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18 records – page 1 of 2.

A comparison of relative and cause-specific survival by cancer site, age and time since diagnosis.

https://arctichealth.org/en/permalink/ahliterature103078
Source
Int J Cancer. 2014 Jul 1;135(1):196-203
Publication Type
Article
Date
Jul-1-2014
Author
Katrine Damgaard Skyrud
Freddie Bray
Bjørn Møller
Author Affiliation
Department of Registration Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
Source
Int J Cancer. 2014 Jul 1;135(1):196-203
Date
Jul-1-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Cause of Death
Female
Humans
Male
Middle Aged
Neoplasms - diagnosis - mortality - pathology
Norway
Registries
Survival Analysis
Abstract
Relative survival (RS) estimates are widely used by cancer registries, mainly because they do not rely on the well-documented deficiencies of cause of death information. The aim of our study was to compare 5-year cause-specific survival (CSS) estimates and 5-year RS estimates for different cancer sites by age and time since diagnosis, and discuss possible reasons for observed differences. Using data from the Cancer Registry of Norway, we identified 200,008 patients diagnosed with cancer at one of the 48 sites included in this analysis during the period 1996-2005, and followed them up until the end of 2010. CSS estimates were calculated (i) considering cause of death to be the cancer that was originally diagnosed and (ii) considering the cause of death to be a cancer within the same organ system. For most cancer sites the difference between CSS and RS estimates was small (
PubMed ID
24302538 View in PubMed
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International variations in childhood cancer in indigenous populations: a systematic review.

https://arctichealth.org/en/permalink/ahliterature105123
Source
Lancet Oncol. 2014 Feb;15(2):e90-e103
Publication Type
Article
Date
Feb-2014
Author
Patricia C Valery
Suzanne P Moore
Judith Meiklejohn
Freddie Bray
Author Affiliation
Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Section of Cancer Information, International Agency for Research on Cancer, Lyon, France. Electronic address: Patricia.Valery@menzies.edu.au.
Source
Lancet Oncol. 2014 Feb;15(2):e90-e103
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Age of Onset
Child
Child Mortality
Child, Preschool
Continental Population Groups - statistics & numerical data
Ethnic Groups - statistics & numerical data
Health Status Disparities
Healthcare Disparities - ethnology
Humans
Incidence
Infant
Infant, Newborn
Neoplasms - ethnology - mortality - pathology - therapy
Prognosis
Residence Characteristics
Risk assessment
Risk factors
Survival Analysis
Survival Rate
Time Factors
Abstract
Although the cancer burden in indigenous children has been reported in some countries, up to now, no international comparison has been made. We therefore aimed to assess the available evidence of the burden of childhood cancer in indigenous populations. We did a systematic review of reports on cancer incidence, mortality, and survival in indigenous children worldwide. Our findings highlight the paucity of accessible information and advocate the pressing need for data by indigenous status in countries where population-based cancer registries are established. The true extent of disparities between the burden in the indigenous community needs to be measured so that targeted programmes for cancer control can be planned and implemented.
PubMed ID
24480559 View in PubMed
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A population-based comparison of the survival of patients with colorectal cancer in England, Norway and Sweden between 1996 and 2004.

