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Bouvier AM, Jooste V, Lillini R, Marcos-Gragera R, Katalinic A, Giorgi Rossi P, Launoy G, Bouvier V, Guevara M, Ardanaz E, Rapiti Aylward E, Innos K, Barranco MR, Sant M. Differences in survival and recurrence of colorectal cancer by stage across population-based European registries. Int J Cancer 2024; 155:807-815. [PMID: 38577898 DOI: 10.1002/ijc.34944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/20/2024] [Accepted: 03/12/2024] [Indexed: 04/06/2024]
Abstract
Recurrence after colorectal cancer resection is rarely documented in the general population while a key clinical determinant for patient survival. We identified 8785 patients with colorectal cancer diagnosed between 2010 and 2013 and clinically followed up to 2020 in 15 cancer registries from seven European countries (Bulgaria, Switzerland, Germany, Estonia, France, Italy, and Spain). We estimated world age-standardized net survival using a flexible cumulative excess hazard model. Recurrence rates were calculated for patients with initially resected stage I, II, or III cancer in six countries, using the actuarial survival method. The proportion of nonmetastatic resected colorectal cancers varied from 58.6% to 78.5% according to countries. The overall 5-year net survival by country ranged between 60.8% and 74.5%. The absolute difference between the 5-year survival extremes was 12.8 points for stage II (Bulgaria vs Switzerland), 19.7 points for stage III (Bulgaria vs. Switzerland) and 14.8 points for Stage IV and unresected cases (Bulgaria vs. Switzerland or France). Five-year cumulative rate of recurrence among resected patients with stage I-III was 17.7%. As compared to the mean of the whole cohort, the risk of developing a recurrence did not differ between countries except a lower risk in Italy for both stage I/II and stage III cancers and a higher risk in Spain for stage III. Survival after colorectal cancer differed across the concerned European countries while there were slight differences in recurrence rates. Population-based collection of cancer recurrence information is crucial to enhance efforts for evidence-based management of colorectal cancer follow up.
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Affiliation(s)
- Anne-Marie Bouvier
- Digestive Cancer Registry of Burgundy, Dijon, France
- French Network of Cancer Registries (FRANCIM), Dijon, France
- Dijon University Hospital, Dijon, France
- INSERM UMR 1231, EPICAD, Dijon, France
- University of Burgundy, Dijon, France
| | - Valérie Jooste
- Digestive Cancer Registry of Burgundy, Dijon, France
- French Network of Cancer Registries (FRANCIM), Dijon, France
- Dijon University Hospital, Dijon, France
- INSERM UMR 1231, EPICAD, Dijon, France
- University of Burgundy, Dijon, France
| | - Roberto Lillini
- Analytical Epidemiology and Health Impact Unit, Epidemiology and Data Science Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona, Spain
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain
| | | | - Paolo Giorgi Rossi
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Guy Launoy
- INSERM-UCN U1086 ANTICIPE, Equipe Labellisée Ligue Contre le Cancer, Caen, France
- Caen University Hospital, Caen, France
| | - Véronique Bouvier
- INSERM-UCN U1086 ANTICIPE, Equipe Labellisée Ligue Contre le Cancer, Caen, France
- Caen University Hospital, Caen, France
- Digestive Cancer Registry of Calvados, Caen, France
| | - Marcela Guevara
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Eva Ardanaz
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | | | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Epidemiology and Data Science Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Saint F, Pasquier D, Villers A, Massa J, Colin P, Vankemmel O, Leroy X, Bonnal JL, Plouvier SD. Incidence, initial management and survival of high-risk non-muscle invasive bladder cancer in Northern France. THE FRENCH JOURNAL OF UROLOGY 2024; 34:102675. [PMID: 38969304 DOI: 10.1016/j.fjurol.2024.102675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 05/25/2024] [Accepted: 06/26/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE Information on bladder cancer (BC) according to the risk scoring for recurrence or progression in a general population is scarce despite its clinical relevance. The objective was to describe the characteristics of incident BC in a general population, with a focus on the initial management of high-risk non-muscle invasive BC (HR-NMIBC). MATERIALS BC incident in 2011-2012 recorded in a population-based cancer registry were studied. Data was extracted from medical files. NMIBC were classified according to potential risk for recurrence/progression. Individual and tumor characteristics of incident BC were described. Incidence, initial management and survival (12/31/2021) of HR-NMIBC were assessed. RESULTS Among 538 BC cases, 380 were NMIBC [119 low (22.1%), 163 intermediate (30.3%), 98 high (18.2%) risk] and 147 (27.3%) were MIBC. HR-NMIBC diagnostic and therapeutic management [imaging, re-TUR, multidisciplinary team meetings (MDT) assessment, specific treatment] revealed discrepancies with guidelines recommendations. Seventy-two out of 98 cases were assessed in an MDT with a median time from diagnosis of 18days [first quartile: 12-third quartile: 32]. Globally, treatment agreed with MDT decisions. Intravesical instillation was the most common treatment (n=56) but 27 HR-NMIBC did not receive specific treatment after TUR. Five and 10years overall survival was 52% [42-63] and 41% [31-51], respectively. Five years net survival was 63% [47-75]. CONCLUSIONS Despite National cancer plans aiming to improve care giving and despite the severity of HR-NMIBC, guideline-recommended patterns of care were underused in this region. This may deserve attention to identify obstacles to guideline adoption to try to improve BC patient care and survival. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Fabien Saint
- Université de Lille, CHU de Lille, Department of Urology, 59000 Lille, France; EPROAD Laboratory EA 4669, Picardie Jules-Verne University, Lille, France
| | - David Pasquier
- Academic Department of Radiation Oncology, Centre Oscar-Lambret, Lille, France; Université de Lille, CRIStAL UMR 9189, Lille, France
| | - Arnauld Villers
- Université de Lille, CHU de Lille, Department of Urology, 59000 Lille, France
| | - Jordan Massa
- Université de Lille, CHU de Lille, Department of Urology, 59000 Lille, France
| | - Pierre Colin
- Service d'Urologie, Hôpital Privé La Louvière, 59800 Lille, France
| | | | - Xavier Leroy
- Université de Lille, CHU de Lille, Department of Pathology, 59000 Lille, France
| | - Jean-Louis Bonnal
- Service d'Urologie, Groupement des Hôpitaux de l'Institut Catholique de Lille, Université Nord de France, Lille, France
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Kuwatsuka Y, Ito H, Tabuchi K, Konuma T, Uchida N, Inamoto Y, Inai K, Nishida T, Ikegame K, Eto T, Katayama Y, Kataoka K, Tanaka M, Takahashi S, Fukuda T, Ichinohe T, Kimura F, Kanda J, Atsuta Y, Matsuo K. Trends in allogeneic hematopoietic cell transplantation survival using population-based descriptive epidemiology method: analysis of national transplant registry data. Bone Marrow Transplant 2024; 59:1295-1301. [PMID: 38898226 DOI: 10.1038/s41409-024-02326-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/02/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024]
Abstract
Prognosis for patients undergoing hematopoietic cell transplantation (HCT) has been improving. Short-term survival information, such as crude survival rates that consider deaths immediately after the transplantation, may not be sufficiently useful for assessing long-term survival. Using the data of the Japanese HCT registry, the net survival rate of patients who survived for a given period was determined according to age, disease, and type of transplant. We included a total of 41,716 patients who received their first allogeneic hematopoietic cell transplantation between 1991 and 2015. For each disease, age group, graft source subcategory, net survival was calculated using the Pohar-Perme method, and 5-year conditional net survival (CS) was calculated. Ten-year net survivals of total patient cohort were 41.5% and 47.4% for males and females, respectively. Except for myelodysplastic syndrome, multiple myeloma, and adult T-cell leukemia/lymphoma, 5-year CS for 5-year transplant survivors exceeded 90%. CS was especially high for aplastic anemia, of which was over 100% for children and younger adults receiving cord blood, suggesting that these patients have similar longevity to an equivalent group from the general population. These findings provide useful information for long-term survival, and can serve as benchmark for comparisons among registries, including other cancers.
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Affiliation(s)
- Yachiyo Kuwatsuka
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan.
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Ken Tabuchi
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
| | - Takaaki Konuma
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Yoshihiro Inamoto
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Inai
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Tetsuya Nishida
- Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Kazuhiro Ikegame
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Yuta Katayama
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Keisuke Kataoka
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Satoshi Takahashi
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Fumihiko Kimura
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Junya Kanda
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
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Ladoire S, Mamguem Kamga A, Galland L, Desmoulins I, Mayeur D, Kaderbhai C, Ilie SM, Hennequin A, Jankowski C, Albuisson J, Nambot S, Coutant C, Arnould L, Reda M, Truntzer C, Dabakuyo S. Real-world prevalence, treatment and survival of "high risk" early breast cancer, with mandatory testing of gBRCA1/2 mutation according to the OlympiA trial inclusion criteria: Data from a population-based registry. Breast 2024; 78:103789. [PMID: 39243563 DOI: 10.1016/j.breast.2024.103789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND The results of the OlympiA study led to the approval of a PARP inhibitor (olaparib) as adjuvant treatment for early breast cancer (eBC) at high risk of relapse in patients with a germline BRCA1/2 mutation (gBRCAm). However, the proportion of patients in routine practice who meet the "high-risk" criteria applied in the OlympiA study, and for whom gBRCAm testing would now be mandatory, remains unknown. PATIENTS AND METHODS In this population-based study, we use unique data from the French specialized Côte d'Or Breast and Gynecological Cancer Registry, to assess the real-life proportion, and long-term prognosis of patients treated for eBC between 2005 and 2015 with standard treatment, and at "high risk" of relapse according to the OlympiA trial criteria. RESULTS We included 3483 patients treated for HER2-negative eBC (N = 380 with ER-, and N = 3103 with ER + tumor). We found N = 62 (1.8 %) patients with gBRCA1/2 mutations. A total of 494 patients (14.2 %) were classified as "high risk" according to the Olympia criteria; 55 % with ER-tumors, and 9.1 % with ER + tumors, respectively. Despite more intensive systemic treatments in "high risk" patients, 10-year overall survival was much worse in these "high risk" patients compared to the others: 60.1 % vs 83.8 % in ER-tumors, and 55.4 % vs 84.1 % in ER + tumors. Our estimates of net survival show an even greater difference. CONCLUSION This study provides real-life insights into the prevalence and prognosis of patients with high-risk eBC, in a context where the approval of adjuvant olaparib requires careful reorganization of care, so as not to overlook a patient with gBRCAm who could benefit from adjuvant olaparib.
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Affiliation(s)
- Sylvain Ladoire
- Department of Medical Oncology, Centre Georges-François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France; INSERM U1231, Université de Bourgogne, 21000, Dijon, France; Université de Bourgogne, 21000, Dijon, France.
