Breast cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK, 2000-2007: a population-based study.


Walters, S; Maringe, C; Butler, J; Rachet, B; Barrett-Lee, P; Bergh, J; Boyages, J; Christiansen, P; Lee, M; Wärnberg, F; Allemani, C; Engholm, G; Fornander, T; Gjerstorff, ML; Johannesen, TB; Lawrence, G; McGahan, CE; Middleton, R; Steward, J; Tracey, E; Turner, D; Richards, MA; Coleman, MP; ICBP Module 1 Working Group, ; (2013) Breast cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK, 2000-2007: a population-based study. British journal of cancer, 108 (5). pp. 1195-208. ISSN 0007-0920 DOI: 10.1038/bjc.2013.6

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Abstract

BACKGROUND: We investigate whether differences in breast cancer survival in six high-income countries can be explained by differences in stage at diagnosis using routine data from population-based cancer registries.<br/> METHODS: We analysed the data on 257,362 women diagnosed with breast cancer during 2000-7 and registered in 13 population-based cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Flexible parametric hazard models were used to estimate net survival and the excess hazard of dying from breast cancer up to 3 years after diagnosis.<br/> RESULTS: Age-standardised 3-year net survival was 87-89% in the UK and Denmark, and 91-94% in the other four countries. Stage at diagnosis was relatively advanced in Denmark: only 30% of women had Tumour, Nodes, Metastasis (TNM) stage I disease, compared with 42-45% elsewhere. Women in the UK had low survival for TNM stage III-IV disease compared with other countries.<br/> CONCLUSION: International differences in breast cancer survival are partly explained by differences in stage at diagnosis, and partly by differences in stage-specific survival. Low overall survival arises if the stage distribution is adverse (e.g. Denmark) but stage-specific survival is normal; or if the stage distribution is typical but stage-specific survival is low (e.g. UK). International differences in staging diagnostics and stage-specific cancer therapies should be investigated.<br/>

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Cancer Survival Group
Centre for Global Non-Communicable Diseases (NCDs)
Population Studies Group
PubMed ID: 23449362
Web of Science ID: 317038100028
URI: http://researchonline.lshtm.ac.uk/id/eprint/639015

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