https://arctichealth.org/en/permalink/ahliterature137234
Source
Gut. 2011 Aug;60(8):1087-93
Publication Type
Article
Date
Aug-2011
Author
Eva J A Morris
Fredrik Sandin
Paul C Lambert
Freddie Bray
Asa Klint
Karen Linklater
David Robinson
Lars Påhlman
Lars Holmberg
Henrik Møller
Author Affiliation
Cancer Epidemiology Group, Centre for Epidemiology & Biostatistics, University of Leeds, NYCRIS, St James's University Hospital, Leeds, UK. eva.morris@nycris.leedsth.nhs.uk
Source
Gut. 2011 Aug;60(8):1087-93
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Child
Child, Preschool
Colorectal Neoplasms - diagnosis - mortality
England - epidemiology
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Middle Aged
Norway - epidemiology
Population Surveillance - methods
Retrospective Studies
Survival Analysis
Survival Rate - trends
Sweden - epidemiology
Time Factors
Young Adult
Abstract
To examine differences in the relative survival and excess death rates of patients with colorectal cancer in Norway, Sweden and England.
All individuals diagnosed with colorectal cancer (ICD10 (International Classification of Diseases, 10th revision) C18-C20) between 1996 and 2004 in England, Norway and Sweden were included in this population-based study of patients with colorectal cancer. The main outcome measures were 5-year cumulative relative period of survival and excess death rates stratified by age and period of follow-up.
The survival of English patients with colorectal cancer was significantly lower than was observed in both Norway and Sweden. Five-year age-standardised colon cancer relative survival was 51.1% (95% CI 50.1% to 52.0%) in England compared with 57.9% (95% CI 55.2% to 60.5%) in Norway and 59.9% (95% CI 57.7% to 62.0%) in Sweden. Five-year rectal cancer survival was 52.3% (95% CI 51.1% to 53.5%) in England compared with 60.7% (95% CI 57.0% to 64.2%) and 59.8% (95% CI 56.9% to 62.6%) in Norway and Sweden, respectively. The lower survival for colon cancer in England was primarily due to a high number of excess deaths among older patients in the first 3 months after diagnosis. In patients with rectal cancer, excess deaths remained elevated until 2 years of follow-up. If the lower excess death rate in Norway applied in the English population, then 890 (13.6%) and 654 (16.8%) of the excess deaths in the colon and rectal cancer populations, respectively, could have been prevented at 5 years follow-up. Most of these avoidable deaths occurred shortly after diagnosis.
There was significant variation in survival between the countries, with the English population experiencing a poorer outcome, primarily due to a relatively higher number of excess deaths in older patients in the short term after diagnosis. It seems likely, therefore, that in England a greater proportion of the population present with more rapidly fatal disease (especially in the older age groups) than in Norway or Sweden.
PubMed ID
21303917 View in PubMed
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Population-based evidence of increased survival in human papillomavirus-related head and neck cancer.

https://arctichealth.org/en/permalink/ahliterature125100
Source
Eur J Cancer. 2012 Jun;48(9):1341-6
Publication Type
Article
Date
Jun-2012
Author
Mari Nygård
Bjarte Aagnes
Freddie Bray
Bjørn Møller
Jon Mork
Author Affiliation
Department of Research, Cancer Registry of Norway, Oslo, Norway. mari.nygard@kreftregisteret.no
Source
Eur J Cancer. 2012 Jun;48(9):1341-6
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Aged
Carcinoma, Squamous Cell - mortality - virology
Female
Follow-Up Studies
Head and Neck Neoplasms - mortality - virology
Humans
Incidence
Male
Middle Aged
Norway - epidemiology
Papillomaviridae - isolation & purification
Papillomavirus Infections - complications - mortality
Registries
Risk factors
Survival Analysis
Abstract
Evidence from clinical, population-based and molecular studies has shown that human papillomavirus (HPV) infection can be a causal risk factor for a subset of head and neck squamous cell carcinomas (HNSCC). It is proposed that HPV-associated oropharyngeal cancer is a new disease entity that requires treatment and prevention strategies distinct from present recommendations.
In our population-based study we estimated incidence and survival trends in 8270 patients with HPV-related HNSCC (HPV(+)HNSCC) and HPV-unrelated HNSCC (HPV(-)HNSCC) in Norway over the past three decades.
In the period 1981-1995, patients with HPV(+)HNSCC had poorer survival than HPV(-)HNSCC (adjusted hazard ratio (HR) 1.3, 95% confidence interval (CI): 1.14-1.44). By 1996-2007, survival had increased in both groups, but the increase was significantly greater among HPV(+)HNSCC patients (HR 0.57, 95% CI: 0.48-0.67). During the same period, incidence also increased, but only for HPV(+)HNSCCs. From 1981-1995 to 1996-2007, median age at diagnosis for HPV(+)HNSCC decreased from 63.2 to 59.8 years, while for HPV(-)HNSCC median age at diagnosis of 66.6 years remained unchanged.
We demonstrate a population level improvement in survival among patients with oropharyngeal squamous cell cancers commonly related to infection with HPV. In contrast, patients with HNSCC not related to HPV only showed a modest improvement in survival in the period 1981-2007. A concomitant increase in incidence and survival was observed for HPV-related cancers only. This trend cannot be explained by changes in treatment, cancer registration nor screening, but is most likely due to an increased prevalence of HPV-positive tumours.
PubMed ID
22516210 View in PubMed
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Quantifying differences in breast cancer survival between England and Norway.