| | - Ariane Mamguem Kamga
- INSERM U1231, Université de Bourgogne, 21000, Dijon, France; Breast and Gynaecologic Cancer Registry of Côte d'Or, Epidemiology and Quality of Life Research Unit, Georges-François Leclerc Comprehensive Cancer Centre-UNICANCER, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Loick Galland
- Department of Medical Oncology, Centre Georges-François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Isabelle Desmoulins
- Department of Medical Oncology, Centre Georges-François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Didier Mayeur
- Department of Medical Oncology, Centre Georges-François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Courèche Kaderbhai
- Department of Medical Oncology, Centre Georges-François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Silvia Mihaelia Ilie
- Department of Medical Oncology, Centre Georges-François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Audrey Hennequin
- Department of Medical Oncology, Centre Georges-François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Clementine Jankowski
- Department of Surgical Oncology Centre Georges-François Leclerc 1 rue du Professeur Marion, 21000, Dijon, France
| | - Juliette Albuisson
- INSERM UMR 1231 GIMI, Genomic and Immunotherapy Medical Institute, Université Bourgogne Franche-Comté, Dijon, France; Unité de Biologie Moléculaire, Centre de Lutte Contre le Cancer Georges François Leclerc-UNICANCER, Dijon, France
| | - Sophie Nambot
- INSERM UMR 1231 GIMI, Genomic and Immunotherapy Medical Institute, Université Bourgogne Franche-Comté, Dijon, France; Centre de Génétique, FHU-TRANSLAD, Centre Hospitalier Universitaire Dijon-Bourgogne, Dijon, France; INSERM UMR 1231 GAD, Génétique des Anomalies du Développement, Université Bourgogne Franche-Comté, Dijon, France; Unité d'Oncogénétique, Centre de Lutte Contre le Cancer Georges François Leclerc-UNICANCER, Dijon, France
| | - Charles Coutant
- Université de Bourgogne, 21000, Dijon, France; Department of Surgical Oncology Centre Georges-François Leclerc 1 rue du Professeur Marion, 21000, Dijon, France
| | - Laurent Arnould
- Department of Biology and Pathology of Tumors. Centre Georges-François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Manon Reda
- Department of Medical Oncology, Centre Georges-François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France; Unité d'Oncogénétique, Centre de Lutte Contre le Cancer Georges François Leclerc-UNICANCER, Dijon, France
| | - Caroline Truntzer
- Platform of Transfer in Biological Oncology - Georges François Leclerc Cancer Center, Dijon, France
| | - Sandrine Dabakuyo
- INSERM U1231, Université de Bourgogne, 21000, Dijon, France; Breast and Gynaecologic Cancer Registry of Côte d'Or, Epidemiology and Quality of Life Research Unit, Georges-François Leclerc Comprehensive Cancer Centre-UNICANCER, 1 rue du Professeur Marion, 21000, Dijon, France
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5
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Ferretti S, Sassoli de Bianchi P, Canuti D, Campari C, Cortesi L, Arcangeli V, Barbieri E, D'Aloia C, Danesi R, De Iaco P, De Lillo M, Lombardo L, Moretti G, Musolino A, Palli D, Palmonari C, Ravegnani M, Tafà A, Tononi A, Turchetti D, Zamagni C, Zampiga V, Bucchi L, The Hboc Study Group. Evaluation of an Italian Population-Based Programme for Risk Assessment and Genetic Counselling and Testing for BRCA1/2-Related Hereditary Breast and Ovarian Cancer after 10 Years of Operation: An Observational Study Protocol. Methods Protoc 2024; 7:63. [PMID: 39195440 DOI: 10.3390/mps7040063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/01/2024] [Accepted: 08/06/2024] [Indexed: 08/29/2024] Open
Abstract
Hereditary breast/ovarian cancer (HBOC) syndrome is caused by the inheritance of monoallelic germline BRCA1/2 gene mutations. If BRCA1/2 mutation carriers are identified before the disease develops, effective actions against HBOC can be taken, including intensive screening, risk-reducing mastectomy and salpingo-oophorectomy, and risk-reducing medications. The Italian National Prevention Plan mandates the creation of regional BRCA genetic testing programmes. So far, however, only informal data have been reported on their implementation. We have designed a study aimed at evaluating the results of a population-based programme for risk assessment and genetic counselling and testing for BRCA1/2-related HBOC that is underway in the Emilia-Romagna region (northern Italy). The programme-which is entirely free-includes basic screening with an estimate of the likelihood of carrying a BRCA1/2 mutation using a familial risk assessment tool, a closer examination of women with suspected risk increase, an assessment of the need for further genetic counselling and, if needed, genetic testing and risk-reducing interventions. In this paper, the design of the programme and the protocol of the study are presented. The study has an observational, historical cohort design. Eligible are the women found to be at an increased risk of HBOC (profile 3 women). The main objectives are (i) to determine the precision of the programme in measuring the level of risk of HBOC for profile 3 women; (ii) to determine the characteristics of profile 3 women and their association with the risk management strategy chosen; (iii) to compare the age at onset, histologic type, tumour stage, molecular subtype, and prognosis of breast/ovarian cancers observed in the cohort of profile 3 women with the features of sporadic cancers observed in the general female population; (iv) to determine the level and the determinants of adherence to recommendations; and (v) to determine the appropriateness and timing of risk-reducing surgery and medications. Investigating the quality and results of the programme is necessary because the best practices in risk assessment and genetic counselling and testing for BRCA1/2-related cancer and the challenges they encounter should be identified and shared. The study has the potential to provide sound empirical evidence for the factors affecting the effectiveness of this type of service.
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Affiliation(s)
- Stefano Ferretti
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44121 Ferrara, Italy
- Local Health Authority, 44121 Ferrara, Italy
| | | | - Debora Canuti
- Department of Health, Emilia-Romagna Region, 40127 Bologna, Italy
| | - Cinzia Campari
- Azienda USL, IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Laura Cortesi
- Struttura di Genetica Oncologica, Dipartimento di Oncologia ed Ematologia, AOU Policlinico di Modena, 41125 Modena, Italy
| | - Valentina Arcangeli
- Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, 47014 Forlì, Italy
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, 47014 Meldola, Italy
| | - Elena Barbieri
- Struttura di Oncologia, Dipartimento di Oncologia ed Ematologia, AOU Policlinico di Modena, 41125 Modena, Italy
| | - Cecilia D'Aloia
- Section of Radiology and Breast Unit, University Hospital of Parma, 43126 Parma, Italy
| | - Rita Danesi
- Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, 47014 Forlì, Italy
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, 47014 Meldola, Italy
| | - Pierandrea De Iaco
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | | | | | | | - Antonino Musolino
- Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
- Medical Oncology, Breast Unit and Cancer Genetics Service, University Hospital of Parma, 43126 Parma, Italy
| | - Dante Palli
- UOC Chirurgia Generale a Indirizzo Senologico and Breast Unit, 29121 Piacenza, Italy
| | - Caterina Palmonari
- Cancer Screening Centre and Spoke Centre, AUSL Ferrara, 44121 Ferrara, Italy
| | - Mila Ravegnani
- Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, 47014 Forlì, Italy
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, 47014 Meldola, Italy
| | - Alfredo Tafà
- UOC Senologia, Ospedale Bellaria, AUSL Bologna, 40139 Bologna, Italy
| | - Alessandra Tononi
- Unità Operativa di Prevenzione Oncologica, Ospedale Infermi, 47923 Rimini, Italy
| | - Daniela Turchetti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Medical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Claudio Zamagni
- Medical Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Valentina Zampiga
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, 47014 Meldola, Italy
| | - Lauro Bucchi
- Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, 47014 Forlì, Italy
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6
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Bucchi L, Mancini S, Zamagni F, Crocetti E, Dal Maso L, Ferretti S, Baldacchini F, Giuliani O, Ravaioli A, Vattiato R, Bella F, Carrozzi G, Cascone G, Ferrante M, Michiara M, Musolino A, Tumino R, Usticano A, Allotta A, Pollina Addario S, Lacarrubba F, Stanganelli I, Falcini F. North-south differences in incidence and surveillance of cutaneous malignant melanoma in Italy. TUMORI JOURNAL 2024; 110:264-272. [PMID: 38825831 DOI: 10.1177/03008916241255458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
BACKGROUND In Italy, the incidence of cutaneous malignant melanoma is two-fold higher in the north than in the south. This gradient might be associated with differences in incidence trends and disease surveillance. We compared the time trends in incidence rates, mortality rates, dermatologic office visit rates and skin biopsy rates between the Emilia-Romagna Region (northern Italy) and the Sicily Region (southern Italy). METHODS The cancer registries of Parma, Modena, Ferrara and Romagna (current population, 2,606,465) and Catania-Messina-Enna, Siracusa and Ragusa (2,775,019) provided incidence and mortality records for the years 2008-2017. The records of outpatient services delivered in public health facilities were obtained from the two Regional Administrations. Trends in rates were assessed with the estimated average annual percent change. North-south differences were expressed as age-standardised rate ratios. RESULTS In the context of a generalised increasing incidence trend, which was more moderate in the female population of the Sicily Region, the standardised rate ratios were: 5.31 (males) and 5.20 (females) for in situ cutaneous malignant melanoma; 2.10 and 2.07 for invasive cutaneous malignant melanoma, with an excess incidence concentrated in lesions ⩽1.00 mm thick (3.58 and 3.05); 3.00 and 2.44 for dermatologic office visits; and 5.25 and 5.02 for skin biopsies. Mortality was stable in both Regions. CONCLUSIONS In the Emilia-Romagna Region, as compared with the Sicily Region, a higher incidence of cutaneous malignant melanoma -especially of in situ and early invasive cutaneous malignant melanoma- coexisted with a higher level of clinical surveillance. The question of the direction of the cause-effect relationship between increased incidence and increased diagnostic scrutiny remains open.
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Affiliation(s)
- Lauro Bucchi
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Silvia Mancini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Federica Zamagni
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Emanuele Crocetti
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry, Section of Ferrara, Local Health Authority and University of Ferrara, Ferrara, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Rosa Vattiato
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Francesca Bella
- Siracusa Cancer Registry, Provincial Health Authority of Siracusa, Italy
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health Department, Local Health Authority, Modena, Italy
| | - Giuseppe Cascone
- Cancer Registry, Provincial Health Authority (ASP), Ragusa, Italy
| | - Margherita Ferrante
- Integrated Cancer Registry of Catania-Messina-Enna, Azienda Ospedaliero-Universitaria Policlinico 'Rodolico-San Marco', Catania, Italy
| | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, Parma University Hospital, Parma, Italy
| | - Antonino Musolino
- Parma Cancer Registry, Medical Oncology Unit, Parma University Hospital, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Rosario Tumino
- Siracusa Cancer Registry, Provincial Health Authority of Siracusa, Italy
| | - Antonella Usticano
- Cancer Registry, Provincial Health Authority (ASP), Ragusa, Italy
- Department of Health Activities and Epidemiological Observatory of Sicily Region, Palermo, Italy
| | - Alessandra Allotta
- Department of Health Activities and Epidemiological Observatory of Sicily Region, Palermo, Italy
| | | | | | - Ignazio Stanganelli
- Skin Cancer Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
- Dermatology Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
- Cancer Prevention Unit, Local Health Authority, Forlì, Italy
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7
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Vega-Escobar K, Bonilla-Escobar FJ, Salamanca O, Martinez-Blanco AM, Garcia LS, Collazos P, Bravo LE. Epidemiology of Eye Cancer in Cali, Colombia: A 55-Year Study. Ophthalmic Epidemiol 2024; 31:374-384. [PMID: 37849291 DOI: 10.1080/09286586.2023.2269253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE To describe the epidemiology, incidence, mortality and survival of ocular cancer in Cali between 1962 and 2019. METHODS Ecological population-based study analyzing data of incidence, mortality, and 5-years survival of malignant ocular tumors from the Populational Cancer Registry of Cali between 1962 and 2019. RESULTS Between 1962 and 2019, 586 ocular tumors were found, 50.5% occurred in females, the mean age at diagnosis was 45 years (standard deviation = 25), 70.3% of ocular malignancies occurred in >14 years. The average annual incidence rate was 7.8 per million for male and 6.9 per million for females. Retinoblastoma (21%), squamous cell carcinoma (20%), melanoma (16%) and lymphoma (8%) were the most common neoplasm. In those <15 years, the most frequent malignant tumors were retinoblastomas (85.7%), followed by non-specified malignant neoplasm (NOS, 7.9%), and rhabdomyosarcoma (3.6%). In those >14 years, there were NOS (30%), followed by squamous cell carcinomas (28%), melanomas (23%), and lymphomas (9.7%). Conjunctiva (38.2%), retina (21%) and orbit (10%) constituted the majority of anatomical sites of ocular tumors. The survival rate was about 83.2% and mortality did not show a decreasing trend over time (p > .05). CONCLUSIONS The incidence of ocular cancer in Cali has a slightly increasing trend, with stable behavior in the last decades. Squamous cell carcinoma, retinoblastoma, melanoma and lymphoma are the most frequent ocular cancers, with being retinoblastoma more frequent than melanoma. In general, ocular cancer had good survival rates in Cali.
