89.1 – 90.9 35.4 33.5 – 37.4 78.5 72.5 – 84.6 40.1§ 37.4 – 42.8 56.8 55.5 – 58.1 84.7 78.0 – 91.4 90.5 84.3 – 96.7
2005–2009 12.8 10.6 – 15.0 25.1 23.4 – 26.8 63.2 61.9 – 64.5 63.8 62.0 – 65.6 9.1§ 7.3 – 10.8 7.3 6.2 – 8.5 12.1 11.3 –13.0 87.4 86.2 – 88.6 87.7 86.9 – 88.5 65.2 61.4 – 69.0 44.2 42.2 – 46.2 93.4 92.6 – 94.1 35.8 34.0 – 37.6 78.0 71.5 – 84.5 41.6§ 39.2 – 44.0 62.5 61.2 – 63.7 88.1 83.2 – 92.9 92.0 84.5 – 99.6
2010–2014 12.4 10.5 – 14.4 25.7 23.9 – 27.5 64.9 63.7 – 66.2 64.4 62.6 – 66.1 10.4§ 8.5 – 12.2 7.4§ 6.3 – 8.4 13.0 12.1 – 13.9 88.7 87.6 – 89.8 88.5 87.7 – 89.3 67.4 63.8 – 71.1 41.1 39.2 – 43.0 93.2 92.4 – 93.9 37.6 35.7 – 39.4 75.6 69.0 – 82.2 47.2§ 44.7 – 49.6 64.4 63.2 – 65.5 95.2 91.5 – 98.9 91.2 84.3 – 98.1

France (23 registries) 2000–2004 13.0 11.8 –14.2 26.3 24.9 – 27.7 60.7 59.8 – 61.5 58.3 56.9 – 59.6 14.0 12.9 – 15.1 7.8 6.9 – 8.7 14.1 13.5 – 14.6 89.7 88.5 – 90.9 86.8 86.1 – 87.4 61.7 59.4 – 64.0 41.6 39.8 – 43.3 90.1 89.4 – 90.8 21.8 20.3 – 23.3 67.2 65.0 – 69.5 53.3 51.9 – 54.7 64.4 63.6 – 65.3 88.1 86.4 – 89.8 92.7 90.8 – 94.6
2005–2009 14.9 13.6 – 16.1 27.1 25.8 – 28.4 63.6 62.8 – 64.3 60.7 59.5 – 61.9 16.5 15.4 – 17.6 9.0 8.2 – 9.8 16.2 15.7 – 16.7 90.9 89.9 – 91.9 87.2 86.6 – 87.8 62.1 60.0 – 64.2 42.1 40.4 – 43.7 93.6 93.1 – 94.1 27.2 25.8 – 28.7 70.8 68.6 – 73.0 54.6 53.3 – 55.8 69.9 69.1 – 70.7 90.0 88.4 – 91.6 92.6 90.6 – 94.6
2010–2014 13.9 11.4 –16.4 26.7 23.9 – 29.6 63.7 62.2 – 65.3 60.9 58.4 – 63.4 18.3 16.0 – 20.5 8.6 7.0 – 10.2 17.3 16.1 – 18.5 90.8 88.7 – 92.9 86.7 85.5 – 88.0 65.0 60.3 – 69.7 43.5 40.0 – 46.9 93.1 91.9 – 94.2 27.2 24.2 – 30.3 70.8 68.1 – 73.5 57.5 54.9 – 60.1 69.6 67.9 – 71.3 88.6 86.5 – 90.8 94.2 92.0 – 96.4

Germany (10 registries) 2000–2004 16.6 15.3 – 17.8 31.8 30.0 – 33.5 62.0 61.2 – 62.8 60.9 60.2 – 61.6 12.5§ 11.6 –13.4 8.0§ 7.5 – 8.6 14.9 14.3 – 15.4 91.0 90.4 – 91.6 83.9 83.4 – 84.4 64.9 63.8 – 66.1 40.8 39.3 – 42.2 90.4 89.9 – 90.9 29.1 24.8 – 33.3 63.1 56.0 – 70.2 46.0 43.9 – 48.1 61.2 60.4 – 62.0 94.0 90.7 – 97.3 90.4 84.2 – 96.5
2005–2009 19.7 18.8 – 20.6 31.4 30.8 – 32.0 64.9 64.4 – 65.3 62.2 61.6 – 62.8 12.9 11.3 –14.5 9.3 8.4 – 10.2 16.9 16.5 – 17.4 92.0 91.5 – 92.6 85.6 85.2 – 85.9 65.7 64.6 – 66.8 40.6 39.6 – 41.6 91.8 91.3 – 92.2 27.3 26.2 – 28.5 67.8 61.1 – 74.6 51.9 50.7 – 53.1 65.7 65.1 – 66.3 92.1 89.2 – 95.0 93.8 88.9 – 98.8
2010–2014 20.8 19.8 – 21.8 33.5 32.8 – 34.2 64.8 64.3 – 65.3 62.3 61.6 – 62.9 13.0 10.5 – 15.5 10.7 9.6 – 11.8 18.3 17.9 – 18.8 93.1 92.6 – 93.6 86.0 85.7 – 86.4 65.2 64.0 – 66.4 41.2 40.2 – 42.2 91.6 91.2 – 92.0 29.6 28.3 – 30.9 69.5 61.8 – 77.2 54.9 53.5 – 56.3 67.9 67.3 – 68.6 91.1 87.4 – 94.8 96.9 94.2 – 99.6

Gibraltar* 2000–2004 8.0 0.0 – 19.9 38.8 17.7 – 59.9 21.7§ 0.0 – 44.9 65.4 37.6 – 93.3 79.3§ 66.5 – 92.1 62.5§ 31.5 – 93.5
2005–2009 39.2§ 12.8 – 65.5 52.3§ 24.3 – 80.4 39.3§ 7.6 – 70.9 0.6§ 0.0 – 1.9 19.6§ 8.0 – 31.1 100.0§ 88.5 – 100.0 72.1§ 56.8 – 87.4 42.3§ 9.1 – 75.6
2010–2014

Greek National Paediatric 2000–2004 80.3 75.3 – 85.4 89.2 82.6 – 95.8
2005–2009 84.8 80.4 – 89.3 84.9 78.3 – 91.6
2010–2014 68.9 60.3 – 77.4 84.2 80.0 – 88.3 87.5 81.5 – 93.5

Iceland* 2000–2004 13.1 3.8 – 22.4 32.9 24.9 – 40.9 61.4 55.4 – 67.4 71.0 63.0 – 79.0 3.9 0.0 – 10.0 4.8 1.4 –8.1 14.1 11.2 –16.9 84.5 77.7 – 91.3 87.4 82.9 – 91.8 81.8 72.8 – 90.8 39.6 30.9 – 48.3 80.1 75.5 – 84.7 24.1 19.5 – 28.6 80.0 56.6 – 100.0 48.2 38.3 – 58.1 66.6 60.4 – 72.8
2005–2009 19.1 10.4 – 27.8 30.3 21.9 – 38.6 64.0 58.8 – 69.1 66.3 58.2 – 74.5 16.0 6.0 – 26.1 0.0 0.0 – 0.1 16.0 12.9 – 19.1 85.4 79.5 – 91.3 85.8 81.4 – 90.2 87.6 79.5 – 95.7 40.9 31.3 – 50.5 89.7 86.5 – 92.9 21.0 14.3 – 27.6 73.4 51.8 – 94.9 47.9 39.7 – 56.1 67.9 62.6 – 73.1
2010–2014 17.7 10.5 – 24.8 28.1 20.2 – 36.1 68.2 63.2 – 73.1 63.0 55.5 – 70.5 14.3 6.9 – 21.7 0.0 0.0 – 0.0 20.2 16.9 – 23.4 87.5 82.1 – 92.9 89.1 85.1 – 93.1 80.1 71.2 – 89.1 40.3 31.2 – 49.4 90.8 87.7 – 93.9 29.2 20.8 – 37.7 90.1 72.4 – 100.0 43.4 35.8 – 50.9 71.5 66.3 – 76.6 92.4 78.4 – 100.0