https://arctichealth.org/en/permalink/ahliterature134263
Source
Cancer Epidemiol. 2011 Dec;35(6):526-33
Publication Type
Article
Date
Dec-2011
Author
Paul C Lambert
Lars Holmberg
Fredrik Sandin
Freddie Bray
Karen M Linklater
Arnie Purushotham
David Robinson
Henrik Møller
Author Affiliation
Centre for Biostatistics and Genetic Epidemiology, Department of Health Sciences, 2nd Floor Adrian Building, University of Leicester, University Road, Leicester LE1 7RH, UK. paul.lambert@le.ac.uk
Source
Cancer Epidemiol. 2011 Dec;35(6):526-33
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Breast Neoplasms - mortality
England - epidemiology
Female
Humans
Middle Aged
Norway - epidemiology
Registries
Survival Analysis
Abstract
Survival from breast cancer is lower in the UK than in some other European countries. We compared survival in England and Norway by age and time from diagnosis.
We included 303,648 English and 24,919 Norwegian cases of breast cancer diagnosed 1996-2004 using flexible parametric relative survival models, enabling improved quantification of differences in survival. Crude probabilities were estimated to partition the probability of death due to all causes into that due to cancer and other causes and to estimate the number of "avoidable" deaths.
England had lower relative survival for all ages with the difference increasing with age. Much of the difference was due to higher excess mortality in England in the first few months after diagnosis. Older patients had a higher proportion of deaths due to other causes. At 5 years post diagnosis, a woman aged 85 in England had probabilities of 0.35 of dying of cancer and 0.32 of dying of other causes, whilst in Norway they were 0.26 and 0.35. By eight years the number of "avoidable" all-cause deaths in England was 1020 with the number of "avoidable" breast cancer related deaths 1488.
Lower breast cancer survival in England is mainly due to higher mortality in the first year after diagnosis. Crude probabilities aid our understanding of the impact of disease on individual patients and help assess different treatment options.
PubMed ID
21606014 View in PubMed
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Survival of patients diagnosed with cancer in the Nordic countries up to 1999-2003 followed to the end of 2006. A critical overview of the results.

https://arctichealth.org/en/permalink/ahliterature96897
Source
Acta Oncol. 2010 Jun;49(5):532-44
Publication Type
Article
Date
Jun-2010
Author
Hans H Storm
Gerda Engholm
Timo Hakulinen
Laufey Tryggvadóttir
Asa Klint
Mette Gislum
Anne Mette T Kejs
Freddie Bray
Author Affiliation
Department of Cancer Prevention and Documentation, Danish Cancer Society, Strandboulevarden 49, Copenhagen, Denmark. hans@cancer.dk
Source
Acta Oncol. 2010 Jun;49(5):532-44
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Age Distribution
Alcohol Drinking - adverse effects - epidemiology
Comorbidity
Denmark - epidemiology
Female
Finland - epidemiology
Humans
Iceland - epidemiology
International Cooperation
Male
Mortality - trends
Neoplasm Staging
Neoplasms - diagnosis - etiology - mortality - therapy
Norway - epidemiology
Registries
Risk factors
Sex Distribution
Smoking - adverse effects - epidemiology
Survival Analysis
Survival Rate - trends
Sweden - epidemiology
Abstract
Differences in Nordic cancer patient survival observed today originate from the 1970s, but were first identified in a mortality prediction from 1995. This paper provides timely comparisons of survival using NORDCAN, a database with comparable information from the Nordic cancer registries. Elucidation of the differences is important when monitoring cancer care generally and evaluating the impact of cancer plans. MATERIAL AND METHODS: The NORDCAN database 1964-2003 with follow-up for death through 2006, was used to analyse incidence, mortality, and survival for all NORDCAN cancer sites. We analysed 5-year relative survival and excess mortality rates in the first three months and 2-5 years after diagnosis. RESULTS: The time trends in survival 1989-2003 were largely similar between the Nordic countries with increases in 14 sites among men and 16 among women. In all countries the excess mortality rates were highest in the first three months after diagnosis, but decreased to similar levels across all countries 2-5 years after diagnosis. Comparing countries excess mortality was highest in Denmark irrespective of follow-up period. Lower survival was observed for Danish cancer patients in 23 of the 33 cancer sites in men and 26 of 35 sites in women. Low and similar levels of survival were observed for cancers of the oesophagus, lung, liver and pancreas, while an 8-10 percentage point difference in survival was found between countries for colorectal cancer. CONCLUSION: The notable differences in Nordic cancer patient survival can be linked to national variations in risk factors, co-morbidity, and the implementation of screening. Improved treatment and primary prevention, in particular the targeting of tobacco and alcohol use, is required to improve cancer control. The recently-initiated cancer plans in Denmark and Norway are yet to show an observable effect on the corresponding cancer survival.
PubMed ID
20491522 View in PubMed
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Trends in survival of patients diagnosed with cancer of the digestive organs in the Nordic countries 1964-2003 followed up to the end of 2006.