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Affiliation(s)
- Katherine Vega-Escobar
- Visión y Salud Ocular (VISOC), Ophthalmology Program, Faculty of Health, Universidad del Valle, Hospital Universitario del Valle, Cali, Colombia
| | - Francisco J Bonilla-Escobar
- Visión y Salud Ocular (VISOC), Ophthalmology Program, Faculty of Health, Universidad del Valle, Hospital Universitario del Valle, Cali, Colombia
- Institute for Clinical Research Education; Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia
| | - Omar Salamanca
- Visión y Salud Ocular (VISOC), Ophthalmology Program, Faculty of Health, Universidad del Valle, Hospital Universitario del Valle, Cali, Colombia
- Orbis International, New York, USA
| | - Alexander M Martinez-Blanco
- Visión y Salud Ocular (VISOC), Ophthalmology Program, Faculty of Health, Universidad del Valle, Hospital Universitario del Valle, Cali, Colombia
| | - Luz Stella Garcia
- Registro Poblacional de Cáncer de Cali (RPCC), Department of Pathology, Universidad del Valle, Cali, Colombia
| | - Paola Collazos
- Registro Poblacional de Cáncer de Cali (RPCC), Department of Pathology, Universidad del Valle, Cali, Colombia
| | - Luis Eduardo Bravo
- Registro Poblacional de Cáncer de Cali (RPCC), Department of Pathology, Universidad del Valle, Cali, Colombia
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8
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Wu Y, Jiang Y, Wang W, Zhang T, Li YX, Bi N. Estimating the long-term survival of unresectable stage III non-small cell lung cancer based on cure model analysis. Radiother Oncol 2024; 197:110341. [PMID: 38795813 DOI: 10.1016/j.radonc.2024.110341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/21/2024] [Accepted: 05/10/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND The predictors of long-term survival and appropriate surrogate endpoints in unresectable stage III non-small cell lung cancer (NSCLC) treated with radiotherapy remain unclear, especially in the immune therapy era. METHODS This study retrospectively analyzed a prospective cohort of 822 patients treated at the Chinese National Cancer Center from 2013 to 2022. Cure fractions, surrogates for long-term survival, and associated factors were assessed using a mixture cure model, with validation against a matched Surveillance, Epidemiology, and End Results (SEER) dataset. RESULTS 27.3% of patients with unresectable stage III NSCLC can achieve long-term survival after treated by radiotherapy. 4-year PFS and 5-year OS, when 80% of patients were considered cured, showed significant correlations with cure rates based on background mortality-adjusted PFS and relative survival, with R-squared values exceeding 0.85. Independent predictors of long-term survival included non-squamous cell carcinoma (non-SCC) pathological type, N category, gross tumor volume, and treatment combination with immune checkpoint inhibitors (ICIs). CONCLUSIONS Radiotherapy, especially when combined with ICIs, offers a potential cure for a proportion of patients with unresectable stage III NSCLC. Tumor burden and ICIs are key predictors of long-term survival. The study suggested 4-year PFS and 5-year OS as surrogate endpoints for cure and long-term survival assessment.
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Affiliation(s)
- Yunpeng Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Ying Jiang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Wenqing Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Tao Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Ye-Xiong Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Nan Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
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9
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Ota M, Taniguchi K, Hori M, Katanoda K, Nakata K, Miyashiro I, Matsuda T, Lee S, Ito Y. Trends in patterns of treatment and survival of colorectal cancer patients using cancer registry data in Japan: 1995-2015. Cancer Sci 2024; 115:2786-2794. [PMID: 38715379 PMCID: PMC11309936 DOI: 10.1111/cas.16210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 08/10/2024] Open
Abstract
Recent advances in treating colorectal cancer (CRC) have increased the importance of multidisciplinary treatment. This study aimed to clarify trends in the treatment and survival of CRC using population-based cancer registry data in Japan. We analyzed the survival of CRC cases diagnosed from 1995 through 2015 from a population-based cancer registry of six prefectures. The year of diagnosis was classified into five periods, and the trends in the detailed categorization of treatments and survival were identified. We calculated net survival and excess hazard of death from cancer using data on 256,590 CRC patients. The use of laparoscopic surgery has been increasing since 2005 and accounts for the largest proportion of treatment types in the most recent period. Net survival of CRC patients diagnosed after 2005 remained high for laparoscopic surgery and endoscopic surgery (endoscopic mucosal resection or endoscopic submucosal dissection). There was an upward trend in treatment with chemotherapy in addition to open and laparoscopic surgery. Using the excess hazard ratio at the regional stage since 2005, there has been a significant improvement in survival in the younger age group and the rectum cancer group. By type of treatment, there was a tendency toward significant improvement in the open surgery + chemotherapy group. We clarified the trends in treating CRC and the associated trends in survival. Continuous survey based on population-based data helps monitor the impact of developments in treatment.
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Affiliation(s)
- Masato Ota
- Department of General and Gastroenterological SurgeryOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
- Center for Medical Research & Development, Division of Translational ResearchOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Kohei Taniguchi
- Translational Research ProgramOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Megumi Hori
- School of NursingUniversity of ShizuokaShizuoka CityJapan
| | - Kota Katanoda
- National Cancer Center Institute for Cancer ControlTokyoJapan
| | - Kayo Nakata
- Cancer Control Center, Osaka International Cancer InstituteOsakaJapan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer InstituteOsakaJapan
| | | | - Sang‐Woong Lee
- Department of General and Gastroenterological SurgeryOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Yuri Ito
- Center for Medical Research & Development, Division of Translational ResearchOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
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10
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Jaya-Prakason S, Kong YC, Yip CH, See MH, Taib NA, Abdul Satar NF, Jamaris S, Teoh LY, Ibrahim RI, Bhoo-Pathy N. Trends in Presentation, Management, and Survival of Women With Breast Cancer in a Multiethnic, Middle-Income Asian Setting. JCO Glob Oncol 2024; 10:e2400054. [PMID: 39088780 DOI: 10.1200/go.24.00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/29/2024] [Accepted: 05/28/2024] [Indexed: 08/03/2024] Open
Abstract
PURPOSE Granular data on breast cancer (BC) are pertinent for surveillance, planning, and monitoring of cancer care delivery. We determined the trends in clinical presentation, management, and survival of women with BC in a multiethnic middle-income Asian setting over 15 years. METHODS Data of 7,478 Malaysian women newly diagnosed with invasive BC between 2005 and 2019 from three hospital-based cancer registries were included. Trends in demographic, tumor, and treatment characteristics were compared across period 1 (P1): 2005-2009, period 2 (P2): 2010-2014, and period 3 (P3): 2015-2019. Overall survival and net survival were determined. RESULTS More women in P3 than P1 were older than 60 years at diagnosis. Only a marginal increase in proportion of women with stage I disease was observed (23.7% v 27.2% in P1 and P3, respectively, P = .004). Nonetheless, patients were increasingly presenting with smaller tumors, fewer axillary node involvement, well-differentiated tumors, and hormone receptor expression in recent times. Proportion of women with human epidermal growth factor receptor 2 (HER2)-overexpressed tumors significantly decreased. Among indicated patients, receipt of anticancer therapies was somewhat similar over the calendar periods, except for neoadjuvant chemotherapy and anti-HER2 therapy, where increases in administration were noted. Significant improvements in survival were observed over the 15 years, particularly for HER2-overexpressed BCs. CONCLUSION Although the improvements in BC survival that we have observed validate ongoing cancer control efforts and treatment advances, study findings suggest that more could be done for earlier detection and improved access to effective therapies in our settings.
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Affiliation(s)
- Sharminii Jaya-Prakason
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Yek-Ching Kong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Cheng-Har Yip
- Ramsay Sime Darby Health Care, Jalan SS12, Subang Jaya, Malaysia
| | - Mee-Hoong See
- Breast Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Nur Aishah Taib
- Breast Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Nur Fadhlina Abdul Satar
- Department of Clinical Oncology, University of Malaya Medical Centre, Jalan Professor Diraja Ungku Aziz, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Suniza Jamaris
- Breast Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Li Ying Teoh
- Breast Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Rose Irnawaty Ibrahim
- Actuarial Science and Risk Management, Faculty of Science and Technology, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, Malaysia
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
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11
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Dahm-Kähler P, Rådestad AF, Holmberg E, Borgfeldt C, Bjurberg M, Sköld C, Hellman K, Kjølhede P, Stålberg K, Åvall-Lundqvist E. Has time to chemotherapy from primary debulking surgery in advanced ovarian cancer an impact on survival? - A population-based nationwide SweGCG study. Gynecol Oncol 2024; 186:69-76. [PMID: 38603954 DOI: 10.1016/j.ygyno.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/29/2024] [Accepted: 03/12/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE The aim of the study was to investigate if time to start chemotherapy (TTC) after primary debulking surgery (PDS) impacted relative survival (RS) in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer (EOC). METHODS Nationwide population-based study of women with EOC FIGO stages IIIC-IV, registered 2008-2018 in the Swedish Quality Register for Gynecologic Cancer, treated with PDS and chemotherapy. TTC was categorized into; ≤21 days, 22-28 days, 29-35 days, 36-42 days and > 42 days. Relative survival (RS) was estimated using the Pohar-Perme estimate of net survival. Multivariable analyses of excess mortality rate ratios (EMRRs) were estimated by Poisson regression models. RESULTS In total, 1694 women were included. The median age was 65.0 years. Older age and no residual disease were more common in TTC >42 days than 0-21 days. The RS at 5-years was 37.9% and did not differ between TTC groups. In the R0 (no residual disease) cohort (n = 806), 2-year RS was higher in TTC ≤21 days (91.6%) and 22-28 days (91.4%) than TTC >42 days (79.1%). TTC >42 days (EMRR 2.33, p = 0.026), FIGO stage IV (EMRR 1.83, p = 0.007) and non-serous histology (EMRR 4.20, p < 0.001) were associated with 2-year worse excess mortality compared to TTC 0-21 days, in the R0 cohort. TTC was associated with 2-year survival in the R0 cohort in FIGO stage IV but not in stage IIIC. TTC was not associated with RS in patients with residual disease. CONCLUSIONS For the entire cohort, stage IV, non-serous morphology and residual disease, but not TTC, influenced 5-year relative survival. However, longer TTC was associated with a poorer 2-year survival for those without residual disease after PDS.
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Affiliation(s)
- Pernilla Dahm-Kähler
- Department of Obstetrics and Gynecology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Regional Cancer Center Western Sweden, Gothenburg, Sweden.
| | - Angelique Flöter Rådestad
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institute, and Department of Hereditary Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Holmberg
- Regional Cancer Center Western Sweden, Gothenburg, Sweden
| | - Christer Borgfeldt
- Department of Obstetrics and Gynecology, Skåne University Hospital, and Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Maria Bjurberg
- Department of Hematology, Oncology, and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden
| | - Camilla Sköld
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Kristina Hellman
- Department of Gynecologic Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Preben Kjølhede
- Department of Obstetrics and Gynecology, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Karin Stålberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Elisabeth Åvall-Lundqvist
- Department of Oncology, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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12
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Swartjes H, Sijtsma FPC, Elferink MAG, van Erning FN, Moons LMG, Verheul HMW, Berbée M, Vissers PAJ, de Wilt JHW. Trends in incidence, treatment, and relative survival of colorectal cancer in the Netherlands between 2000 and 2021. Eur J Cancer 2024; 205:114104. [PMID: 38733716 DOI: 10.1016/j.ejca.2024.114104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND The epidemiology of colorectal cancer (CRC) has changed rapidly over the years. The aim of this study was to assess the trends in incidence, treatment, and relative survival (RS) of patients diagnosed with CRC in the Netherlands between 2000 and 2021. PATIENTS AND METHODS 2 75667 patients diagnosed with CRC between 2000 and 2021 were included from the Netherlands Cancer Registry. Analyses were stratified for disease extent (localised: T1-3N0M0; regional: T4N0M0/T1-4N1-2M0; distant: T1-4N0-2M1) and localisation (colon; rectum). Trends were assessed with joinpoint regression. RESULTS CRC incidence increased until the mid-2010s but decreased strongly thereafter to rates comparable with the early 2000s. Amongst other trend changes, local excision rates increased for patients with localised colon (2021: 13.6 %) and rectal cancer (2021: 34.9 %). Moreover, primary tumour resection became less common in patients with distant colon (2000-2021: 60.9-12.5 %) or rectal cancer (2000-2021: 47.8-6.9 %), while local treatment of metastases rates increased. Five-year RS improved continuously for localised and regional colon (97.7 % and 72.0 % in 2017, respectively) and rectal cancer (95.2 % and 76.3 % in 2017, respectively). The rate of anti-cancer treatments decreased in distant colon (2010-2021: 80.3 % to 67.2 %; p < 0.001) and rectal cancer (2011-2021: 86.0 % to 77.0 %; p < 0.001). The improvement of five-year RS stagnated for distant colon (2010-2017: 11.2 % to 11.9 %; average percentage of change [APC]: 2.1, 95 % confidence interval [CI]: -7.6, 4.7) and rectal cancer (2009-2017: 12.7 % to 15.6 %; APC: 1.4, 95 % CI: -19.1, 5.5). CONCLUSIONS Major changes in the incidence and treatment of CRC between 2000 and 2021 were identified and quantified. Five-year RS increased continuously for patients with localised and regional CRC, but stagnated for patients with distant CRC, likely caused by decreased rates of anti-cancer treatment in this group.