Ireland* 2000–2004 12.9 11.0 –14.7 18.6 16.7 – 20.4 53.3 51.8 – 54.7 51.1 48.9 – 53.2 11.6 8.7 – 14.6 5.7 4.4 – 7.0 10.1 9.3 – 10.9 85.5 83.6 – 87.4 77.2 75.8 – 78.5 57.8 54.1 – 61.6 29.4 27.2 – 31.7 83.7 82.5 – 84.9 26.9 24.9 – 29.0 67.8 60.0 – 75.6 47.6 44.9 – 50.2 55.4 53.8 – 57.0 82.9 76.6 – 89.2 97.4 94.6 – 100.0
2005–2009 17.2 15.2 – 19.1 22.2 20.4 – 24.1 58.4 57.1 – 59.7 57.1 55.0 – 59.1 11.8 9.4 – 14.2 6.9 5.6 – 8.2 13.5 12.7 – 14.3 86.6 85.1 – 88.1 81.4 80.2 – 82.6 58.7 55.5 – 61.9 31.2 28.9 – 33.4 89.7 88.7 – 90.7 30.8 28.7 – 33.0 68.6 61.1 – 76.1 52.5 50.1 – 55.0 64.2 62.7 – 65.7 87.1 80.9 – 93.4 96.2 92.0 – 100.0
2010–2014 20.3 18.0 – 22.7 27.6 25.4 – 29.8 60.5 59.1 – 62.0 61.7 59.4 – 64.0 14.2 11.2 –17.2 9.6 7.9 – 11.4 17.5 16.5 – 18.5 89.2 87.7 – 90.7 82.0 80.7 – 83.3 63.6 60.1 – 67.2 32.8 30.3 – 35.3 91.1 90.1 – 92.2 34.5 32.0 – 36.9 74.0 66.4 – 81.5 53.1 50.5 – 55.8 66.9 65.3 – 68.5 88.3 82.4 – 94.3 95.3 89.6 – 100.0

Italy (45 registries) 2000–2004 11.5 10.5 – 12.6 31.6 30.9 – 32.2 59.0 58.6 – 59.5 55.8 54.9 – 56.6 15.9 15.2 – 16.5 6.8 6.3 – 7.3 14.0 13.7 – 14.3 84.1 83.3 – 84.8 84.2 83.8 – 84.5 67.3 66.0 – 68.7 37.7 36.8 – 38.6 87.2 86.7 – 87.7 24.1 23.2 – 25.1 68.5 64.5 – 72.5 46.4 45.5 – 47.3 58.5 57.9 – 59.0 82.6 79.2 – 86.0 88.3 84.9 – 91.8
2005–2009 12.9 11.9 –14.0 31.1 30.5 – 31.7 64.3 63.9 – 64.7 61.1 60.4 – 61.8 20.0 19.4 – 20.6 7.9 7.5 – 8.3 15.5 15.2 – 15.8 86.0 85.5 – 86.6 85.9 85.5 – 86.2 67.7 66.5 – 68.9 39.3 38.5 – 40.1 89.6 89.2 – 90.0 27.0 26.2 – 27.8 75.5 72.3 – 78.8 49.2 48.5 – 49.9 61.9 61.5 – 62.4 89.2 86.8 – 91.6 89.4 86.5 – 92.4
2010–2014 13.8 12.3 – 15.3 30.5 29.7 – 31.3 64.2 63.6 – 64.7 61.3 60.3 – 62.2 20.3 19.6 – 21.1 9.2 8.5 – 9.8 15.9 15.5 – 16.3 85.7 85.0 – 86.5 86.0 85.5 – 86.4 66.8 65.1 – 68.5 39.4 38.3 – 40.5 89.5 89.0 – 89.9 28.8 27.8 – 29.9 74.8 70.4 – 79.2 49.2 48.2 – 50.2 62.6 61.9 – 63.2 87.8 84.4 – 91.2 91.6 87.4 – 95.7

Latvia* 2000–2004 6.9 3.4 – 10.3 24.2 22.2 – 26.3 50.5 47.8 – 53.3 39.4 36.3 – 42.5 12.0 3.8 – 20.3 8.8 5.4 – 12.1 17.3 15.3 – 19.3 66.3 62.0 – 70.6 79.7 77.1 – 82.2 52.8 49.0 – 56.6 40.3 36.6 – 44.0 69.9 66.5 – 73.3 22.2 18.8 – 25.7 79.7 67.1 – 92.2 22.2 18.7 – 25.7 59.8 54.9 – 64.8 80.5 70.0 – 91.0
2005–2009 10.8 7.3 – 14.2 26.7 24.6 – 28.9 54.0 51.4 – 56.5 46.6 43.4 – 49.7 7.8 3.8 – 11.7 11.2 7.5 – 14.8 19.5 17.7 – 21.2 65.1 61.1 – 69.1 79.9 77.8 – 82.1 57.7 54.2 – 61.2 39.8 36.5 – 43.1 88.8 86.0 – 91.6 23.9 20.8 – 27.0 72.3 52.2 – 92.3 17.9 14.4 – 21.4 64.7 60.5 – 68.9 77.0 66.4 – 87.7
2010–2014 6.1 3.6 – 8.6 28.0 25.7 – 30.3 56.5 54.0 – 58.9 53.3 50.2 – 56.5 12.9 7.7 – 18.0 13.7 9.3 – 18.1 20.4 18.7 – 22.1 72.1 68.3 – 75.8 82.2 80.3 – 84.2 56.0 52.6 – 59.5 45.5 41.9 – 49.0 90.4 87.6 – 93.2 26.1 22.7 – 29.5 67.1 51.2 – 83.1 21.4 17.9 – 25.0 71.6 67.8 – 75.4 84.1 73.2 – 94.9

Lithuania* 2000–2004 4.7 2.9 – 6.4 22.0 20.7 – 23.3 44.5 42.6 – 46.3 40.6 38.4 – 42.8 7.9 5.6 – 10.2 6.5 5.3 – 7.7 8.8 8.0 – 9.6 67.2 63.9 – 70.6 64.6 62.9 – 66.4 53.8 51.6 – 56.0 30.2 28.1 – 32.3 75.8 73.7 – 77.9 19.4 17.2 – 21.6 47.5 36.2 – 58.8 25.4 22.5 – 28.3 43.5 41.5 – 45.5 74.3 65.2 – 83.3 86.1 77.2 – 95.0
2005–2009 6.2 4.2 – 8.1 24.9 23.4 – 26.4 51.1 49.2 – 53.0 48.8 46.6 – 51.1 8.3§ 5.9 – 10.7 5.4§ 4.3 – 6.5 8.8 8.0 – 9.7 70.6 67.6 – 73.7 71.3 69.6 – 73.1 59.1 56.9 – 61.3 31.6 29.5 – 33.8 93.8 92.6 – 95.1 22.0 19.7 – 24.3 66.6 53.4 – 79.8 47.5 45.1 – 49.9 50.8 48.9 – 52.7 67.7 56.5 – 78.8 79.6 67.1 – 92.1
2010–2014 5.6 3.3 – 7.8 27.0 24.9 – 29.0 56.9 54.4 – 59.4 52.7 49.7 – 55.7 8.0§ 5.3 – 10.7 7.0§ 5.2 – 8.8 9.9 8.7 – 11.0 75.3 71.8 – 78.9 73.5 71.3 – 75.7 59.2 56.4 – 62.0 35.0 32.0 – 37.9 94.3 92.7 – 95.8 23.4§ 20.4 – 26.4 61.8 44.7 – 78.9 52.8 49.7 – 56.0 56.7 54.0 – 59.3 74.7 62.8 – 86.5 93.7 85.9 – 100.0

Malta* 2000–2004 7.8 0.0 – 15.6 19.9 14.6 – 25.2 57.0 51.9 – 62.2 55.1 47.7 – 62.5 4.2 0.0 – 10.5 5.9 3.0 – 8.7 9.2 6.5 – 12.0 87.3 80.0 – 94.7 79.7 75.6 – 83.8 46.4 30.8 – 62.0 39.6 31.6 – 47.5 81.9 76.6 – 87.2 22.3 15.2 – 29.3 60.1 31.7 – 88.6 32.7 24.6 – 40.8 43.4 37.8 – 49.0 87.5 71.8 – 100.0
2005–2009 6.1 0.5 – 11.8 24.8 19.3 – 30.3 52.9 48.5 – 57.4 53.8 47.2 – 60.5 0.0§ 0.0 – 0.0 2.2§ 0.5 – 4.0 11.4 8.7 – 14.1 81.6 75.2 – 88.1 84.8 81.3 – 88.2 65.1 51.4 – 78.9 27.5 22.0 – 33.0 86.4 81.9 – 91.0 20.1 14.0 – 26.1 25.4§ 18.0 – 32.8 52.4 47.3 – 57.6 93.8 82.3 – 100.0
2010–2014 11.2 1.6 – 20.8 23.8 17.5 – 30.0 57.5 52.6 – 62.3 56.1 49.2 – 62.9 0.0§ 0.0 – 0.0 5.5§ 2.7 – 8.3 14.9 11.5 –18.2 81.9 75.6 – 88.3 86.9 83.1 – 90.6 57.4 46.8 – 68.1 28.0 21.4 – 34.6 88.2 83.9 – 92.5 28.0 19.7 – 36.2 46.3§ 38.3 – 54.3 61.9 55.8 – 68.0