https://arctichealth.org/en/permalink/ahliterature96895
Source
Acta Oncol. 2010 Jun;49(5):578-607
Publication Type
Article
Date
Jun-2010
Author
Asa Klint
Gerda Engholm
Hans H Storm
Laufey Tryggvadóttir
Mette Gislum
Timo Hakulinen
Freddie Bray
Author Affiliation
Swedish Cancer Registry, National Board of Health and Welfare, Stockholm, Sweden.
Source
Acta Oncol. 2010 Jun;49(5):578-607
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Alcohol Drinking - adverse effects
Biliary Tract Neoplasms - mortality
Denmark - epidemiology
Digestive System Neoplasms - diagnosis - epidemiology - etiology - mortality - therapy
Environmental Exposure
Esophageal Neoplasms - mortality
Female
Finland - epidemiology
Follow-Up Studies
Humans
Iceland - epidemiology
Incidence
Intestinal Neoplasms - mortality
Liver Neoplasms - mortality
Male
Middle Aged
Mortality - trends
Norway - epidemiology
Pancreatic Neoplasms - mortality
Registries
Risk factors
Sedentary lifestyle
Sex Distribution
Smoking - adverse effects
Stomach Neoplasms - mortality
Survival Analysis
Survival Rate - trends
Sweden - epidemiology
Abstract
Cancers of the digestive organs (including the oesophagus, stomach, small intestine, colon, rectum and anus, liver, gallbladder, and pancreas) constitute one-fifth of all cancer cases in the Nordic countries and is a group of diseases with diverse time trends and varying consequences for public health. In this study we examine trends in relative survival in relation to the corresponding incidence and mortality rates in the Nordic countries during the period 1964-2003. MATERIAL AND METHODS: Data were retrieved from the NORDCAN database for the period 1964 to 2003, grouped into eight 5-year periods of diagnosis. The patients were followed up until the end of 2006. Analysis comprised trends in 5-year relative survival, excess mortality and age-specific relative survival. RESULTS: Survival following cancers of the colon and rectum has increased continuously over the observed period, yet Danish patients fall behind those in the other Nordic countries. The largest inter-country variation is seen for the rare cancers in the small intestine. There has been little increase in prognosis for patients diagnosed with cancers of the liver, gallbladder or pancreas; 5-year survival is generally below 15%. Survival also remains consistently low for patients with oesophageal cancer, while minor increases in survival are seen among stomach cancer patients in all countries except Denmark. The concomitant incidence and mortality rates of stomach cancer have steadily decreased in each Nordic country at least since 1964. CONCLUSION: While the site-specific variations in mortality and survival largely reflect the extent of changing and improving diagnostic and clinical practices, the incidence trends highlight the importance of risk factor modification. Alongside the ongoing clinical advances, effective primary prevention measures, including the control of alcohol and tobacco consumption as well as changing dietary pattern, will reduce the incidence and mortality burden of digestive cancers in the Nordic countries.
PubMed ID
20491524 View in PubMed
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Trends in survival of patients diagnosed with cancers of the brain and nervous system, thyroid, eye, bone, and soft tissues in the Nordic countries 1964-2003 followed up until the end of 2006.