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Affiliation(s)
- Hidde Swartjes
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Femke P C Sijtsma
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.
| | - Marloes A G Elferink
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Felice N van Erning
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands; Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | - Leon M G Moons
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Maaike Berbée
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Pauline A J Vissers
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Johannes H W de Wilt
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
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13
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Quaresma M, Rubio FJ, Rachet B. An index of cancer survival to measure progress in cancer control: A tutorial. Cancer Epidemiol 2024; 90:102576. [PMID: 38696968 DOI: 10.1016/j.canep.2024.102576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Cancer survival is a key component to assess the overall effectiveness of healthcare systems in their cancer management efforts. A key supporting tool for planning and decision making was introduced with the development of an index of cancer survival that summarises survival for all adults and cancer types into one single estimate, but the implementation details have not been previously described. METHODS We detail the construction of the index, including the structure, the calculation of 'sex-age-cancer' specific weights and our proposed modelling strategy to estimate net survival. We provide some practical recommendations through an illustration using a synthetic dataset ('Replica') that we generated for this purpose. An example of R code usage to estimate the index using our approach is provided. RESULTS The 'Replica' contains 500 000 artificial cancer records that mimic a cohort of adult cancer patients diagnosed with cancer in England between 1980 and 2004. Using this dataset, we estimated an index of cancer survival at one, five, and ten years after diagnosis for five selected periods of diagnosis, and provide an example of interpretation of these results. DISCUSSION We propose a flexible penalised regression modelling strategy to estimate the index's 'sex-age-cancer' specific cancer survival components that minimises the estimation challenge of these components. This tutorial will support researchers in constructing an index of cancer survival for their own setting, facilitating the enrichment of existing toolkits of cancer indicators to more effectively measure progress against cancer in their respective regions/countries.
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Affiliation(s)
- Manuela Quaresma
- Inequalities in Cancer Outcomes Network (ICON), Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
| | - Francisco Javier Rubio
- Department of Statistical Science, University College London, Gower Street, London WC1E 6BT, UK
| | - Bernard Rachet
- Inequalities in Cancer Outcomes Network (ICON), Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
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14
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Plouvier SD, Marcq G, Vankemmel O, Colin P, Bonnal JL, Leroy X, Saint F, Pasquier D. Practice patterns and survival outcomes for muscle-invasive bladder cancer: real-life experience in a general population setting. Int J Qual Health Care 2024; 36:mzae040. [PMID: 38722033 DOI: 10.1093/intqhc/mzae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/05/2024] [Accepted: 05/02/2024] [Indexed: 05/22/2024] Open
Abstract
Bladder cancer (BC) is a common malignancy in Europe and North America. Among BCs, muscle-invasive BCs (MIBCs) are distinguished, as they require aggressive treatment due to their spreading potential and poor prognosis. Despite its clinical relevance, little information on MIBC in a general population setting is available. This study aims to report practice patterns and survival outcomes for MIBC patients in a general population setting. MIBCs among BC incidence in 2011 and 2012 recorded in a French population-based cancer registry (810 000 inhabitants) were included in the study. Data were extracted from the medical files. Individual, tumour-related characteristics and initial management including diagnostic tools, multidisciplinary team meeting (MDT) assessment, and treatment delivered were described. Cystectomy, chemoradiation, radiotherapy, and chemotherapy were considered as specific treatments. Matching between MDT decision and the treatment provided was detailed. Management practices were discussed according to the guideline's recommendations. Overall survival (using the Kaplan-Meier method) and net survival (using the Pohar-Perme estimator) were calculated. Among 538 incident BC cases, 147 (27.3%) were MIBCs. Diagnostic practices displayed a relevant locoregional assessment of BC. Almost all cases (n = 136, 92.5%) were assessed during an uro-oncological MDT with a median time from diagnosis of 18 days (first quartile:12-third quartile:32). Discrepancies appeared between MDT decisions and treatments delivered: 71 out of 86 subjects received the recommended cystectomy or chemoradiation (with or without neoadjuvant chemotherapy); 6 out of 11 had the recommended radio- or chemotherapy; and 9 patients did not undergo any specific treatment despite the MDT decision. Cystectomy was the most common treatment performed; the time to surgery appeared consistent with the guideline's recommendations. Forty people only received supportive care. Still, the 5-year overall and net survival was poor, with 19% (13-26) and 22% (14-31), respectively. The 5-year net survival was 35% (23-48) for people who underwent curative-intent treatments. MIBC management remains challenging even for cases assessed during an MDT. Many people did not undergo any specific treatment. Prognosis was poor even when curative-intent therapies were delivered. Efforts to reduce exposure to risk factors such as tobacco smoking and occupational exposures must be maintained.
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Affiliation(s)
- Sandrine D Plouvier
- General Cancer Registry of Lille area, C2RC, Bld du Pr Jules Leclercq, Lille 59037, France
| | - Gautier Marcq
- Urology Department, Claude Huriez Hospital, CHU Lille, Rue Michel Polonowski, Lille F-59000, France
- University Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille F-59000, France
| | - Olivier Vankemmel
- Cabinet urologie, Hôpital privé Le Bois, 85 av Marx Dormoy, Lille 59000, France
| | - Pierre Colin
- Service d'Urologie, Hôpital privé La Louvière, rue des Vicaires, Lille 59000, France
| | - Jean-Louis Bonnal
- Service d'Urologie, Groupement des hôpitaux de l'Institut Catholique de Lille, Université nord de France, Rue du Grand But, 59160
| | - Xavier Leroy
- Department of Pathology, CHU Lille, Université de Lille, Bld du Pr Jules Leclercq, Lille 59037, France
| | - Fabien Saint
- Service d'Urologie Transplantation CHU Amiens Picardie, Laboratoire EPROAD EA 4669 UPJV, 1 Rond-Point du Professeur Christian Cabrol, Amiens cedex 01 80054, France
| | - David Pasquier
- Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Combemale, CEDEX Lille F-59020, France
- University Lille & CNRS, Centrale Lille, UMR 9189-CRIStAL, Lille F-59000, France
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15
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Smittenaar R, Quaife SL, von Wagner C, Higgins T, Hubbell E, Lee L. Impact of screening participation on modelled mortality benefits of a multi-cancer early detection test by socioeconomic group in England. J Epidemiol Community Health 2024; 78:345-353. [PMID: 38429085 PMCID: PMC11103338 DOI: 10.1136/jech-2023-220834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/10/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Cancer burden is higher and cancer screening participation is lower among individuals living in more socioeconomically deprived areas of England, contributing to worse health outcomes and shorter life expectancy. Owing to higher multi-cancer early detection (MCED) test sensitivity for poor-prognosis cancers and greater cancer burden in groups experiencing greater deprivation, MCED screening programmes may have greater relative benefits in these groups. We modelled potential differential benefits of MCED screening between deprivation groups in England at different levels of screening participation. METHODS We applied the interception multi-cancer screening model to cancer incidence and survival data made available by the National Cancer Registration and Analysis Service in England to estimate reductions in late-stage diagnoses and cancer mortality from an MCED screening programme by deprivation group across 24 cancer types. We assessed the impact of varying the proportion of people who participated in annual screening in each deprivation group on these estimates. RESULTS The modelled benefits of an MCED screening programme were substantial: reductions in late-stage diagnoses were 160 and 274 per 100 000 persons in the least and most deprived groups, respectively. Reductions in cancer mortality were 60 and 99 per 100 000 persons in the least and most deprived groups, respectively. Benefits were greatest in the most deprived group at every participation level and were attenuated with lower screening participation. CONCLUSIONS For the greatest possible population benefit and to decrease health inequalities, an MCED implementation strategy should focus on enhancing equitable, informed participation, enabling equal participation across all socioeconomic deprivation groups. TRIAL REGISTRATION NUMBER NCT05611632.
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Affiliation(s)
| | | | | | - Thomas Higgins
- National Cancer Registration and Analysis Service, Leeds, UK
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16
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Syriopoulou E, Osterman E, Miething A, Nordenvall C, Andersson TML. Income disparities in loss in life expectancy after colon and rectal cancers: a Swedish register-based study. J Epidemiol Community Health 2024; 78:402-408. [PMID: 38514169 PMCID: PMC11103304 DOI: 10.1136/jech-2024-221916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Differences in the prognosis after colorectal cancer (CRC) by socioeconomic position (SEP) have been reported previously; however, most studies focused on survival differences at a particular time since diagnosis. We quantified the lifetime impact of CRC and its variation by SEP, using individualised income to conceptualise SEP. METHODS Data included all adults with a first-time diagnosis of colon or rectal cancers in Sweden between 2008 and 2021. The analysis was done separately for colon and rectal cancers using flexible parametric models. For each cancer and income group, we estimated the life expectancy in the absence of cancer, the life expectancy in the presence of cancer and the loss in life expectancy (LLE). RESULTS We found large income disparities in life expectancy after a cancer diagnosis, with larger differences among the youngest patients. Higher income resulted in more years lost following a cancer diagnosis. For example, 40-year-old females with colon cancer lost 17.64 years if in the highest-income group and 13.68 years if in the lowest-income group. Rectal cancer resulted in higher LLE compared with colon cancer. Males lost a larger proportion of their lives. All patients, including the oldest, lost more than 30% of their remaining life expectancy. Based on the number of colon and rectal cancer diagnoses in 2021, colon cancer results in almost double the number of years lost compared with rectal cancer (24 669 and 12 105 years, respectively). CONCLUSION While our results should be interpreted in line with what individualised income represents, they highlight the need to address inequalities.
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Affiliation(s)
- Elisavet Syriopoulou
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik Osterman
- Department of Surgery, Gävle Hospital, Gävle, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Miething
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Caroline Nordenvall
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Pelvic Cancer, Colorectal Surgery Unit, Karolinska University Hospital, Stockholm, Sweden
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17
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Lundberg FE, Birgisson H, Engholm G, Ólafsdóttir EJ, Mørch LS, Johannesen TB, Pettersson D, Lambe M, Seppä K, Lambert PC, Johansson ALV, Hölmich LR, Andersson TML. Survival trends for patients diagnosed with cutaneous malignant melanoma in the Nordic countries 1990-2016: The NORDCAN survival studies. Eur J Cancer 2024; 202:113980. [PMID: 38452724 DOI: 10.1016/j.ejca.2024.113980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/09/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND The survival in patients diagnosed with cutaneous malignant melanoma (CMM) has improved in the Nordic countries in the last decades. It is of interest to know if these improvements are observed in all ages and for both women and men. METHODS Patients diagnosed with CMM in the Nordic countries in 1990-2016 were identified in the NORDCAN database. Flexible parametric relative survival models were fitted, except for Iceland where a non-parametric Pohar-Perme approach was used. A range of survival metrics were estimated by sex, both age-standardised and age-specific. RESULTS The 5-year relative survival improved in all countries, in both women and men and across age. While the improvement was more pronounced in men, women still had a higher survival at the end of the study period. The survival was generally high, with age-standardised estimates of 5-year relative survival towards the end of the study period ranging from 85% in Icelandic men to 95% in Danish women. The age-standardised and reference-adjusted 5-year crude probability of death due to CMM ranged from 5% in Danish and Swedish women to 13% in Icelandic men. CONCLUSION Although survival following CMM was relatively high in the Nordic countries in 1990, continued improvements in survival were observed throughout the study period in both women and men and across age.