Netherlands* 2000–2004 12.1 11.2 –13.0 19.7 18.8 – 20.6 58.1 57.4 – 58.7 58.0 57.0 – 59.1 10.1 8.6 – 11.7 3.7 3.2 – 4.2 12.4 12.1 – 12.7 88.4 87.6 – 89.2 83.9 83.4 – 84.4 66.1 64.1 – 68.0 36.3 35.1 – 37.6 83.4 82.7 – 84.1 21.4 20.4 – 22.5 62.7 58.4 – 67.0 39.4 38.2 – 40.6 54.7 53.9 – 55.4 84.1 80.7 – 87.4 86.5 81.9 – 91.2
2005–2009 16.8 15.8 – 17.7 22.9 22.0 – 23.9 60.9 60.3 – 61.5 63.1 62.2 – 64.0 13.4 11.8 –14.9 5.5 5.0 – 6.1 15.7 15.3 – 16.0 89.8 89.1 – 90.4 85.8 85.3 – 86.3 65.5 63.6 – 67.3 37.2 36.0 – 38.5 87.5 86.9 – 88.1 26.3 25.2 – 27.3 66.0 61.9 – 70.1 49.9 48.8 – 51.0 63.7 63.0 – 64.4 89.8 86.9 – 92.6 86.5 82.3 – 90.8
2010–2014 21.0 20.0 – 22.0 25.0 24.0 – 26.0 63.1 62.5 – 63.7 65.3 64.5 – 66.2 15.8 14.2 – 17.4 7.4 6.8 – 8.1 17.3 16.9 – 17.6 91.0 90.4 – 91.6 86.6 86.1 – 87.1 67.5 65.6 – 69.3 37.5 36.2 – 38.7 88.5 87.9 – 89.0 28.2 27.2 – 29.3 69.1 65.1 – 73.1 52.2 51.2 – 53.2 66.4 65.8 – 67.1 90.4 87.5 – 93.3 87.9 83.5 – 92.2

Norway* 2000–2004 9.0 6.7 – 11.3 22.4 20.5 – 24.2 60.0 58.8 – 61.2 62.4 60.8 – 64.1 7.9 5.4 – 10.3 5.0 3.9 – 6.0 12.3 11.5 –13.1 86.4 85.1 – 87.6 84.7 83.7 – 85.8 70.9 68.0 – 73.7 41.4 39.3 – 43.6 83.8 82.8 – 84.9 32.4 30.5 – 34.3 79.7 73.8 – 85.5 41.5 39.2 – 43.8 57.5 56.1 – 58.8 87.7 82.4 – 93.1 93.3 87.2 – 99.4
2005–2009 13.3 10.8 – 15.8 25.3 23.3 – 27.4 64.3 63.2 – 65.4 66.8 65.1 – 68.4 14.2 11.2 –17.2 6.1 5.0 – 7.2 15.9 15.1 – 16.8 87.3 86.2 – 88.3 87.2 86.1 – 88.3 70.7 67.8 – 73.6 42.8 40.7 – 45.0 90.3 89.5 – 91.1 36.7 34.9 – 38.5 75.9 69.7 – 82.1 50.9 48.8 – 53.0 64.9 63.7 – 66.2 84.9 78.2 – 91.6 90.9 84.3 – 97.5
2010–2014 16.5 14.0 – 19.0 26.5 24.4 – 28.6 66.7 65.6 – 67.8 69.2 67.6 – 70.8 18.7 15.5 – 22.0 9.5 8.0 – 11.0 19.0 18.1 – 19.8 89.3 88.3 – 90.3 87.7 86.6 – 88.8 73.3 70.3 – 76.3 45.5 43.3 – 47.7 92.9 92.2 – 93.7 36.8 34.9 – 38.7 74.3 67.6 – 81.0 52.7 50.7 – 54.7 68.4 67.2 – 69.6 83.0 76.5 – 89.5 95.2 90.9 – 99.4

Poland* (16 registries) 2000–2004 7.2 6.3 – 8.1 15.9 15.2 – 16.5 45.3 44.6 – 45.9 42.5 41.8 – 43.3 9.5 8.5 – 10.5 8.2 7.6 – 8.8 12.1 11.8 –12.4 63.2 62.0 – 64.4 71.3 70.7 – 71.9 51.6 50.8 – 52.5 32.7 31.9 – 33.6 68.8 67.9 – 69.7 26.6 25.6 – 27.7 62.6 59.2 – 66.0 18.9 17.9 – 19.9 40.3 39.6 – 41.0 79.6 76.3 – 82.9 81.7 77.8 – 85.6
2005–2009 8.9 7.9 – 9.8 19.9 19.3 – 20.4 51.1 50.5 – 51.6 47.6 46.9 – 48.3 10.7 9.8 – 11.7 9.7 9.2 – 10.3 14.1 13.8 – 14.4 67.1 66.2 – 68.1 74.7 74.2 – 75.2 54.4 53.6 – 55.3 35.4 34.6 – 36.2 75.0 74.4 – 75.7 29.0 28.2 – 29.8 61.7 58.1 – 65.3 26.3 25.2 – 27.5 47.8 47.2 – 48.5 84.4 81.7 – 87.0 89.4 86.4 – 92.4
2010–2014 9.1 8.1 – 10.1 20.9 20.3 – 21.4 52.9 52.3 – 53.4 48.4 47.7 – 49.1 10.8 9.9 – 11.8 8.0 7.5 – 8.5 14.4 14.1 – 14.7 69.8 68.9 – 70.7 76.5 76.1 – 77.0 55.1 54.2 – 55.9 37.5 36.7 – 38.3 78.1 77.5 – 78.7 28.2 27.4 – 28.9 62.5 58.7 – 66.4 27.3 26.2 – 28.4 52.1 51.4 – 52.8 86.9 84.1 – 89.7 92.6 89.7 – 95.5

Portugal* (4 registries) 2000–2004 10.2 8.6 – 11.7 29.8 28.9 – 30.8 56.5 55.6 – 57.4 54.4 53.1 – 55.7 13.6 11.8 –15.5 8.0 6.7 – 9.2 10.6 10.0 – 11.2 78.8 76.8 – 80.7 81.6 80.7 – 82.5 60.4 58.6 – 62.2 39.9 37.7 – 42.1 87.2 86.2 – 88.1 22.9 21.3 – 24.6 62.0 55.0 – 69.1 43.7 41.6 – 45.8 51.3 50.1 – 52.6 80.8 75.3 – 86.4 86.2 81.0 – 91.4
2005–2009 12.5 11.0 –14.1 32.4 31.5 – 33.3 61.1 60.4 – 61.9 59.8 58.7 – 60.9 15.3 13.6 – 17.0 10.3 9.1 – 11.4 14.1 13.5 – 14.7 81.7 80.2 – 83.2 86.1 85.3 – 86.9 65.3 63.6 – 67.0 41.8 39.7 – 44.0 90.0 89.3 – 90.8 23.8 22.4 – 25.3 63.1 56.5 – 69.7 49.0 47.1 – 50.9 58.2 57.1 – 59.2 84.1 78.8 – 89.5 94.0 90.1 – 97.9
2010–2014 16.1 12.0 – 20.2 32.2 30.2 – 34.2 60.9 59.2 – 62.6 59.6 57.1 – 62.1 18.7 14.5 – 22.9 10.7 8.2 – 13.1 15.7 14.3 – 17.1 83.7 80.4 – 87.0 87.6 85.9 – 89.3 66.2 62.6 – 69.8 43.6 38.7 – 48.4 90.9 89.1 – 92.6 22.7 19.7 – 25.8 70.5 57.0 – 84.1 49.8 45.4 – 54.2 59.7 57.3 – 62.1 89.8 80.7 – 98.9 94.7 88.9 – 100.0

Romania (Cluj) 2000–2004
2005–2009 10.2§ 4.4 – 16.0 19.3§ 16.0 – 22.7 53.5§ 48.9 – 58.0 44.8 38.9 – 50.8 4.1§ 1.8 –6.4 4.5§ 2.2 – 6.7 7.9§ 6.1 – 9.6 68.4 61.5 – 75.3 74.8 70.4 – 79.3 61.7 57.0 – 66.5 28.9§ 22.3 – 35.6 78.2 72.5 – 83.8 20.4§ 14.0 – 26.7 44.9 37.2 – 52.5 47.3 42.0 – 52.5
2010–2014 0.0§ 0.0 – 0.1 26.0§ 21.5 – 30.5 52.2§ 46.0 – 58.4 58.4 49.8 – 67.0 13.2§ 9.2 – 17.3 6.0§ 2.69.3 11.1§ 8.7 – 13.6 71.3 63.0 – 79.6 74.8 68.5 – 81.1 65.3 59.7 – 70.9 37.2§ 29.7 – 44.6 77.1 70.0 – 84.2 34.0§ 23.8 – 44.1 60.1 31.6 – 88.5 51.5 42.7 – 60.3 40.4 33.3 – 47.5 53.9 28.2 – 79.6