https://arctichealth.org/en/permalink/ahliterature97864
Source
Acta Oncol. 2010 Jun;49(5):673-93
Publication Type
Article
Date
Jun-2010
Author
Freddie Bray
Gerda Engholm
Timo Hakulinen
Mette Gislum
Laufey Tryggvadóttir
Hans H Storm
Asa Klint
Author Affiliation
Department of Clinical- and Registry-based Research, Cancer Registry of Norway, Oslo, Norway. freddie.bray@kreftregisteret.no
Source
Acta Oncol. 2010 Jun;49(5):673-93
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Bone Neoplasms - epidemiology - mortality - therapy
Brain Neoplasms - epidemiology - mortality - therapy
Denmark - epidemiology
Eye Neoplasms - epidemiology - mortality - therapy
Female
Finland - epidemiology
Follow-Up Studies
Humans
Iceland - epidemiology
Incidence
Lymphatic Metastasis
Male
Mass Screening
Middle Aged
Mortality - trends
Neoplasm Staging
Nervous System Neoplasms - epidemiology - mortality - therapy
Norway - epidemiology
Registries
Risk factors
Soft Tissue Neoplasms - epidemiology - mortality - therapy
Survival Analysis
Survival Rate - trends
Sweden - epidemiology
Thyroid Neoplasms - epidemiology - mortality - therapy
Abstract
BACKGROUND: Diagnoses of cancer of the brain, thyroid, eye, bone, and soft tissues are categorised by heterogeneity in disease frequency, survival, aetiology and prospects for curative therapy. In this paper, temporal trends in patient survival in the Nordic countries are considered. MATERIAL AND METHODS: Age-standardised incidence and mortality rates, 5-year relative survival, and excess mortality rates for varying follow-up periods are presented, as are age-specific 5-year relative survival by country, sex and 5-year diagnostic period. RESULTS: Brain cancer incidence rates have been rising but mortality has been relatively stable, with 5-year survival uniformly increasing from the early-1970s, particularly in younger patients. Five-year survival from brain cancer among men varies between 45% and 50% for men and 60% to 70% in women, with excess deaths decreasing with time in each of the Nordic populations. Age-standardised incidence rates of thyroid cancer have been mainly increasing during the 1960s and 1970s, although trends thereafter diverge, with 5-year relative survival increasing 20-30 percentage points over the last 40 years to around 80-90%. Thyroid cancer survival is consistently lower in Denmark, particularly in patients diagnosed aged over 60, while there is less geographic variation in excess deaths three months beyond initial diagnosis. Relative survival from eye cancer increased with time from approximately 60% in 1964-1968 to 80% 1999-2003, while for bone sarcoma, incidence rates remained stable, mortality rates declined, and 5-year survival increased slightly to around 55-65%. Soft tissue sarcoma incidence and survival have been slowly increasing since the 1960s, with little variation in survival (around 65%) for the most recent period. CONCLUSIONS: There have been some notable changes in survival that can be linked to epidemiological and clinical factors in different countries over time. Time-varying proportions of the major histological subtypes might however have affected the survival estimates for a number of the cancer forms reviewed here.
PubMed ID
20192877 View in PubMed
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Trends in survival of patients diagnosed with male genital cancers in the Nordic countries 1964-2003 followed up until the end of 2006.

https://arctichealth.org/en/permalink/ahliterature98071
Source
Acta Oncol. 2010 Jun;49(5):644-54
Publication Type
Article
Date
Jun-2010
Author
Freddie Bray
Asa Klint
Mette Gislum
Timo Hakulinen
Gerda Engholm
Laufey Tryggvadóttir
Hans H Storm
Author Affiliation
Department of Clinical- and Registry-based Research, Cancer Registry of Norway, Majorsteuen, Oslo, Norway. freddie.bray@kreftregisteret.no
Source
Acta Oncol. 2010 Jun;49(5):644-54
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Denmark - epidemiology
Finland - epidemiology
Follow-Up Studies
Genital Neoplasms, Male - diagnosis - epidemiology - mortality - prevention & control - therapy
Humans
Iceland - epidemiology
Incidence
Male
Mass Screening
Middle Aged
Mortality - trends
Neoplasm Staging
Norway - epidemiology
Penile Neoplasms - mortality
Prostatic Neoplasms - mortality
Registries
Risk factors
Survival Analysis
Survival Rate - trends
Sweden - epidemiology
Testicular Neoplasms - mortality
Abstract
BACKGROUND: Prostate, testicular and penile cancer constitute about one-third of the cancer incidence burden among Nordic males, but less than one-fifth of the corresponding mortality. The aim of this study is to describe and interpret trends in relative survival and excess mortality in the five Nordic populations. MATERIAL AND METHODS: Age-standardised incidence and mortality rates, 5-year relative survival, and excess mortality rates for varying follow-up periods are presented, as are age-specific 5-year relative survival by country, sex and 5-year diagnostic period. RESULTS: The vast majority of male genital cancer incident cases and deaths are prostate cancers, with 5-year and 10-year survival trends resembling the diagnostic-led increasing incidence over the past 25 years. Five-year prostate cancer survival is estimated at 53% in Denmark compared to 78% or above in the other Nordic populations for patients diagnosed 1999-2003. Excess mortality has declined over time, with Denmark having a greater excess of deaths compared to the other countries, irrespective of time of diagnosis. Concomitant with the declines in testicular cancer mortality, testicular cancer survival has increased since the 1970s in each Nordic country. Men diagnosed with testicular cancer in recent decades have had, on average, a continually better prognosis with time, with relative 5-year survival for patients diagnosed 1999-2003 ranging from 88% in Finland to 94% in Sweden. For the few patients diagnosed with cancer of the penis and other male genital organs, survival trends have been rather stable over time, with recent 5-year relative survival estimates ranging from 62% in Finland to 80% in Norway. CONCLUSIONS: There are intriguing country-specific and temporal variations in male genital cancer survival in the Nordic countries. Prognosis varies widely by cancer site and relates to both changing diagnostic and clinical practices. The increasing PSA detection and biopsy makes interpretation of the prostate cancer survival trends particularly difficult.
PubMed ID
20151937 View in PubMed
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Trends in the overall survival of cancer patients diagnosed 1964-2003 in the Nordic countries followed up to the end of 2006: the importance of case-mix.