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Affiliation(s)
- Frida E Lundberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Sweden
| | | | | | | | | | | | - David Pettersson
- Swedish Cancer Registry, National Board of Health and Welfare, Sweden
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Karri Seppä
- Finnish Cancer Registry, Finland; Faculty of Social Sciences, Tampere University, Finland
| | - Paul C Lambert
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; Biostatistics Research Group, Department of Health Sciences, University of Leicester, UK
| | - Anna L V Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; Cancer Registry of Norway, the Norwegian Institute of Public Health, Norway
| | | | - Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
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18
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Lammers SWM, Meegdes M, Vriens IJH, Voogd AC, de Munck L, van Nijnatten TJA, Keymeulen KBMI, Tjan-Heijnen VCG, Geurts SME. Treatment and survival of patients diagnosed with high-risk HR+/HER2- breast cancer in the Netherlands: a population-based retrospective cohort study. ESMO Open 2024; 9:103008. [PMID: 38677006 PMCID: PMC11067336 DOI: 10.1016/j.esmoop.2024.103008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/21/2024] [Accepted: 03/03/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Several factors may increase the risk of recurrence of patients diagnosed with hormone receptor-positive human epidermal growth factor receptor 2-negative (HR+/HER2-) breast cancer (BC). We aim to determine the proportion of patients with high-risk HR+/HER2- BC within the total HR+/HER2- BC cohort and compare their systemic treatments and survival rates with those of patients with low- and intermediate-risk HR+/HER2- BC and triple-negative (TN) BC. PATIENTS AND METHODS Women diagnosed with nonmetastatic invasive HR+/HER2- BC and TNBC in the Netherlands between 2011 and 2019 were identified from the Netherlands Cancer Registry. Patients with HR+/HER2- BC were categorised according to risk profile, defined by nodal status, tumour size, and histological grade. High-risk HR+/HER2- BC was defined by either four or more positive lymph nodes or one to three positive lymph nodes with a tumour size of ≥5 cm or a histological grade 3 tumour. Overall survival (OS) and relative survival (RS) were calculated using the Kaplan-Meier and Pohar-Perme method. RESULTS In this study of 87 455 patients with HR+/HER2- BC, 44 078 (50%) patients were diagnosed with low risk, 28 452 (33%) with intermediate risk, and 11 285 (13%) with high-risk HR+/HER2- BC. In 3640 (4%) patients, the risk profile could not be defined. Endocrine therapy and chemotherapy were used in 38% and 7% of low-risk, 90% and 47% of intermediate-risk, and 94% and 73% of high-risk patients, respectively. The 10-year OS and RS rates were 84.1% [95% confidence interval (95% CI) 83.5% to 84.7%] and 98.7% (95% CI 97.3% to 99.4%) in low-risk, 75.1% (95% CI 74.2% to 76.0%) and 91.7% (95% CI 89.7% to 93.3%) in intermediate-risk, and 63.4% (95% CI 62.0% to 64.7%) and 72.3% (70.1% to 74.3%) in high-risk patients. The 10-year OS and RS rates of 12 689 patients with TNBC were 69.7% (95% CI 68.6% to 70.8%) and 79.1% (95% CI 77.0% to 80.9%), respectively. CONCLUSION The poor prognosis of patients with high-risk HR+/HER2- BC highlights the need for a better acknowledgement of this subgroup and supports ongoing clinical trials aimed at optimising systemic therapy.
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Affiliation(s)
- S W M Lammers
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht.
| | - M Meegdes
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht
| | - I J H Vriens
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht
| | - A C Voogd
- Department of Epidemiology, Maastricht University, Maastricht
| | - L de Munck
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht
| | - T J A van Nijnatten
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, GROW, Maastricht
| | - K B M I Keymeulen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - V C G Tjan-Heijnen
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht
| | - S M E Geurts
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht.
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19
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Ho VKY, Deijen CL, Hemmes B, van Erning FN, Snaebjornsson P, van Triest B, Grotenhuis BA. Trends in epidemiology and primary treatment of anal squamous cell carcinoma in the Netherlands (1990-2021). Int J Cancer 2024; 154:1569-1578. [PMID: 38151810 DOI: 10.1002/ijc.34811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 12/29/2023]
Abstract
A rapid increase in the incidence of anal squamous cell carcinoma (SCC) was reported in several countries over the past decades. This study assessed trends in epidemiology and primary treatment over a 32-year period (1990-2021) using the Netherlands Cancer Registry. The study population included 4273 patients, 44.2% male and 55.8% female (median age 63 years). The age-standardised incidence rate (European Standardised Rate, ESR) increased from 0.5 to 1.6 per 100,000, which entailed an average annual percentage change (AAPC) of 5.0% (95% confidence interval [CI]: 4.5%-5.8%). While incidence among females increased continuously over the total period (AAPC 4.9%; 95%CI: 4.4%-5.6%), to 1.8 per 100,000 ESR in 2021, incidence among males increased until 2016 (annual percentage change [APC] of 6.3%; 95%CI: 5.6%-10.7%), after which it seemed to stabilise (APC -2.1%; 95%CI: -16.8%-4.5%). Significant trends were also observed in distribution of age, tumour stage and primary treatment modalities. Five-year relative survival (RS) was estimated using the Pohar-Perme estimator, and this improved from 56.1% in 1990-1997 (95%CI: 49.3%-62.4%) to 67.9% in 2014-2021 (95%CI: 64.7%-70.9%), but remained poor for stage IV disease. Evaluation through a multivariable Poisson regression model demonstrated diagnosis in the most recent period to be independently associated with better RS, in addition to female sex, younger age, early disease stage and any treatment. In conclusion, the rising incidence of anal SCC seems to decline in males, but not in females, and advances in diagnostics and therapeutic management have likely contributed to improved prognosis.
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Affiliation(s)
- Vincent K Y Ho
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Charlotte L Deijen
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Birgit Hemmes
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Felice N van Erning
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Petur Snaebjornsson
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Baukelien van Triest
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Brechtje A Grotenhuis
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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20
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Johansson ALV, Kønig SM, Larønningen S, Engholm G, Kroman N, Seppä K, Malila N, Steig BÁ, Gudmundsdóttir EM, Ólafsdóttir EJ, Lundberg FE, Andersson TML, Lambert PC, Lambe M, Pettersson D, Aagnes B, Friis S, Storm H. Have the recent advancements in cancer therapy and survival benefitted patients of all age groups across the Nordic countries? NORDCAN survival analyses 2002-2021. Acta Oncol 2024; 63:179-191. [PMID: 38597666 PMCID: PMC11332520 DOI: 10.2340/1651-226x.2024.35094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Since the early 2000s, overall and site-specific cancer survival have improved substantially in the Nordic countries. We evaluated whether the improvements have been similar across countries, major cancer types, and age groups. MATERIAL AND METHODS Using population-based data from the five Nordic cancer registries recorded in the NORDCAN database, we included a cohort of 1,525,854 men and 1,378,470 women diagnosed with cancer (except non-melanoma skin cancer) during 2002-2021, and followed for death until 2021. We estimated 5-year relative survival (RS) in 5-year calendar periods, and percentage points (pp) differences in 5-year RS from 2002-2006 until 2017-2021. Separate analyses were performed for eight cancer sites (i.e. colorectum, pancreas, lung, breast, cervix uteri, kidney, prostate, and melanoma of skin). RESULTS Five-year RS improved across nearly all cancer sites in all countries (except Iceland), with absolute differences across age groups ranging from 1 to 21 pp (all cancer sites), 2 to 20 pp (colorectum), -1 to 36 pp (pancreas), 2 to 28 pp (lung), 0 to 9 pp (breast), -11 to 26 pp (cervix uteri), 2 to 44 pp (kidney), -2 to 23 pp (prostate) and -3 to 30 pp (skin melanoma). The oldest patients (80-89 years) exhibited lower survival across all countries and sites, although with varying improvements over time. INTERPRETATION Nordic cancer patients have generally experienced substantial improvements in cancer survival during the last two decades, including major cancer sites and age groups. Although survival has improved over time, older patients remain at a lower cancer survival compared to younger patients.
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Affiliation(s)
- Anna L V Johansson
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Simon M Kønig
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Siri Larønningen
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Gerda Engholm
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Niels Kroman
- Department Breast Surgery, Copenhagen University Hospital (Herlev/Gentofte), Copenhagen, Denmark
| | - Karri Seppä
- Finnish Cancer Registry, Helsinki, Finland; Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland
| | - Bjarni Á Steig
- National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | | | | | - Frida E Lundberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul C Lambert
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Biostatistics Research Group, Department of Health Sciences, University of Leicester, UK
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Regional Cancer Center Mid-Sweden, Uppsala, Sweden
| | - David Pettersson
- Swedish Cancer Registry, National Board of Health and Welfare, Stockholm, Sweden
| | - Bjarte Aagnes
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Søren Friis
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Hans Storm
- Danish Cancer Society, Copenhagen, Denmark
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21
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Amaral AVR, Rubio FJ, Quaresma M, Rodríguez-Cortés FJ, Moraga P. Extended excess hazard models for spatially dependent survival data. Stat Methods Med Res 2024; 33:681-701. [PMID: 38444377 DOI: 10.1177/09622802241233767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Relative survival represents the preferred framework for the analysis of population cancer survival data. The aim is to model the survival probability associated with cancer in the absence of information about the cause of death. Recent data linkage developments have allowed for incorporating the place of residence into the population cancer databases; however, modeling this spatial information has received little attention in the relative survival setting. We propose a flexible parametric class of spatial excess hazard models (along with inference tools), named "Relative Survival Spatial General Hazard," that allows for the inclusion of fixed and spatial effects in both time-level and hazard-level components. We illustrate the performance of the proposed model using an extensive simulation study, and provide guidelines about the interplay of sample size, censoring, and model misspecification. We present a case study using real data from colon cancer patients in England. This case study illustrates how a spatial model can be used to identify geographical areas with low cancer survival, as well as how to summarize such a model through marginal survival quantities and spatial effects.
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Affiliation(s)
- André Victor Ribeiro Amaral
- CEMSE Division, Department of Statistics, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | | | - Manuela Quaresma
- Faculty of Epidemiology and Population Health, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Paula Moraga
- CEMSE Division, Department of Statistics, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
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22
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Skaga E, Trewin-Nybråten CB, Niehusmann P, Johannesen TB, Marienhagen K, Oltedal L, Schipman S, Skjulsvik AJ, Solheim O, Solheim TS, Sundstrøm T, Vik-Mo EO, Petter Brandal, Ingebrigtsen T. Stable glioma incidence and increased patient survival over the past two decades in Norway: a nationwide registry-based cohort study. Acta Oncol 2024; 63:83-94. [PMID: 38501768 PMCID: PMC11332456 DOI: 10.2340/1651-226x.2024.24970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/08/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Surveillance of incidence and survival of central nervous system tumors is essential to monitor disease burden and epidemiological changes, and to allocate health care resources. Here, we describe glioma incidence and survival trends by histopathology group, age, and sex in the Norwegian population. MATERIAL AND METHODS We included patients with a histologically verified glioma reported to the Cancer Registry of Norway from 2002 to 2021 (N = 7,048). Population size and expected mortality were obtained from Statistics Norway. Cases were followed from diagnosis until death, emigration, or 31 December 2022, whichever came first. We calculated age-standardized incidence rates (ASIR) per 100,000 person-years and age-standardized relative survival (RS). Results: The ASIR for histologically verified gliomas was 7.4 (95% CI: 7.3-7.6) and was higher for males (8.8; 95% CI: 8.5-9.1) than females (6.1; 95% CI: 5.9-6.4). Overall incidence was stable over time. Glioblastoma was the most frequent tumor entity (ASIR = 4.2; 95% CI: 4.1-4.4). Overall, glioma patients had a 1-year RS of 63.6% (95% CI: 62.5-64.8%), and a 5-year RS of 32.8% (95% CI: 31.6-33.9%). Females had slightly better survival than males. For most entities, 1- and 5-year RS improved over time (5-year RS for all gliomas 29.0% (2006) and 33.1% (2021), p < 0.001). Across all tumor types, the RS declined with increasing age at diagnosis. INTERPRETATION The incidence of gliomas has been stable while patient survival has increased over the past 20 years in Norway. As gliomas represent a heterogeneous group of primary CNS tumors, regular reporting from cancer registries at the histopathology group level is important to monitor disease burden and allocate health care resources in a population.