Russian Federation (5 registries) 2000–2004 10.9 8.8 – 13.0 22.9 21.7 – 24.1 40.4 38.9 – 41.9 38.5 36.4 – 40.6 7.4 5.2 – 9.5 7.5 6.0 – 9.1 16.8 15.7 – 17.8 64.7 61.4 – 68.0 71.6 69.8 – 73.4 59.8 57.3 – 62.2 38.1 35.2 – 41.1 58.8 55.4 – 62.1 25.2 21.3 – 29.0 61.2 50.4 – 72.0 33.1 28.7 – 37.5 40.5 37.4 – 43.5 71.3 62.6 – 80.0 67.0 54.9 – 79.1
2005–2009 8.6 7.0 – 10.2 20.2 19.3 – 21.1 42.4 41.2 – 43.6 38.9 37.3 – 40.5 5.1 3.6 – 6.6 5.4 4.5 – 6.4 13.9 13.2 – 14.6 63.3 60.3 – 66.3 67.7 66.4 – 69.0 58.0 56.0 – 59.9 33.2 31.3 – 35.0 68.6 66.2 – 71.0 21.2 19.2 – 23.2 61.2 50.3 – 72.0 35.3 31.7 – 39.0 42.4 39.8 – 45.0 74.2 65.3 – 83.0 73.5 62.6 – 84.4
2010–2014 8.6 7.1 – 10.1 21.0 20.0 – 21.9 44.9 43.8 – 46.1 41.9 40.2 – 43.5 6.3 4.8 – 7.9 4.4 3.7 – 5.2 13.7 13.0 – 14.4 66.5 63.6 – 69.3 70.8 69.5 – 72.1 57.7 55.7 – 59.7 34.8 32.8 – 36.8 79.3 77.1 – 81.5 22.8 20.8 – 24.9 61.7 51.5 – 71.8 33.2 29.8 – 36.7 45.5 42.9 – 48.2 76.9 68.4 – 85.4 92.1 84.6 – 99.6

Slovakia* 2000–2004 5.8§ 3.8 – 7.9 20.6§ 19.1 – 22.0 50.4 49.1 – 51.7 43.6 41.7 – 45.5 5.6§ 4.1 – 7.2 4.8§ 3.8 – 5.8 9.5§ 8.7 – 10.3 75.0 72.7 – 77.3 75.3 73.5 – 77.2 61.8 59.4 – 64.3 35.0 32.4 – 37.6 63.6 61.1 – 66.0 22.0§ 20.0 – 24.0 67.9 60.5 – 75.4 35.1§ 32.2 – 38.1 46.6 44.6 – 48.6 79.2 71.8 – 86.5 83.8 75.1 – 92.5
2005–2009 6.4 4.7 – 8.0 20.9 19.5 – 22.4 51.2 50.1 – 52.4 47.5 45.8 – 49.2 6.1§ 4.8 – 7.5 5.8 4.8 – 6.7 10.5 9.7 – 11.2 79.7 77.7 – 81.7 76.6 75.1 – 78.2 58.9 56.5 – 61.3 34.5 31.7 – 37.3 74.4 72.7 – 76.2 27.2 25.3 – 29.0 70.0 62.5 – 77.5 37.1 34.8 – 39.4 49.6 48.0 – 51.2 80.7 73.8 – 87.7 94.6 90.1 – 99.1
2010–2014 6.4 3.3 – 9.4 21.1 17.8 – 24.3 51.8 49.1 – 54.4 48.6 44.9 – 52.4 7.6§ 4.5 – 10.7 6.4 4.4 – 8.4 11.2 9.5 – 12.8 78.2 73.9 – 82.5 75.5 72.4 – 78.5 60.5 56.2 – 64.9 33.4 28.6 – 38.2 74.7 70.9 – 78.6 28.5 24.3 – 32.8 80.6 69.4 – 91.7 37.5 32.2 – 42.8 51.6 48.0 – 55.2 87.0 77.3 – 96.7 88.6 75.4 – 100.0

Slovenia* 2000–2004 8.2 5.7 – 10.8 25.9 23.8 – 27.9 53.6 51.6 – 55.6 48.6 46.1 – 51.1 3.8 2.2 – 5.4 4.7 3.4 – 6.1 9.9 9.1 – 10.8 79.3 76.7 – 81.9 78.7 76.9 – 80.5 67.2 63.8 – 70.7 37.8 34.4 – 41.2 74.4 71.9 – 76.9 23.0 19.9 – 26.1 76.5 66.8 – 86.3 42.4 38.5 – 46.2 52.7 50.2 – 55.2 89.7 82.1 – 97.3 80.1 68.7 – 91.5
2005–2009 9.3 6.2 – 12.3 25.8 23.7 – 27.8 56.2 54.4 – 58.0 57.0 54.6 – 59.4 7.0 5.2 – 8.8 5.7 4.3 – 7.1 12.7 11.7 –13.7 85.0 83.0 – 87.0 82.5 81.0 – 84.1 67.1 63.3 – 70.9 35.4 32.3 – 38.4 83.2 81.6 – 84.8 24.1 21.2 – 27.0 61.2 49.2 – 73.1 39.8 36.6 – 42.9 56.7 54.6 – 58.9 79.1 67.1 – 91.1 100.0 86.3 – 100.0
2010–2014 8.6 5.2 – 11.9 28.8 26.4 – 31.2 61.9 60.0 – 63.8 60.3 57.7 – 62.9 7.4 5.3 – 9.5 6.6 4.9 – 8.4 14.8 13.6 – 16.1 85.1 83.0 – 87.1 83.5 81.8 – 85.2 65.5 61.3 – 69.8 37.0 33.4 – 40.5 85.0 83.3 – 86.7 24.8 21.4 – 28.3 60.1 44.2 – 76.1 37.5 34.2 – 40.7 59.0 56.6 – 61.3 70.1 54.4 – 85.8 100.0 100.0 – 100.0

Spain (10 registries) 2000–2004 8.9 7.5 – 10.3 25.7 24.5 – 26.9 56.5 55.6 – 57.4 55.2 53.7 – 56.6 14.4 13.2 – 15.7 5.6 4.8 – 6.4 10.8 10.4 – 11.3 85.3 83.8 – 86.8 82.9 82.0 – 83.8 63.6 61.3 – 65.9 36.0 34.1 – 37.9 85.0 84.1 – 85.9 21.6 20.2 – 23.0 63.6 57.7 – 69.4 45.4 43.6 – 47.2 58.2 57.1 – 59.3 80.9 76.3 – 85.5 85.8 80.2 – 91.4
2005–2009 11.6 10.2 – 13.1 26.7 25.5 – 27.9 61.1 60.3 – 61.9 58.6 57.3 – 59.9 16.3 15.1 – 17.4 6.9 6.1 – 7.7 12.5 12.0 – 13.0 87.1 85.9 – 88.3 84.6 83.8 – 85.4 64.5 62.2 – 66.8 37.9 36.1 – 39.6 90.4 89.7 – 91.1 27.2 25.8 – 28.7 63.4 58.2 – 68.6 52.3 50.8 – 53.8 62.2 61.3 – 63.2 80.0 75.4 – 84.5 89.9 85.9 – 94.0
2010–2014 13.0 10.6 – 15.4 27.6 25.7 – 29.5 63.2 62.0 – 64.5 59.5 57.4 – 61.5 17.3 15.4 – 19.2 7.7 6.3 – 9.2 13.5 12.7 – 14.3 86.8 84.8 – 88.7 85.2 84.0 – 86.5 64.5 60.8 – 68.1 39.8 36.9 – 42.7 89.7 88.6 – 90.7 27.4 25.2 – 29.7 66.2 58.0 – 74.4 50.0 47.7 – 52.3 62.0 60.5 – 63.6 84.7 77.6 – 91.7 92.9 87.5 – 98.3

Sweden* 2000–2004 11.4 9.6 – 13.1 21.2 19.8 – 22.6 60.2 59.2 – 61.2 59.9 58.7 – 61.1 7.8 6.4 – 9.1 4.9 4.1 – 5.8 13.9 13.2 – 14.6 88.9 88.1 – 89.8 85.6 84.9 – 86.3 66.9 64.7 – 69.1 43.2 41.6 – 44.8 85.9 85.3 – 86.5 26.5 25.1 – 28.0 75.9 70.5 – 81.3 30.7 28.9 – 32.6 58.5 57.6 – 59.5 86.8 82.6 – 90.9 84.7 75.8 – 93.6
2005–2009 13.1 11.4 –14.8 23.6 22.1 – 25.1 64.2 63.3 – 65.2 63.0 61.9 – 64.2 13.0 11.4 –14.6 7.9 6.9 – 8.9 16.6 15.9 – 17.3 90.3 89.5 – 91.0 87.9 87.2 – 88.5 67.7 65.6 – 69.9 42.9 41.2 – 44.6 90.1 89.6 – 90.6 29.0 27.5 – 30.4 78.4 73.2 – 83.6 54.6 53.1 – 56.1 64.2 63.3 – 65.1 87.1 82.6 – 91.5 88.6 81.5 – 95.8
2010–2014 14.8 12.8 – 16.7 24.8 23.3 – 26.3 64.9 64.0 – 65.8 64.7 63.5 – 65.8 16.6 14.9 – 18.3 9.7 8.7 – 10.8 19.5 18.7 – 20.2 91.5 90.9 – 92.2 88.8 88.2 – 89.4 68.3 66.1 – 70.4 46.5 44.8 – 48.2 90.7 90.2 – 91.2 31.6 30.1 – 33.0 79.8 74.9 – 84.7 57.5 56.0 – 58.9 66.7 65.9 – 67.6 89.0 84.6 – 93.3 88.0 80.4 – 95.7