https://arctichealth.org/en/permalink/ahliterature96892
Source
Acta Oncol. 2010 Jun;49(5):713-24
Publication Type
Article
Date
Jun-2010
Author
Hans H Storm
Anne Mette T Kejs
Gerda Engholm
Laufey Tryggvadóttir
Asa Klint
Freddie Bray
Timo Hakulinen
Author Affiliation
Department of Cancer Prevention and Documentation, Danish Cancer Society, Strandboulevarden 49, Copenhagen, Denmark. hans@cancer.dk
Source
Acta Oncol. 2010 Jun;49(5):713-24
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Denmark - epidemiology
Female
Finland - epidemiology
Follow-Up Studies
Humans
Iceland - epidemiology
Incidence
Male
Mass Screening
Middle Aged
Mortality - trends
Neoplasm Staging
Neoplasms - diagnosis - epidemiology - mortality
Norway - epidemiology
Registries
Risk Adjustment
Risk factors
Socioeconomic Factors
Survival Analysis
Survival Rate - trends
Sweden - epidemiology
Abstract
AIM: Overall survival after cancer is frequently used when assessing the health care service performance as a whole. While used by the public, politicians, and the media, it is often discarded by clinicians and epidemiologists due to the heterogeneous mix of different cancers, risk factors and treatment modalities. We studied the trend in the Nordic 5-year relative survival and excess mortality for all cancers combined to see if the impact of case-mix and variations between countries in diagnostic methods such as breast screening and PSA testing could explain the lower survival in Denmark. MATERIAL AND METHODS: From the NORDCAN database 1964-2003, we defined two cohorts of cancer patients, one excluding non-melanoma skin cancer and another also excluding breast and prostate cancer. We estimated age-standardised incidence and mortality rates, 5-year relative survival, and excess mortality rates for varying follow-up periods, and age-specific 5-year relative survival by country, sex and 5-year diagnostic period. RESULTS: Prostate cancer is the main driver of the incidence increase in men, as do breast cancer in women, whereas cancer mortality in all Nordic countries is declining. The 5-year relative survival ratios are increasing in each Nordic population, but less so in Denmark. Country differences in survival stem mainly from follow-up periods immediately after diagnosis. Adjusting for the case-mix of diagnoses diminished differences a little while exclusion of breast and prostate cancer reduced the gap between countries in survival and excess mortality more considerably, yet post-adjustment, Danish patients still fare worse during the first three months after diagnosis. CONCLUSION: Adjustment for case-mix and exclusion of sites where diagnostic procedures change the pattern of incidence is important when comparing overall cancer survival across countries, but the correction only explains part of the observed differences in survival. Other factors such as stage at presentation, co-morbidity, tobacco and alcohol consumption are likely contributors.
PubMed ID
20491527 View in PubMed
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18 records – page 1 of 2.