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Affiliation(s)
- Erlend Skaga
- Vilhelm Magnus Laboratory for Neurosurgical Research and Department of Neurosurgery, Oslo University Hospital, Oslo, Norway; Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA.
| | - Cassia B Trewin-Nybråten
- Department of Registration, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Pitt Niehusmann
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Tom Børge Johannesen
- Department of Registration, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Leif Oltedal
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Stephanie Schipman
- Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway; Medical Faculty, University Hospital Muenster, Germany
| | - Anne Jarstein Skjulsvik
- Department of Pathology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ole Solheim
- Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tora Skeidsvoll Solheim
- Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Terje Sundstrøm
- Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Einar O Vik-Mo
- Vilhelm Magnus Laboratory for Neurosurgical Research and Department of Neurosurgery, Oslo University Hospital, Oslo, Norway; Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Petter Brandal
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway; Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
| | - Tor Ingebrigtsen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Neurosurgery, Otorhinolaryngology and Ophthalmology, University Hospital of North Norway, Tromsø, Norway
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23
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Nilssen Y, Brustugun OT, Fjellbirkeland L, Helland Å, Møller B, Wahl SGF, Solberg S. Distribution and characteristics of malignant tumours by lung lobe. BMC Pulm Med 2024; 24:106. [PMID: 38439038 PMCID: PMC10910834 DOI: 10.1186/s12890-024-02918-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The main focus on the characteristics of malignant lung tumours has been the size, position within the lobe, and infiltration into neighbouring structures. The aim of this study was to investigate the distribution and characteristics of malignant tumours between the lung lobes and whether the diagnosis, treatment, and outcome differed based on location. METHODS This study is based on 10,849 lung cancer patients diagnosed in 2018-2022 with complete data on the location and characteristics of the tumours. The proportions of tumours in each lobe divided by its volume were termed the relative proportion. RESULTS The right upper lobe comprised 31.2% of the tumours and 17.6% of the lung volume. The relative proportion of 1.77 was higher than in the other lobes (p < 0.001). The right middle lobe had a relative proportion of 0.64 but the highest proportion of neuroendocrine tumours (26.1% vs. 15.3 on average). Surgical resection was more often performed in patients with tumours in the lower lobes, and curative radiotherapy was more often performed in the upper lobes. After adjusting for age, sex, stage, and histology, the location of the tumour was found to be a significant independent predictor for resection but not for survival. CONCLUSION The main finding of the right upper lobe as a site of predilection for lung cancer is similar to tuberculosis and pneumoconiosis. This may be explained that most of the inhaled air, containing bacilli, inorganic particles or tobacco smoke goes to the upper and right parts of the lung.
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Affiliation(s)
- Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, Box 5313 Majorstuen, Oslo, 0304, Norway
| | - Odd Terje Brustugun
- Section of Oncology, Vestre Viken Hospital Trust, Drammen, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars Fjellbirkeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Åslaug Helland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Bjørn Møller
- Department of Registration, Cancer Registry of Norway, Box 5313 Majorstuen, Oslo, 0304, Norway
| | - Sissel Gyrid Freim Wahl
- Department of Pathology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Steinar Solberg
- Department of Registration, Cancer Registry of Norway, Box 5313 Majorstuen, Oslo, 0304, Norway.
- Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
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Zhong Q, Liu Y, Wu Y, Liu X, Chen S, Chen B, Su F, Li G, Xu Y, Liu L, Chen F, Qi S, Li Y. Impact of age on long-term relative survival benefit of radiotherapy for early-stage grade I-II follicular lymphoma from the SEER database (2000-2015). Leuk Lymphoma 2024; 65:312-322. [PMID: 37987687 DOI: 10.1080/10428194.2023.2283296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/07/2023] [Indexed: 11/22/2023]
Abstract
The aim of this study was to investigate the effect of age on long-term mortality and net survival benefit of radiotherapy (RT) for early-stage grade I-II FL. Five thousand three hundred and five patients with early-stage grade I-II FL in the SEER database (2000-2015) were identified. Primary therapy included RT alone (RT, 20.7%), chemotherapy alone (CT, 27.6%), combined modality therapy (CMT, 5.9%), and observation (45.8%). Inverse probability of treatment weighting (IPTW) was conducted to balance the treatment arms. Relative survival (RS), the standardized mortality ratio (SMR), and transformed Cox regression were used to compare survival differences between treatments. RT with or without CT had significantly higher 10-year OS (approximately 78%) and RS (>95%), but lower SMR (1.47-1.76), compared with CT (67.8%; 86.3%; 2.35; ps < .001), observation (70.2%; 91.2%; 1.82; ps < .05). RT was an independent predictor of better OS and RS in multivariate analyses (p < .001). No significant interaction between age and RT was identified for RS (Pinteraction = .509) or OS (Pinteraction = .769), indicating similar survival benefits across all-ages patients. RT was associated with long-term OS and net survival benefits in patients with early-stage grade I-II FL, irrespective of age.HighlightsThe pattern and incidence of mortality varied by age-group as elderly patients often die of other diseases other than FL beyond 5 years.Radiotherapy was associated with higher long-term OS/RS and better SMR compared with other approaches, regardless of age.
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Affiliation(s)
- Qiuzi Zhong
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Ye Liu
- Peking University Fifth School of Clinical Medicine, Beijing, PR China
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, PR China
| | - Yunpeng Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, PR China
| | - Xin Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, PR China
| | - Siye Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, PR China
| | - Bo Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, PR China
| | - Fei Su
- Institute of Geriatric Medicine, Clinical Biobank, Beijing Hospital, National Center of Gerontology, National Health Commission, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Gaofeng Li
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Yonggang Xu
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Lipin Liu
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Fan Chen
- Affiliated Hospital of Qinghai University, Qinghai, PR China
| | - Shunan Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, PR China
| | - Yexiong Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, PR China
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Afshar N, Dashti SG, Mar V, Te Marvelde L, Evans S, Milne RL, English DR. Do age at diagnosis, tumour thickness and tumour site explain sex differences in melanoma survival? A causal mediation analysis using cancer registry data. Int J Cancer 2024; 154:793-800. [PMID: 37823184 DOI: 10.1002/ijc.34752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023]
Abstract
Women diagnosed with melanoma have better survival than men, but little is known about potential intervention targets to reduce this survival gap by sex. We conducted a population-based study using Victorian Cancer Registry data including 5833 women and 6780 men aged 15 to 70 years when diagnosed with first primary melanoma between 2007 and 2015. Deaths to the end of 2020 were identified through linkage to the Victorian and national death registries. We estimated the effect of age at diagnosis, tumour thickness and tumour site on reducing the melanoma-specific survival gap by sex (ie, interventional indirect effects [IIEs]) on risk difference (RD) scale. Compared to women, there were 211 (95% CI: 145-278) additional deaths per 10 000 in men within 5 years following diagnosis. We estimated that 44% of this gap would be reduced by a hypothetical intervention shifting the distribution of melanoma thickness in men to be the same as that observed for women (IIEthickness RD 93 [95% CI: 75-118] per 10 000) and 20% by an intervention on tumour site (head and neck/trunk vs upper limb/lower limb; IIEsite RD 42 [95% CI: 15-72] per 10 000), while an intervention on age at diagnosis would have a negligible effect. Tumour thickness, tumour site and age at diagnosis mediated 65% of the effect of sex on 5-year melanoma survival in Victoria. Of these factors, tumour thickness had the most considerable mediating effect, suggesting that effective promotion of earlier detection of melanoma in men could potentially nearly halve the gap in melanoma-specific survival by sex.
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Affiliation(s)
- Nina Afshar
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - S Ghazaleh Dashti
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Clinical Epidemiology and Biostatistics Unit, Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Victoria Mar
- Victorian Melanoma Service, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Luc Te Marvelde
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sue Evans
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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26
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Dantony E, Uhry Z, Fauvernier M, Coureau G, Mounier M, Trétarre B, Molinié F, Roche L, Remontet L. Multidimensional penalized splines for survival models: illustration for net survival trend analyses. Int J Epidemiol 2024; 53:dyae033. [PMID: 38499394 DOI: 10.1093/ije/dyae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND In descriptive epidemiology, there are strong similarities between incidence and survival analyses. Because of the success of multidimensional penalized splines (MPSs) in incidence analysis, we propose in this pedagogical paper to show that MPSs are also very suitable for survival or net survival studies. METHODS The use of MPSs is illustrated in cancer epidemiology in the context of survival trends studies that require specific statistical modelling. We focus on two examples (cervical and colon cancers) using survival data from the French cancer registries (cases 1990-2015). The dynamic of the excess mortality hazard according to time since diagnosis was modelled using an MPS of time since diagnosis, age at diagnosis and year of diagnosis. Multidimensional splines bring the flexibility necessary to capture any trend patterns while penalization ensures selecting only the complexities necessary to describe the data. RESULTS For cervical cancer, the dynamic of the excess mortality hazard changed with the year of diagnosis in opposite ways according to age: this led to a net survival that improved in young women and worsened in older women. For colon cancer, regardless of age, excess mortality decreases with the year of diagnosis but this only concerns mortality at the start of follow-up. CONCLUSIONS MPSs make it possible to describe the dynamic of the mortality hazard and how this dynamic changes with the year of diagnosis, or more generally with any covariates of interest: this gives essential epidemiological insights for interpreting results. We use the R package survPen to do this type of analysis.
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Affiliation(s)
- Emmanuelle Dantony
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Zoé Uhry
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Direction des Maladies Non Transmissibles et des Traumatismes, Santé Publique France, Saint-Maurice, France
| | - Mathieu Fauvernier
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Gaëlle Coureau
- French Network of Cancer Registries (Francim), Toulouse, France
- Gironde General Cancer Registry, Univ Bordeaux, Bordeaux, France
- Service d'information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Morgane Mounier
- French Network of Cancer Registries (Francim), Toulouse, France
- Registre des Hémopathies Malignes de la Côte-d'Or, CHU de Dijon Bourgogne, Dijon, France
- UMR INSERM 1231, Université Bourgogne Franche-Comté, Dijon, France
| | - Brigitte Trétarre
- French Network of Cancer Registries (Francim), Toulouse, France
- Hérault Cancer Registry, Montpellier, France
- CERPOP, UMR 1295, Université de Toulouse III, Toulouse, France
| | - Florence Molinié
- French Network of Cancer Registries (Francim), Toulouse, France
- CERPOP, UMR 1295, Université de Toulouse III, Toulouse, France
- Loire-Atlantique/Vendée Cancer Registry, SIRIC-ILIAD, Nantes, France
| | - Laurent Roche
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Laurent Remontet
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
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27
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Lamb M, Painter D, Howell D, Barrans S, Cargo C, de Tute R, Tooze R, Burton C, Patmore R, Roman E, Smith A. Lymphoid blood cancers, incidence and survival 2005-2023: A report from the UK's Haematological Malignancy Research Network. Cancer Epidemiol 2024; 88:102513. [PMID: 38160571 DOI: 10.1016/j.canep.2023.102513] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Population-based information on cancer incidence and outcome are required to inform clinical practice and research; but contemporary data are lacking for many lymphoid cancer subtypes. METHODS Set within a socio-demographically representative UK population of ∼4 million, data are from an established UK patient cohort (N = 22,414 diagnoses). Information on incidence (crude and age-standardised) and survival (overall and net) is presented for > 40 subtypes. RESULTS The median diagnostic age was 69.9 years (interquartile range 59.1-78.3), but unlike many other cancers, lymphoid malignancies can be diagnosed at any age; different subtypes dominating at different ages. Males were more likely to be diagnosed than females (age-standardised sex rate ratio: 1.55 (95% Confidence Interval: 1.50,1.59)), and most subtypes had a male predominance, some more than three-fold (e.g. Burkitt lymphoma 3.26 (2.42, 4.40)). Five-year net survival estimates varied hugely, ranging from 97.4% (95% CI: 56.5, 99.9) in patients with hairy cell leukaemia to 31.6% (95% CI: 2.5, 69.8) in those with T-cell prolymphocytic leukaemia. No significant sex difference in survival were observed for the majority of diagnoses; one exception being classical Hodgkin lymphoma, where males had a higher mortality (Excess Mortality Ratio: 1.44 (95% CI: 1.11, 1.87)). An improvement in survival over time was observed for some, but not all, of the major diagnostic groups. CONCLUSIONS Marked incidence and survival variations by subtype, sex and age confirm the heterogeneity of lymphoid neoplasms and highlight the importance of accurately characterising disease entities. Despite recent improvements, routine cancer registration of lymphoid neoplasms remains challenging and new issues continue to emerge; including the lack of an international consensus on classification and the recording of progressions and transformations. Furthermore, the increasing need for additional molecular and genomic information required for accurate classification is likely to impact negatively on the quality of cancer registration data, especially in low income countries.
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Affiliation(s)
- Maxine Lamb
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Daniel Painter
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Debra Howell
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Catherine Cargo
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Ruth de Tute
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Reuben Tooze
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Cathy Burton
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Russell Patmore
- Queen's Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, United Kingdom
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Alexandra Smith
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom.