Switzerland (10 registries) 2000–2004 16.1 13.6 – 18.6 29.2 26.9 – 31.4 62.8 61.3 – 64.3 59.5 57.2 – 61.8 12.2 10.3 – 14.0 5.6 4.4 – 6.9 14.7 13.8 – 15.6 90.7 88.4 – 92.9 84.4 83.3 – 85.5 63.4 58.4 – 68.4 36.9 34.4 – 39.5 86.9 85.8 – 87.9 26.4 23.9 – 28.8 73.7 67.7 – 79.8 46.5 43.9 – 49.1 61.6 60.1 – 63.2 87.3 82.4 – 92.2 94.0 89.5 – 98.6
2005–2009 20.6 17.9 – 23.2 31.4 29.0 – 33.7 65.1 63.7 – 66.6 65.6 63.5 – 67.7 13.4 11.6 –15.3 7.0 5.8 – 8.2 17.3 16.5 – 18.2 92.4 91.3 – 93.5 86.4 85.3 – 87.4 69.4 65.1 – 73.6 42.0 39.5 – 44.4 88.6 87.6 – 89.5 29.0 26.7 – 31.2 68.0 61.2 – 74.8 51.6 49.3 – 53.9 70.9 69.5 – 72.3 89.2 84.9 – 93.4 94.2 89.5 – 98.9
2010–2014 23.9 21.0 – 26.9 32.2 29.9 – 34.5 67.3 65.7 – 68.9 67.3 65.0 – 69.6 15.4 13.5 – 17.4 9.4 7.9 – 10.8 20.4 19.4 – 21.4 93.6 92.4 – 94.7 86.2 85.1 – 87.3 71.4 66.6 – 76.2 44.1 41.3 – 46.8 89.2 88.2 – 90.3 29.7 27.5 – 31.9 71.6 65.1 – 78.0 49.7 47.2 – 52.2 72.0 70.4 – 73.5 90.3 86.1 – 94.5 93.6 88.1 – 99.1

United Kingdom* (4 registries) 2000–2004 11.5 11.1 –11.9 16.2 15.7 – 16.6 52.0 51.6 – 52.3 54.6 54.0 – 55.1 7.1 6.6 – 7.7 3.7 3.4 – 4.0 8.3 8.1 – 8.5 86.4 85.9 – 86.8 79.8 79.5 – 80.1 58.9 58.0 – 59.9 30.2 29.7 – 30.7 81.9 81.6 – 82.3 20.6 20.1 – 21.2 68.4 66.2 – 70.7 42.3 41.7 – 42.9 54.3 53.9 – 54.6 85.9 84.1 – 87.7 86.8 84.1 – 89.5
2005–2009 14.0 13.5 – 14.4 19.2 18.7 – 19.7 56.5 56.2 – 56.9 58.7 58.2 – 59.2 9.7 9.1 – 10.2 5.2 4.9 – 5.5 10.1 9.9 – 10.3 89.2 88.9 – 89.6 83.8 83.6 – 84.1 61.9 61.0 – 62.9 33.2 32.6 – 33.7 86.7 86.4 – 86.9 23.8 23.3 – 24.4 69.1 66.9 – 71.3 47.7 47.1 – 48.2 60.7 60.4 – 61.1 91.4 89.9 – 92.8 90.6 88.3 – 93.0
2010–2014 15.7 15.3 – 16.1 20.7 20.1 – 21.2 60.0 59.7 – 60.4 62.5 62.0 – 63.0 13.0 12.4 – 13.6 6.8 6.5 – 7.2 13.3 13.1 – 13.5 90.9 90.6 – 91.3 85.6 85.4 – 85.9 63.8 62.8 – 64.7 36.2 35.7 – 36.8 88.7 88.5 – 89.0 26.3 25.7 – 26.8 71.9 69.8 – 74.0 48.7 48.1 – 49.2 64.9 64.6 – 65.3 92.2 90.9 – 93.6 91.7 89.7 – 93.8

OCEANIA
Australia* (8 registries)
2000–2004 18.0 16.9 – 19.2 27.7 26.7 – 28.8 63.7 63.2 – 64.3 64.4 63.5 – 65.2 14.2 13.1 – 15.3 7.3 6.7 – 8.0 14.8 14.4 – 15.2 92.0 91.7 – 92.4 87.0 86.5 – 87.4 67.9 66.1 – 69.6 37.3 36.1 – 38.6 87.8 87.4 – 88.2 24.5 23.5 – 25.4 62.0 57.7 – 66.3 43.3 42.3 – 44.3 61.5 60.9 – 62.1 86.5 83.8 – 89.1 91.4 88.0 – 94.8
2005–2009 19.9 18.7 – 21.0 29.8 28.8 – 30.9 68.1 67.6 – 68.6 68.6 67.8 – 69.5 17.7 16.6 – 18.7 9.1 8.5 – 9.8 17.1 16.7 – 17.5 92.5 92.2 – 92.8 88.5 88.1 – 89.0 67.5 65.7 – 69.3 41.0 39.8 – 42.2 93.2 92.9 – 93.5 28.9 27.9 – 29.8 60.6 56.4 – 64.9 50.3 49.4 – 51.1 68.1 67.6 – 68.7 90.3 87.9 – 92.6 94.2 91.4 – 96.9
2010–2014 23.7 22.4 – 25.0 31.8 30.7 – 32.9 70.7 70.1 – 71.2 71.0 70.2 – 71.9 19.2 18.1 – 20.3 12.0 11.2 –12.8 19.4 19.0 – 19.9 92.9 92.5 – 93.2 89.5 89.1 – 90.0 66.4 64.5 – 68.2 42.0 40.8 – 43.2 94.5 94.1 – 94.8 30.2 29.2 – 31.2 67.1 62.9 – 71.4 51.8 50.9 – 52.7 71.2 70.6 – 71.8 90.7 88.3 – 93.1 92.3 89.2 – 95.4

New Zealand* 2000–2004 11.5 9.4 – 13.6 24.6 22.4 – 26.8 61.4 60.2 – 62.7 60.1 58.0 – 62.1 12.4 9.9 – 15.0 7.0 5.5 – 8.5 11.4 10.5 – 12.2 90.0 89.1 – 90.8 82.8 81.6 – 84.1 67.4 63.8 – 71.1 38.7 36.0 – 41.4 89.1 88.1 – 90.0 19.0 16.8 – 21.2 60.2 50.6 – 69.8 40.3 37.8 – 42.9 61.0 59.6 – 62.5 85.8 79.9 – 91.6 93.6 88.7 – 98.4
2005–2009 14.5 12.1 – 16.8 24.8 22.5 – 27.0 62.8 61.6 – 64.0 63.3 61.4 – 65.3 16.8 14.4 – 19.1 7.7 6.3 – 9.0 12.4 11.6 –13.3 91.1 90.3 – 91.8 86.1 84.9 – 87.3 64.4 60.4 – 68.4 33.4 31.0 – 35.9 89.3 88.4 – 90.2 22.7 20.4 – 25.0 54.4 42.9 – 66.0 49.7 47.7 – 51.8 63.5 62.1 – 64.9 91.2 86.8 – 95.6 93.5 88.0 – 99.0
2010–2014 15.3 13.0 – 17.7 25.7 23.5 – 27.9 64.0 62.8 – 65.1 66.0 64.1 – 67.9 19.0 16.7 – 21.4 8.1 6.7 – 9.6 15.3 14.3 – 16.2 91.8 91.1 – 92.5 87.6 86.4 – 88.7 67.4 63.4 – 71.5 36.7 34.1 – 39.3 90.3 89.4 – 91.1 23.3 21.0 – 25.7 58.2 46.1 – 70.4 44.1 42.1 – 46.2 65.6 64.3 – 66.9 91.4 86.7 – 96.1 96.6 92.7 – 100.0

Survival estimates that are not age-standardised are italicised.

Survival estimates of 100% shown without a confidence interval are those for which the first event (either death or censoring) in that group of patients occurred more than five years after diagnosis.

*

Data with 100% coverage of the national population.

Data with 100% coverage of the national population for childhood malignancies only.

Korea: Republic of Korea; Russia: Russian Federation.

§

Survival estimate considered less reliable because 15% or more of patients were (a) lost to follow-up or censored alive within five years of diagnosis or, if diagnosed in 2010 or later, before 31 December 2014; or (b) registered only from a death certificate or at autopsy; or (c) registered with incomplete dates, i.e., unknown year of birth, unknown month and/or year of diagnosis or unknown year of last vital status.

