Cancer survival increases in Europe, but international differences remain wide


Sant, M; Capocaccia, R; Coleman, MP; Berrino, F; Gatta, G; Micheli, A; Verdecchia, A; Faivre, J; Hakulinen, T; Coebergh, JWW; Martinez-Garcia, C; Forman, D; Zappone, A; (2001) Cancer survival increases in Europe, but international differences remain wide. European journal of cancer (Oxford, England , 37 (13). pp. 1659-67. ISSN 0959-8049

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Abstract

The EUROCARE project analysed cancer survival data from 45 population-based cancer registries in 17 European countries, revealing wide international differences in cancer survival. We calculated 5-year relative survival for 1836287 patients diagnosed with one of 13 cancers during the period 1978-1989. The data, from 20 cancer registries in 13 countries, were grouped into four regions: Finland, Sweden, Iceland (Northern Europe); Denmark, England and Scotland (UK and Denmark); France, The Netherlands, Germany, Italy and Switzerland (Western Europe); Estonia and Poland (Eastern Europe), and broken down into four periods (1978-1980, 1981-1983, 1984-1986, 1987-1989). For each cancer, mean European and regional survival was estimated as the weighted mean of 5-year relative survival in each country. Survival increased with time for all tumours, particularly for cancers of testis (12% increase, i.e. from 79.9 to 91.9%), breast, large bowel, skin melanoma (approximately 9-10%), and lymphomas (approximately 7%). For most solid tumours, survival was highest in Northern Europe and lowest in Eastern Europe, and also low in the UK and Denmark. Regional variation was less marked for the lymphomas. Survival improved more in Western than Northern Europe, and the differences between these regions fell for bowel cancer (from 8.0% for those diagnosed in 1978-1980 to 2% for those diagnosed in 1987-1989), breast cancer (from 7.4% to 3.9%), skin melanoma (from 13.4% to 11.0%) and Hodgkin's disease (from 7.2 to 0.6%). For potentially curable malignancies such as Hodgkin's disease, large bowel, breast and testicular cancers, there were substantial increases in survival, suggesting an earlier diagnosis and more effective treatment. The persisting regional differences suggest there are corresponding differences in the availability of diagnostic and therapeutic facilities, and in the effectiveness of healthcare systems.

Item Type: Article
Keywords: cancer survival, cancer registries, mortality, EUROCARE, Prostate-cancer, breast-cancer, relative survival, diagnosis, deprivation, denmark, trends, stage, Adolescence, Adult, Age Distribution, Aged, Aged, 80 and over, Europe, epidemiology, Female, Human, Male, Middle Age, Mortality, trends, Neoplasms, mortality, Registries, Residence Characteristics, Sex Distribution, Support, Non-U.S. Gov't, Survival Analysis, Survival Rate
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Cancer Survival Group
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 11527693
Web of Science ID: 170660700022
URI: http://researchonline.lshtm.ac.uk/id/eprint/17134

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