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28
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Tsuge H, Kawakita D, Taniyama Y, Oze I, Koyanagi YN, Hori M, Nakata K, Sugiyama H, Miyashiro I, Oki I, Nishino Y, Katanoda K, Ito Y, Shibata A, Matsuda T, Iwasaki S, Matsuo K, Ito H. Subsite-specific trends in mid- and long-term survival for head and neck cancer patients in Japan: A population-based study. Cancer Sci 2024; 115:623-634. [PMID: 37994633 PMCID: PMC10859624 DOI: 10.1111/cas.16028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/24/2023] Open
Abstract
Advances in diagnostic techniques and treatment modalities have impacted head and neck cancer (HNC) prognosis, but their effects on subsite-specific prognosis remain unclear. This study aimed to assess subsite-specific trends in mid- and long-term survival for HNC patients diagnosed from 1993 to 2011 using data from population-based cancer registries in Japan. We estimated the net survival (NS) for HNC by subsite using data from 13 prefectural population-based cancer registries in Japan. Changes in survival over time were assessed by multivariate excess hazard model of mortality. In total, 68,312 HNC patients were included in this analysis. We observed an overall improvement in 5-year NS for HNC patients in Japan. However, survival varied among subsites of HNC, with some, such as naso-, oro- and hypopharyngeal cancers, showing significant improvement in both 5- and 10-year NS, whereas others such as laryngeal cancer showed only a slight improvement in 5-year NS and no significant change in 10-year NS after adjustment for age, sex and stage. In conclusion, the study provides insights into changing HNC survival by site at the population level in Japan. Although advances in diagnostic techniques and treatment modalities have improved survival, these improvements are not shared equally among subsites.
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Affiliation(s)
- Hiroshi Tsuge
- Division of Cancer Information and Control, Department of Preventive MedicineAichi Cancer Center Research InstituteNagoyaJapan
- Department of Otorhinolaryngology, Head and Neck SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Yukari Taniyama
- Division of Cancer Information and Control, Department of Preventive MedicineAichi Cancer Center Research InstituteNagoyaJapan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Department of Preventive MedicineAichi Cancer Center Research InstituteNagoyaJapan
| | - Yuriko N. Koyanagi
- Division of Cancer Epidemiology and Prevention, Department of Preventive MedicineAichi Cancer Center Research InstituteNagoyaJapan
| | - Megumi Hori
- School of NursingUniversity of ShizuokaShizuokaJapan
| | - Kayo Nakata
- Cancer Control CenterOsaka International Cancer InstituteOsakaJapan
| | - Hiromi Sugiyama
- Department of EpidemiologyRadiation Effects Research FoundationHiroshimaJapan
| | - Isao Miyashiro
- Cancer Control CenterOsaka International Cancer InstituteOsakaJapan
| | - Izumi Oki
- Department of Health Sciences, School of Health and Social ServicesSaitama Prefectural UniversitySaitamaJapan
| | - Yoshikazu Nishino
- Department of Epidemiology and Public HealthKanazawa Medical UniversityIshikawaJapan
| | - Kota Katanoda
- Division of Population Data ScienceNational Cancer Center Institute for Cancer ControlTokyoJapan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development CenterOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Akiko Shibata
- Department of Radiology, Division of Diagnostic RadiologyYamagata University Faculty of MedicineYamagataJapan
| | - Tomohiro Matsuda
- Division of International Collaborative ResearchCenter for Public Health Sciences, National Cancer CenterTokyoJapan
| | - Shinichi Iwasaki
- Department of Otorhinolaryngology, Head and Neck SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Department of Preventive MedicineAichi Cancer Center Research InstituteNagoyaJapan
- Department of Cancer EpidemiologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive MedicineAichi Cancer Center Research InstituteNagoyaJapan
- Division of Descriptive Cancer EpidemiologyNagoya University Graduate School of MedicineNagoyaJapan
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29
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Al-Rammahy A, Fadum EA, Nilssen Y, Larsen IK, Hem E, Bringedal BH. Educational disparities in cancer incidence, stage, and survival in Oslo. RESEARCH IN HEALTH SERVICES & REGIONS 2024; 3:1. [PMID: 39177868 PMCID: PMC11281764 DOI: 10.1007/s43999-024-00037-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/03/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVES This study aimed to examine disparities in cancer incidence, stage at diagnosis, and survival rates across districts with differences in education levels in Oslo, Norway. METHODS Aggregated data from the Cancer Registry of Norway in the period 2013-2021 were used to describe the distribution of cancer incidence and survival across Oslo's 15 administrative districts, subsequently grouped into three areas based on the population's level of education. Age-standardised incidence rates and five-year relative survival were calculated for colon, rectal, lung, melanoma, breast, and prostate cancer. The stage at the time of diagnosis was categorised as localised, regional, distant, and unknown for all cancer types except breast cancer, which was categorised into stage I-IV and unknown. RESULTS Mid- and high-education areas had higher incidences of breast, melanoma, and prostate cancer, while the low-education area had higher incidence rates for lung cancer. The low-education area had a higher proportion diagnosed at a distant stage than the other groups for all cancer types studied, except breast cancer. The mid- and high-education areas had higher five-year relative survival rates overall. CONCLUSIONS Incidence, stage at diagnosis, and survival varied between education areas. The variation indicates disparities in healthcare access, quality of care, and health behaviours. Addressing these disparities can help improve overall health outcomes and promote health equity.
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Affiliation(s)
- Afaf Al-Rammahy
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
- Institute for Studies of the Medical Profession, PO Box 1152, NO-0107, Sentrum, Oslo, Norway.
| | - Elin Anita Fadum
- Institute for Studies of the Medical Profession, PO Box 1152, NO-0107, Sentrum, Oslo, Norway
- The Norwegian Armed Forces Joint Medical Services, Institute for Military Epidemiology, Sessvollmoen, Norway
| | - Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | | | - Erlend Hem
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Institute for Studies of the Medical Profession, PO Box 1152, NO-0107, Sentrum, Oslo, Norway
| | - Berit Horn Bringedal
- Institute for Studies of the Medical Profession, PO Box 1152, NO-0107, Sentrum, Oslo, Norway
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30
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Schuurman MS, Lemmens VEPP, Portielje JEA, van der Aa MA, Visser O, Dinmohamed AG. The cancer burden in the oldest-old: Increasing numbers and disparities-A nationwide study in the Netherlands, 1990 to 2019. Int J Cancer 2024; 154:261-272. [PMID: 37664984 DOI: 10.1002/ijc.34705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 09/05/2023]
Abstract
Adults aged ≥80 years (the oldest-old) comprise the fastest growing age group in Western populations. Yet little is known about their cancer burden. In this nationwide study, we assessed their trends in incidence, treatment and survival over a 30-year period, and predicted their future cancer incidence. All 2 468 695 incident cancer cases during 1990 to 2019 were selected from the Netherlands Cancer Registry, of whom 386 611 were diagnosed in the oldest-old (16%). The incidence of the oldest-old was predicted until 2032. Net and overall survival (OS) were calculated. Patients were divided into four age groups (<80, 80-84, 85-89 and ≥90 years). The incidence of the oldest-old doubled between 1990 and 2019 and is expected to grow annually with 5% up to 2032. In virtually all cancers the share of oldest-old patients grew, but declined for prostate cancer (25% in 1990-1994 vs 13% in 2015-2019). The proportion of undetermined disease stage increased with age in most cancers. The application of systemic therapy increased, albeit less pronounced in the oldest-old than their younger counterparts (1990 vs 2019: 12%-34%, 3%-15%, 2%-7% and 1%-3% in <80, 80-84, 85-89 and ≥90 years old). Five-year OS of the oldest-old patients increased by 7 percentage points (to 26%) between 1990 to 1994 and 2015 to 2019 compared to 19 percentage points (to 63%) in <80 years old. The oldest-old cancer patients are a rapidly growing group who benefitted less from improvements in cancer treatment than younger patients, reflecting the multiple challenges faced in the care of the oldest-old.
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Affiliation(s)
- Melinda S Schuurman
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Valery E P P Lemmens
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Maaike A van der Aa
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Otto Visser
- Department of Registration, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Avinash G Dinmohamed
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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31
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Bi J, Tuo J, Xiao Y, Tang D, Zhou X, Jiang Y, Ji X, Tan Y, Yuan H, Xiang Y. Observed and relative survival trends of lung cancer: A systematic review of population-based cancer registration data. Thorac Cancer 2024; 15:142-151. [PMID: 37986711 PMCID: PMC10788469 DOI: 10.1111/1759-7714.15170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Using the published survival statistics from cancer registration or population-based studies, we aimed to describe the global pattern and trend of lung cancer survival. METHODS By searching SinoMed, PubMed, Web of Science, EMBASE, and SEER, all survival analyses from cancer registration or population-based studies of lung cancer were collected by the end of November 2022. The survival rates were extracted by sex, period, and country. The observed, relative, and net survival rates of lung cancer were applied to describe the pattern and time changes from the late 1990s to the early 21st century. RESULTS Age-standardized 5-year relative/net survival rate of lung cancer was typically low, with 10%-20% for most regions. The highest age-standardized relative/net survival rate was observed in Japan (32.9%, 2010-2014), and the lowest was in India (3.7%, 2010-2014). In most countries, the five-year age-standardized relative/net survival rates of lung cancer were higher in females and younger people. The patients with adenocarcinoma had a better prognosis than other groups. In China, the highest 5-year overall relative/net survival rates were 27.90% and 31.62% in men and women in Jiangyin (2012-2013). CONCLUSION Over the past decades, the prognosis of lung cancer has gradually improved, but significant variations were also observed globally. Worldwide, a better prognosis of lung cancer can be observed in females and younger patients. It is essential to compare and evaluate the histological or stage-specific survival rates of lung cancer between different regions in the future.
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Affiliation(s)
- Jing‐Hao Bi
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Jia‐Yi Tuo
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yu‐Xuan Xiao
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Dan‐Dan Tang
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Xiao‐Hui Zhou
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yu‐Fei Jiang
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Xiao‐Wei Ji
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yu‐Ting Tan
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Hui‐Yun Yuan
- Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yong‐Bing Xiang
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
- Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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Serdà-Ferrer BC, Sanvisens A, Fuentes-Raspall R, Puigdemont M, Farré X, Vidal-Vila A, Rispau-Pagès M, Baltasar-Bagué A, Marcos-Gragera R. Significantly reduced incidence and improved survival from prostate cancer over 25 years. BMC Public Health 2023; 23:2552. [PMID: 38129873 PMCID: PMC10734155 DOI: 10.1186/s12889-023-17440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) was the second most frequent cancer and the fifth leading cause of cancer death among men in 2020. The aim of this study was to analyze trends in the incidence, mortality and survival of PCa in Girona, Spain, over 25 years. METHODS Population-based study of PCa collected in the Girona Cancer Registry, 1994-2018. Age-adjusted incidence and mortality rates were calculated per 100,000 men-year. Joinpoint regression models were used for trends, calculating the annual percentage changes (APC). Observed and net survival were analyzed using Kaplan-Meier and Pohar-Perme estimations, respectively. RESULTS A total of 9,846 cases of PCa were registered between 1994-2018. The age-adjusted incidence and mortality rates were 154.7 (95%CI: 151.7 157.8) and 38.9 (95%CI: 37.3 -40.6), respectively. An increased incidence of 6.2% was observed from 1994 to 2003 (95%CI: 4.4 -8.1), and a decrease of -2.7% (95%CI: -3.5 -;-1.9) between 2003 and 2018. Mortality APC was -2.6% (95%CI: -3.3 --2.0). Five-year observed and net survival were 72.8% (95%CI: 71.8 - 73.7) and 87.2% (95%CI: 85.9 - 88.4), respectively. Five-year net survival increased over time from 72.9% (1994-1998) to 91.3% (2014-2018). CONCLUSIONS The analyses show a clear reduction in PCa incidence rates from 2003 on, along with an increase in overall survival when comparing the earlier period with more recent years.