Italics denote survival estimates that are not age-standardised

Survival was highest in Japan (36%), China (34%) and Korea* (31%), and below 30% in all other countries (Table 5, web-figure 2). Survival was in the range 20–30% in 11 countries: Mauritius*, Puerto Rico*, the US, 2 countries in western Asia (Israel*, Turkey), in 5 European countries (North: Ireland*; West: Belgium*, Germany, the Netherlands*, Switzerland) and in Australia*.

Survival trends from 2000 to 2014 increased by 4–5% in Singapore*, 3 European countries (North: Denmark*, the UK*; West: Germany) and in the US (web-figure 3). Survival increased by 6–10% in China, Israel* and Japan, in 6 European countries (North: Ireland*, Norway*; South: Portugal*; West: Belgium*, the Netherlands*, Switzerland) and in Australia*. The increase in Korea* was 13%.

Stomach

Results are available for 2,019,382 adults from 294 registries in 62 countries (Tables 2 and 4).

Age-standardised five-year net survival was generally in the range 20–40%, with very wide variation in Asia (web-figure 4). Most estimates were considered reliable (Table 5, web-table 4).

In 2010–2014, survival was very high in Korea* (69%) and Japan (60%), followed by Jordan* (56%) and Costa Rica* (46%) (Table 5, web-figure 2). Survival was in the range 30–40% in 16 countries: in Canada and the US; in Puerto Rico* and Martinique*; 5 Asian countries (South: Malaysia (Penang), Singapore*; East: China, Taiwan*; West: Israel*); 6 European countries (South: Italy, Portugal*; West: Austria*, Belgium*, Germany, Switzerland) and in Australia* (Table 5, web-figure 2).

Survival was in the range 20–29% in 25 countries (Mauritius*, Brazil, Kuwait*, Turkey, 20 European countries, New Zealand*), and below 20% in Chile, Ecuador, Thailand and Bulgaria*.

Survival trends between 1995–1999 and 2010–2014 were rather flat in most countries, but after 2000, survival increased by 5% in Canada and the US, Singapore* and in 6 European countries (North: Denmark*, Lithuania*, the UK*; East: Poland*; West: Austria*, the Netherlands*).

Over the same 20 years, 5-year survival increased by up to 10% in Israel*, Japan, Estonia* and Ireland*, and by 20% or more in China and Korea*.

Colon

Results are available for 4,198,637 adults from 296 registries in 65 countries (Tables 2 and 4).

Survival for colon cancer varied widely, especially in Central and South America, in Asia and in Europe (Figure 4A, web-figure 4). Most estimates were considered reliable (Table 5, web-table 4).

Figure 4. Global range of breast cancer* survival among 296 cancer registry populations in 64 countries: age-standardised five-year net survival (%) estimates for 6,420,288 women diagnosed during 2000–2014, by continent and calendar period of diagnosis.

Figure 4

*See web-figure 4 for other cancers.

Each box-plot shows the range of survival estimates among all cancer registries for which suitable estimates could be obtained for patients diagnosed in each calendar period, in each continent. The number of registries included in each box-plot is shown in parentheses. Survival estimates considered less reliable are not included (see text). The vertical line inside each box represents the median survival estimate among all contributing registries (the central value in the range, or 50th centile). The box covers the inter-quartile range (IQR) between the lower and upper quartiles (25th and 75th centiles). Where there are only a few widely scattered estimates, the median may be close to the lower or upper quartile. The extreme limits of the box-plot are 1.5*IQR below the lower quartile and 1.5*IQR above the upper quartile. Open circles indicate „outlier‟ values, outside this range.

For patients diagnosed during 2010–2014, survival was higher than 70% in 4 countries: Israel*, Jordan*, Korea* and Australia*. Survival was in the range 50–69% in 26 countries: Mauritius*; in Costa Rica* and Puerto Rico*; in Canada and the US; in Japan, Singapore* and Taiwan*; in 17 European countries (North: Denmark*, Finland*, Iceland*, Ireland*, Norway*, Sweden*, the UK*; South: Italy, Portugal*, Slovenia*, Spain; West: Austria*, Belgium*, France, Germany, the Netherlands*, Switzerland) and in New Zealand* (Table 5, web-figure 2).

Survival ranged from 50% to 60% in 20 countries: in 4 Central and South American countries (Brazil, Martinique, Peru (Lima), Uruguay*); in 5 Asian countries (South: Malaysia (Penang) East: China, Hong Kong*; West: Kuwait*, Turkey) and in 9 European countries (North: Estonia*, Lithuania*, Latvia*; South: Croatia*, Malta*; East: Bulgaria*, Czech Republic*, Poland*, Slovakia*).

Five-year net survival was below 50% in Ecuador (48%), Thailand (47%), Russia (45%) and India (39%).

Survival trends between 1995–1999 and 2000–2014 were generally flat or increasing (web-figure 3). Five-year survival increased over this period by 5–10% in 11 countries: in Canada; in Japan and Taiwan*, and in 7 European countries (North: Estonia*, Ireland*, Lithuania*, Norway*, Sweden*; South: Italy; West: the Netherlands*) and in Australia*.

Over the same period, survival increased by more than 10% in China, Israel* and Korea*, and in 8 European countries (North: Denmark*, Iceland*, Latvia*, the UK*; South: Slovenia*, Spain; East: Bulgaria*, Czech Republic*, Poland*).

Rectum

Results are available for 1,720,488 adults from 294 registries in 64 countries (Tables 2 and 4).

As for colon, five-year net survival for rectal cancer varied widely. The range of survival estimates in Asia for 2010–2014 was even wider than for colon cancer (web-figure 4). Almost all the survival estimates were considered reliable (Table 5, web-table 4).

Survival was higher than 70% in Jordan* (73%), Korea* (71%), and Australia* (71%).

For patients diagnosed during 2010–2014, survival was in the range 60–69% in 24 countries: in Canada and the US; in 4 Asian countries (South: Singapore*; East: Japan, Taiwan*; West: Israel*), in 17 European countries: (North: Denmark*, Finland*, Iceland*, Ireland*, Norway*; Sweden*, the UK*; South: Italy, Portugal*, Slovenia*, Spain; West: Austria*; Belgium*; France, Germany, the Netherlands*, Switzerland); and in New Zealand* (Table 5, web-figure 2).

Survival was in the range 50–59% in 18 countries: in 7 countries in Central and South America (Argentina, Brazil, Costa Rica*, Martinique*, Peru (Lima), Puerto Rico*, Uruguay*); in 5 Asian countries (South: Malaysia (Penang); East: China, Hong Kong*; West: Kuwait*, Turkey) and in 6 European countries (North: Estonia*, Latvia*, Lithuania*; South: Malta*; East: Czech Republic*, Romania (Cluj)).

Five-year survival was below 50% in Slovakia* (49%), Poland* (48%), Croatia* (48%), Bulgaria* (46%), Ecuador (45%), Thailand (44%), Russia (42%) and India (30%).

Survival trends between 1995–1999 and 2000–2014 were generally increasing, especially since 2000, in Asia, Europe and Oceania (web-figure 3). Survival increased by 5–10% in Japan and Taiwan*; in Finland*, Italy and Sweden; and in New Zealand*.

Over the same period, 5-year survival increased by 10% or more in Canada; in China, Israel* and Korea*; in 13 European countries (North: Denmark*, Estonia*, Ireland*, Lithuania*, Norway*, the UK*; South: Portugal*, Spain, East: Bulgaria*, Czech Republic*, Poland*; West: the Netherlands*, Switzerland), and in Australia*. The increase was about 20% in Korea* and Slovenia*.

Liver

Results are available for 1,178,364 adults from 291 registries in 61 countries (Tables 2 and 4).

Five-year net survival was in the range 5–30% throughout 2000–2014 (web-figure 4). Estimates are often flagged as less reliable than for other solid tumours (Table 5, web-table 4), because of the exclusion of higher proportions of DCO registrations (Table 3, web-table 2).

For patients diagnosed during 2010–2014, age-standardised five-year net survival was 30% in Japan, and in the range 20–29% only in Korea*, Singapore* and Taiwan*; and in Belgium* and Italy.

Survival was in the range 10–19% in 32 countries: Canada and the US, in 4 countries in Central and South America (Argentina, Brazil, Martinique*, Puerto Rico*); in 4 Asian countries (East: China; West: Israel*, Kuwait*, Turkey); in 15 European countries (North: Iceland*, Ireland*, Latvia*, Norway*, Sweden*, the UK*; South: Portugal*, Spain; East: Poland*, Romania (Cluj); West: Austria*, France, Germany, the Netherlands*, Switzerland) and in Australia* and New Zealand*.

Five-year survival was less than 10% in Denmark*, Slovenia*, Thailand, Czech Republic*, Russia and Estonia*.

In most countries, survival has changed very little during the 20-year period 1995–1999 to 2000–2014. It increased by 5–10% in Canada and the US; in Japan; in 9 European countries (North: Denmark*, Ireland, the UK*; South: Italy, Spain; West: France, Germany, the Netherlands*, Switzerland) and Australia* and New Zealand*. Survival increased by more than 10% in China, Korea* and Taiwan*; and in Norway*, Portugal* and Sweden*.

Pancreas

Results are available for 1,229,379 adults from 290 registries in 59 countries (Tables 2 and 4).

Age-standardised five-year net survival estimates were generally in the range 5–15% throughout 2000–2014 (web-figure 4). As for liver cancer, some estimates are less reliable (Table 5, web-table 4), due to the high proportion of DCO registrations (Table 3, web-table 2).

For patients diagnosed during 2010–2014, survival was higher in Kuwait* (24%) and Malaysia (Penang, 19%) (Table 5, web-figure 2). Survival was in the range 10–15% in 16 countries: in Canada and the US; in Brazil and Martinique*; in China, Korea* and Turkey, in 8 European countries (North: Estonia*, Ireland*, Latvia*, Norway*, Sweden*; South: Portugal*; West: Belgium*, Germany), and in Australia*. Five-year net survival ranged between 5% and 10% in 19 countries. Survival was very low in Russia (4%).

Trends in 5-year survival between 2000–2004 and 2010–2014 were generally flat, but increases of 3–5% were seen in Canada and the US; in Korea* and Singapore*, in 12 European countries (North: Denmark*, Estonia*, Ireland*, Latvia*, Norway*, Sweden*, the UK*; South: Portugal*; East: Czech Republic*; West: Belgium*, the Netherlands*, Switzerland), and in Australia* (web-figure 3).

Lung

Results are available for 6,051,262 adults from 290 registries in 61 countries (Tables 2 and 4).

Age-standardised five-year net survival was in the range 10–20% in most countries (Table 5, web-figure 4). Most estimates in Central and South America were less reliable, due to the high proportion of DCO registrations excluded from analysis (Table 5, web-table 4), although the proportion of DCOs has generally decreased world-wide (Table 3, web-table 3).

For patients diagnosed during 2010–2014, the five-year survival estimate was high in Japan (33%). It was in the range 20–30% in 12 countries: Mauritius*, Canada and the US; 4 Asian countries (East: China, Korea*, Taiwan*; West: Israel*), and 5 European countries (North: Latvia*, Iceland*, Sweden*; West: Austria*, Switzerland) (Table 5, web-figure 2). In most countries, however, survival was in the range 10–19%: in Martinique* and Puerto Rico*; in 6 Asian countries (South: Malaysia (Penang), Singapore*; West: Cyprus*, Kuwait*, Qatar*, Turkey); in 21 European countries (North: Denmark*, Estonia*, Finland*, Lithuania*, Norway*; South: Croatia*, Italy, Malta*, Portugal*, Slovenia*, Spain; East: Czech Republic*, Poland*, Russia, Slovakia*; West: Belgium*, France, Germany, Ireland*, the Netherlands*, the UK*); and in Oceania (Australia* and New Zealand*).

Survival was below 10% in Thailand, Brazil, Bulgaria and India.

Lung cancer survival trends between 1995–1999 and 2000–2014 were generally flat, but survival increased by 5–10% in 21 countries: in Canada and the US; in Israel*, Singapore* and Taiwan*; and in 15 European countries (North: Denmark*, Estonia*, Iceland*, Ireland*, Latvia*, Norway*, Sweden*, the UK*; South: Portugal*, Slovenia*; West: Austria*, France, Germany, the Netherlands*, Switzerland), and in Australia*. Survival increased by more than 10% in China, Japan and Korea* (Table 5, web-figure 3).

Melanoma of the skin

Results are available for 1,553,109 adults from 281 registries in 59 countries (Tables 2 and 4).

Age-standardised 5-year net survival was in the range 60–90% in most countries (web-figure 4). Most estimates were considered reliable (Table 5, web-table 4).

For patients diagnosed during 2010–2014, five-year survival estimates exceeded 90% in 14 countries: in the US, and in 8 European countries (North: Denmark*, Sweden*, the UK*; West: Belgium*, France, Germany, the Netherlands, Switzerland); and in Australia* and New Zealand* (Table 5, web-figure 2).

Survival was in the range 80–89% in 14 countries: in Canada, in Israel* and in 12 European countries (North: Estonia*, Finland*, Iceland*, Ireland*, Norway*; South: Italy, Malta*, Portugal*, Slovenia*, Spain; East: Czech Republic*; West: Austria*).

Survival was in the range 70–79% in 10 countries: in 4 countries in Central and South America (Argentina, Brazil, Costa Rica*, Puerto Rico*); and in 6 European countries (North: Latvia*, Lithuania*; South: Croatia*; East; Poland*, Romania (Cluj), Slovakia*).

Survival was in the range 60–69% in 7 countries: in 5 Asian countries (South: India, Singapore*; East: Korea*, Japan; West: Turkey) and in Bulgaria* and Russia. Survival was below 60% in Ecuador and in 5 Asian countries (South: Thailand; East: China, Taiwan*; West: Jordan*, Kuwait*).

Trends between 2000–2004 and 2010–2014 were generally stable in North America, Oceania and Japan, and in several European countries, where five-year survival was already around 85–90% among patients diagnosed during 2000–2004. Survival increased by 5–10% in China and Korea*; 13 European countries (North: Denmark*, Estonia*, Latvia*, Lithuania*, UK*; South: Croatia*, Portugal*, Slovenia*; East: Bulgaria*, Czech Republic*, Poland*; West: Austria*, Belgium*).

Women’s cancers

Breast

Results are available for 6,422,553 women from 298 cancer registries in 66 countries (Tables 2 and 4).

The range of survival estimates is still wide in each continent, apart from North America and Oceania (Figure 4, web-figure 4). Most estimates were considered reliable (Table 5, web-table 4).

For women diagnosed during 2010–2014, age-standardised five-year net survival was 85% or above in 25 countries: in Costa Rica* and Martinique*; Canada* and the US; in Israel*, Japan and Korea*; in 16 European countries (North: Denmark*, Finland*, Iceland*, Norway*, Sweden*, the UK*; West: Austria*, Belgium*, France, Germany, the Netherlands*, Switzerland; South: Italy, Malta*, Portugal*, Spain); and in Australia* and New Zealand* (Table 5, Figure 2B, web-figure 2).

Figure 2. Global distribution of age-standardised five-year net survival (%) for adults (15–99 years) diagnosed during 2010–2014 with colon cancer or breast cancer (women) and children (0–14 years) diagnosed with acute lymphoblastic leukaemia: continent and country.

Figure 2

Survival estimates for each country are ranked from highest to lowest within each continent. Where data were available for more than one registry in a given country, the survival estimates are derived by pooling the data for that country, but excluding data from registries for which the estimates are considered less reliable (see text).

See web-figures 2.1–2.18 for all 18 cancers included in CONCORD-3, and for each calendar period 2000–2004, 2005–2009, 2010–2014.

*Data with 100% coverage of the national population.

National estimate not age-standardised.

§National estimate flagged as less reliable because the only available estimates are from a registry or registries in this category (see text).

Five-year survival was in the range 80–84% in 13 countries: 4 countries in Central and South America (Argentina, Brazil, Peru (Lima), Puerto Rico*); 5 Asian countries (South: Singapore*; East: China, Hong Kong*, Taiwan*; West: Turkey) and 4 European countries (North: Ireland*; East: Czech Republic*, Latvia*; South: Slovenia*). Survival was in the range 70–79% in 12 countries: in Cuba* and Ecuador; in Kuwait* and Mongolia*; and 8 countries in Europe (North: Estonia*, Lithuania*; South: Croatia*; East: Bulgaria*, Poland*, Romania (Cluj), Russia, Slovakia*).

Survival was still low in Thailand (69%) and India (Karunagappally, 66%).

Five-year net survival continued to increase up to 2010–2014 in most countries in Central and South America, Eastern and Western Asia and in all of Europe. Even so, survival remains lower in Eastern Europe than in other parts of the continent. In North America and Oceania, five-year net survival approached 90% (Figure 3, web-figure 3).

Figure 3. 20-year trends in age-standardised five-year net survival (%) for women (15–99 years) with breast cancer,* by calendar period of diagnosis (1995–1999, 2000–2004, 2005–2009 and 2010–2014), continent (or continental region) and country.

Figure 3

Estimates for women diagnosed during 1995–1999 are taken from the analyses for CONCORD-2.6 Where data were available for more than one registry in a given country, the survival estimates are derived by pooling the data for that country, excluding data from registries for which the survival estimates are considered less reliable (see text).

*See web-figures 3.1–3.18 for other cancers.

§Continent or continental region with one or more national estimates flagged as less reliable.

Standard ISO abbreviations for country names: Algeria - DZA; Argentina - ARG; Australia - AUS; Austria - AUT; Belgium - BEL; Brazil - BRA; Bulgaria - BGR; Canada - CAN; Chile - CHL; China - CHN; Colombia - COL; Costa Rica - CRI; Croatia - HRV; Cuba - CUB; Cyprus - CYP; Czech Republic - CZE; Denmark - DNK; Ecuador - ECU; Estonia - EST; Finland - FIN; France - FRA; Germany - DEU; Gibraltar - GIB; Guadeloupe - GLP; Hong Kong SAR - HKG; Iceland - ISL; India - IND; Ireland - IRL; Israel - ISR; Italy - ITA; Japan - JPN; Jordan - JOR; Kuwait - KWT; Latvia - LVA; Lithuania - LTU; Malaysia - MYS; Malta - MLT; Martinique - MTQ; Mauritius - MUS; Mongolia - MNG; Morocco - MAR; Netherlands - NLD; New Zealand - NZL; Nigeria - NGA; Norway - NOR; Peru - PER; Poland - POL; Portugal - PRT; Puerto Rico - PRI; Qatar - QAT; Republic of Korea - KOR; Romania - ROU; Russian Federation - RUS; Singapore - SGP; Slovakia - SVK; Slovenia - SVN; South Africa - ZAF; Spain - ESP; Sweden - SWE; Switzerland - CHE; Taiwan - TWN; Thailand - THA; Turkey - TUR; United Kingdom of Great Britain and Northern Ireland - GBR; United States of America - USA

Cervix

Results are available for 660,744 women from 295 cancer registries in 64 countries (Tables 2 and 4).

The global range in cervical cancer survival is still wide (50–70%), especially in Central and South America, Asia and Europe (Table 5, web-figure 4). Most survival estimates are reliable (web-table 4).

For women diagnosed during 2010–2014, age-standardised five-year net survival was 70% or higher in 7 countries, of which 5 with national coverage: in Japan, Korea* and Taiwan*; in Denmark*, Norway* and Switzerland, and in Cuba* (Table 5, web-figure 2).

Survival was in the range 60–69% in 29 countries: Canada and the US; Brazil and Puerto Rico*; 5 countries in Asia (East: China, Hong Kong*; South: Singapore*; West: Israel*, Turkey), 18 countries in Europe, and in Australia* and New Zealand*.

Survival was in the range 50–59% in 5 countries in Central and South America (Argentina, Ecuador, Martinique, Peru (Lima), Uruguay*); in India, Kuwait* and Thailand, and in 6 European countries (North: Latvia*, Lithuania*; East: Bulgaria*, Poland*, Russia; South: Malta*).

Over the 15 years up to 2014, five-year survival has increased by 4–6% in Japan and in 11 European countries (North: Denmark*, Estonia*, Ireland*, Lithuania*, Norway*; the UK*; South: Portugal*; East: Bulgaria*, Poland*; West: Switzerland) (web-figure 3). Survival increased by 8–10% in Cuba* and India. In China, five-year survival increased from 53% for women diagnosed during 2000–2004 to 68% in 2010–2014.

Ovary

Results are available for 865,501 women from 289 registries in 61 countries (Tables 2 and 4).

Age-standardised five-year net survival was mostly in the range 30–50%, with even wider variation in Europe and Asia (web-figure 4). Most survival estimates were reliable (Table 5, web-table 4).

For women diagnosed during 2010–2014, five-year survival was still below 50% in most countries, except Costa Rica* (62%) (Table 5, web-figures 2–4). Survival was in the range 40–49% in 25 countries: in Canada and the US, in 8 countries in Asia (South: Singapore*; East: China, Korea*, Japan, Taiwan*; West: Israel*, Turkey), in 14 European countries (North: Denmark*, Estonia*, Finland*, Iceland*, Latvia*, Norway*, Sweden*; South: Portugal*, Spain; West: Austria*, Belgium*, France, Germany, Switzerland), and in Australia*.

Survival was in the range 30–39% in 19 countries: 4 in Central and South America (Argentina, Brazil, Ecuador, Puerto Rico*); in Kuwait* and Thailand, in 12 European countries (North: Ireland*, Lithuania*, the UK* South: Croatia*, Italy, Slovenia*; East: Bulgaria*, Czech Republic*, Poland*, Russia, Slovakia*; West: the Netherlands*), and in New Zealand*.

Survival was below 30% in Malta* (28%) and India (16%).

Survival trends between 1995–1999 and 2010–2014 were rather flat in most countries. However, five-year survival rose by 5–10% in the US; in Israel*, Korea* and Taiwan*; in 11 European countries (North: Denmark*, Iceland*, Ireland*, Norway*, Sweden*; South: Portugal*, Spain; East: Bulgaria*, Poland*; West: France, Switzerland), and in Australia*. Survival increased by more than 10% in Estonia* and Latvia*, and by 20% in Japan.

Prostate

Results are available for 5,864,878 men from 290 registries in 62 countries (Tables 2 and 4).

Age-standardised five-year net survival was in the range 70–100% in most countries (web-figure 4). Most estimates were reliable (Table 5, web-table 4).

For men diagnosed during 2010–2014, five-year survival was approaching 100% in Puerto Rico*, Martinique* and the US. Survival was higher than 90% in a further 22 countries: in Brazil and Costa Rica*; in Canada; in Israel*, Japan and Korea*; in 14 European countries (North: Iceland*, Ireland*, Finland*, Latvia*, Lithuania*, Norway*, Sweden*; South: Italy, Portugal*, Spain; West: Austria*, Belgium*, France, Germany), and in Australia* and New Zealand*.

Survival was in the range 80–89% in 18 countries: in Argentina, Ecuador and Uruguay*; in 6 Asian countries (South: Malaysia (Penang), Singapore*; East: Taiwan*; West: Jordan*, Kuwait*, Turkey); and in 9 European countries (North: Denmark*, Estonia*, the UK*; South: Croatia*, Malta*, Slovenia*; East: Czech Republic*; West: the Netherlands*, Switzerland).

Survival was approaching 80% in Russia (79%), Poland* (78%) and Romania (Cluj, 77%). It was 75% in Slovakia*, and below 70% in China (69%), Mauritius* (69%), Bulgaria* (68%) and Thailand (68%). Five-year survival was 44% in India.

Over the 20-year period between 1995–1999 and 2010–2014, age-standardised five-year net survival was rising in most countries. Survival increased by 5–10% in Brazil and Ecuador; in Canada; in China and Turkey; in Austria* and Portugal*; and in New Zealand*.

Five-year survival rose by more than 10% in Israel*, Taiwan* and Thailand, and in 12 European countries (North: Finland*, Iceland*, Norway*, Sweden*; South: Croatia*, Italy, Malta*, Spain; West: France, Germany, the Netherlands*, Switzerland), and in Australia.

Survival increased by more than 20% in 13 countries: in Japan, Korea* and Malaysia (Penang), and in 10 European countries (North: Denmark*, Estonia*, Ireland*, Latvia*, Lithuania*, the UK*; South: Slovenia*; East: Bulgaria*, Czech Republic*, Poland*).

Brain

Results are available for 656,659 adults from 286 registries in 59 countries (Tables 2 and 4).

Age-standardised five-year net survival was in the range 20–40% in most countries (web-figure 4). Most estimates were considered reliable (Table 5, web-table 5).

For patients diagnosed during 2010–2014, five-year survival was higher than 40% only in Japan (46%) and Croatia* (42%).

Survival was in the range 30–40% in 22 countries: Canada, the US, Puerto Rico* and Martinique; in 8 Asian countries (South: Singapore*, East: China, India, Korea*; West: Israel*, Jordan*, Kuwait*, Turkey), in 9 European countries (North: Denmark*, Estonia*, Finland*, Ireland*, Norway*, Sweden*; West: Belgium*, Germany, Switzerland), and in Australia*.

Survival was in the range 20–29% in 20 countries: Chile and Ecuador; in Malaysia (Penang) and Taiwan*; in 15 European countries (North: Iceland*, Latvia*, the UK*; South: Italy, Malta*, Portugal*, Slovenia*, Spain; East: Czech Republic*, Poland*, Russia, Slovakia*; West: Austria*, France, The Netherlands*), and in New Zealand*. Five-year survival was 15% in Thailand.

Trends in 5-year survival between 2000–2004 and 2010–2014 were generally rather flat, but survival increased by 3–5% in 15 countries: Martinique* and Puerto Rico*; in Canada; in Israel* and Thailand; in 9 European countries (North: Iceland*, Latvia*, Lithuania*, Norway*, Sweden*; South: Croatia*, Italy; West: France, Switzerland), and in New Zealand*.

Survival increased by 6–10% in a further 13 countries: the US; in China, India (Karunagappally); Korea* and Singapore*, and in 7 European countries (North: Denmark*, Estonia*, Ireland*, the UK*; South: Malta*, Spain; West: the Netherlands*), and Australia*. A striking increase (18%) was observed in Japan.

Haematological malignancies