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Affiliation(s)
| | - Arantza Sanvisens
- Epidemiology Unit and Girona Cancer Registry, Institut Català d'Oncologia, Pla Director d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17004, Girona, Spain
| | - Rafael Fuentes-Raspall
- Radiation Oncology Department, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17007, Girona, Spain
| | - Montse Puigdemont
- Epidemiology Unit and Girona Cancer Registry, Institut Català d'Oncologia, Pla Director d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17004, Girona, Spain
| | - Xavier Farré
- Department of Health, Agència de Salut Pública de Catalunya, 25006, Lleida, Spain
| | - Anna Vidal-Vila
- Epidemiology Unit and Girona Cancer Registry, Institut Català d'Oncologia, Pla Director d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17004, Girona, Spain
| | - Martí Rispau-Pagès
- Registre de Tumors Hospitalari (RTH ICO-ICS), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17007, Girona, Spain
| | | | - Rafael Marcos-Gragera
- Department of Nursing, Universitat de Girona, 17003, Girona, Spain
- Epidemiology Unit and Girona Cancer Registry, Institut Català d'Oncologia, Pla Director d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17004, Girona, Spain
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de Vries E, Uribe C, Beltrán Rodríguez CC, Caparros A, Meza E, Gil F. Descriptive Epidemiology of Melanoma Diagnosed between 2010 and 2014 in a Colombian Cancer Registry and a Call for Improving Available Data on Melanoma in Latin America. Cancers (Basel) 2023; 15:5848. [PMID: 38136393 PMCID: PMC10741499 DOI: 10.3390/cancers15245848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
We aimed to improve the available information on morphology and stage for cutaneous melanoma in the population-based cancer registry of the Bucaramanga Metropolitan Area in Colombia. The incidence and survival rates and the distribution of melanoma patients by age, gender, anatomical subsite, and histological subtype were calculated. All 113 melanoma patients (median age 61) were followed up (median time 7.4 years). This exercise (filling in missing information in the registry by manual search of patient clinical record and other available information) yielded more identified invasive melanomas and cases with complete information on anatomical localization and stage. Age-standardized incidence and mortality rates were 1.86 and 1.08, being slightly higher for males. Most melanomas were localized on the lower limbs, followed by the trunk. For 35% of all melanomas, the morphological subtype remained unknown. Most of the remaining melanomas were nodular and acral lentiginous melanomas. Overall global and relative 5-year survival was 61.6% and 71.3%, respectively, with poorer survival for males than females. Melanomas on the head and neck and unspecified anatomical sites had the worst survival. Patients without stage information in their medical files had excellent survival, unlike patients for whom medical files were no longer available. This study shows the possibility of improving data availability and the importance of good quality population-based data.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicina, Pontificia Universidad Javeriana, Ed. Hospital Universitario San Ignacio, Carrera 7 N° 40–62–piso 2, Bogotá 110231, Colombia;
| | - Claudia Uribe
- Population Based Cancer Registry of Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Calle 157 #14 55, Floridablanca 68276, Colombia; (C.U.); (E.M.)
| | | | - Alfredo Caparros
- MSD Medical Affairs Latin America, Cazadores de Coquimbo 2841/57, Munro, Vicente López, Buenos Aires B1605AZE, Argentina
| | - Erika Meza
- Population Based Cancer Registry of Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Calle 157 #14 55, Floridablanca 68276, Colombia; (C.U.); (E.M.)
| | - Fabian Gil
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicina, Pontificia Universidad Javeriana, Ed. Hospital Universitario San Ignacio, Carrera 7 N° 40–62–piso 2, Bogotá 110231, Colombia;
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Leontyeva Y, Lambe M, Bower H, Lambert PC, Andersson TML. Including uncertainty of the expected mortality rates in the prediction of loss in life expectancy. BMC Med Res Methodol 2023; 23:291. [PMID: 38087236 PMCID: PMC10714581 DOI: 10.1186/s12874-023-02118-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE This study introduces a novel method for estimating the variance of life expectancy since diagnosis (LEC) and loss in life expectancy (LLE) for cancer patients within a relative survival framework in situations where life tables based on the entire general population are not accessible. LEC and LLE are useful summary measures of survival in population-based cancer studies, but require information on the mortality in the general population. Our method addresses the challenge of incorporating the uncertainty of expected mortality rates when using a sample from the general population. METHODS To illustrate the approach, we estimated LEC and LLE for patients diagnosed with colon and breast cancer in Sweden. General population mortality rates were based on a random sample drawn from comparators of a matched cohort. Flexible parametric survival models were used to model the mortality among cancer patients and the mortality in the random sample from the general population. Based on the models, LEC and LLE together with their variances were estimated. The results were compared with those obtained using fixed expected mortality rates. RESULTS By accounting for the uncertainty of expected mortality rates, the proposed method ensures more accurate estimates of variances and, therefore, confidence intervals of LEC and LLE for cancer patients. This is particularly valuable for older patients and some cancer types, where underestimation of the variance can be substantial when the entire general population data are not accessible. CONCLUSION The method can be implemented using existing software, making it accessible for use in various cancer studies. The provided example of Stata code further facilitates its adoption.
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Affiliation(s)
- Yuliya Leontyeva
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hannah Bower
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Paul C Lambert
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Population Health Sciences, Biostatistics research group, University of Leicester, Leicester, UK
| | - Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Bruneaux E, Iborra F, Trouche-Sabatier SG, Foucan AS, Gras-Aygon C, Poinas G, Rébillard X, Azria D, Trétarre B. [Bladder tumors in the Hérault department: Results of the Hérault tumor registry registration from1987 to 2019]. Prog Urol 2023; 33:974-982. [PMID: 37648602 DOI: 10.1016/j.purol.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/10/2023] [Accepted: 08/01/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES The Hérault Tumor Registry (RTH) is a general registry qualified by the national committee of registries since 1987. The objective of this study is to present the evolution of the epidemiology of bladder cancer (stage≥T1) in the Hérault department based on data collected by the RTH over a period from 1987 to 2019. MATERIAL AND METHODS We analyzed trends in bladder cancer incidence in Hérault between 1987 and 2019 by sex, age, and stage, as well as mortality trends between 1987 and 2017. For the years 2018-2019, which are the last two years validated by the registry, we described relative frequencies, sex ratio, mean and median age at diagnosis, cumulative risk, stages at diagnosis, pathology data, and primary treatments. Observed and net survival data are analyzed for those diagnosed between 01/01/2000 and 12/31/2015 with a point date of 06/30/2018. RESULTS In 2018-2019, bladder cancer was the 7th most common cancer in Hérault (5th in men and 12th in women) with an incidence sex ratio of 3.9 men to one woman. The mean age at diagnosis was 75.3 years for men and 77.8 years for women. The probability of having bladder cancer before the age of 75 years was 1.68% for a man (1/59) and 0.34% for a woman (1/295). Urothelial carcinomas accounted for 90.7% of cancers. Between 1987 and 2019, bladder cancer incidence TSMs (worldwide standardized rates) decreased by 0.8% per year in men and remained stable in women. Mortality TSMs between 1987 and 2017 followed the same trends with a decrease of 2.2% per year in men and stability in women. For the 3304 bladder cancers diagnosed between 01/01/2000 and 12/31/2015, the observed 5-year survival was 38% (34% in women and 38% in men). CONCLUSIONS Bladder cancer incidence and mortality rates have decreased slightly in men but remain stable in women in the Hérault. Registries collect only a limited number of variables for each patient. In 2018 the Hérault Registry Specialized in Onco-Urology (RHESOU) was created, to have comprehensive data. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- E Bruneaux
- Département d'urologie, centre hospitalier universitaire Lapeyronie, avenue doyen Gaston-Giraud, 34090 Montpellier, France.
| | - F Iborra
- Département d'urologie, centre hospitalier universitaire Lapeyronie, avenue doyen Gaston-Giraud, 34090 Montpellier, France; Registre des tumeurs de l'Hérault, Montpellier, France
| | | | - A S Foucan
- Registre des tumeurs de l'Hérault, Montpellier, France
| | - C Gras-Aygon
- Registre des tumeurs de l'Hérault, Montpellier, France
| | - G Poinas
- Département d'urologie, clinique Beau Soleil, Montpellier, France
| | - X Rébillard
- Département d'urologie, clinique Beau Soleil, Montpellier, France
| | - D Azria
- Institut national de la santé et de la recherche médicale U1194, institut du cancer, université Montpellier, Montpellier, France
| | - B Trétarre
- Registre des tumeurs de l'Hérault, Montpellier, France; CERPOP, université de Toulouse, institut national de la santé et de la recherche médicale UPS, Toulouse, France
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Ribeiro AG, Mafra da Costa A, Pereira TF, Guimarães DP, Fregnani JHTG. Colorectal cancer spatial pattern in the northeast region of São Paulo, Brazil. GLOBAL EPIDEMIOLOGY 2023; 5:100097. [PMID: 37638369 PMCID: PMC10446010 DOI: 10.1016/j.gloepi.2022.100097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Background This study examined the spatial pattern of the colorectal cancer (CRC) in the 18 municipalities that compose the Regional Health Department of Barretos (RHD-V), which is in the northeast of the state of São Paulo, Brazil. Methods All incident cases and deaths from CRC between 2002 and 2016 were included. Age-standardized rates (ASR) for incidence and mortality per 100,000 person-years were used to evaluate the spatial distribution for the total and five-year periods. The lethality rates were also assessed. Excess risk maps compared the observed and expected events. Age-standardized net survival was used to evaluate CRC survival. Results For CRC incidence, the ASR value for the general population over the entire period (2002-2016) was 17.7 (95% CI: 16.7, 18.6), ranging from 16.7 (95% CI: 14.9, 18.4) (2002-2006) to 20.0 (95% CI: 18.3, 21.7) (2012-2016) per 100,000. When males and females were compared, the ASR was 20.1 (95% CI: 18.6, 21.6) and 15.7 (95% CI: 14.5, 17.0) per 100,000, respectively. For CRC mortality (2002-2016), the ASR was 8.2 (95% CI: 7.6, 8.9), ranging from 9.0 (95% CI: 7.8, 10.3) (2002-2006) to 8.2 (95% CI: 7.2, 9.3) (2012-2016) per 100,000. Overall, the excess risk up to 2.0 was more frequent. In terms of survival, municipalities with large port populations had lower survival in comparison with medium port. Conclusions This study showed a variation in CRC incidence and mortality, with differences considering five-year periods and gender, being the incidence higher in males than females in the entire period, with mortality equivalent to half the incidence. The survival was lower in municipalities with large port populations in comparison with medium port. Knowing spatial patterns of incidence, mortality, lethality, and survival can be necessary to support policymakers to advance or implement effective cancer control programs.
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Affiliation(s)
- Adeylson Guimarães Ribeiro
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
| | - Allini Mafra da Costa
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
| | - Talita Fernanda Pereira
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
| | - Denise Peixoto Guimarães
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
| | - José Humberto Tavares Guerreiro Fregnani
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
- A.C. Camargo Cancer Center, Rua Tamandaré, 753, Liberdade, São Paulo 01525-001, SP, Brazil
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Guerreiro T, Forjaz G, Antunes L, Bastos J, Mayer A, Aguiar P, Araújo A, Nunes C. Lung cancer survival and sex-specific patterns in Portugal: A population-based analysis. Pulmonology 2023; 29 Suppl 4:S70-S79. [PMID: 34642125 DOI: 10.1016/j.pulmoe.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/10/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION In Portugal, lung cancer (LC) is the first cause of cancer-related death and of death and disability combined. This study aims to analyze the overall survival (OS) and relative survival (RS) of patients diagnosed with LC in 2009-2011 by socio-demographic and tumor characteristics, and analyze sex-specific patterns. METHODS We estimated 5-year OS using the Kaplan-Meier method and 5-year net survival through the RS framework. Cox regression modeling was used to determine the hazard ratio (HR) of death associated with each independent variable. FINDINGS For the 11,523 cases analyzed, median 5-year OS was 264 days (95% confidence interval [CI]: 254.8-273.2), the cumulative OS was 13.6% and RS was 15.1%. Males had a lower median survival (237 days; 95% CI: 228.2-245.7) compared to females (416 days; 95% CI: 384.4-447.6) (p < 0.0001) and lower 5-year RS proportions (12.1% vs. 24.9%). RS progressively decreased with age (41.7% for age-group <40 to 7.2% for ≥80) and stage (66.6% for stage I to 2.4% for stage IV). As predictors of decreased survival, we identified male gender, increasing age >50, histologic types (squamous cell carcinoma, non-small cell lung cancer not otherwise specified, other unspecified and small cell lung cancer), and increasing stage. Compared to women, the risk of death in men was 37.7% higher (HR = 1.386; 95% CI: 1.295-1.484). CONCLUSIONS The differences between OS and RS were small, reflecting the high lethality of LC. Male gender and older age are factors related to poor prognosis. Histology also plays a role in survival prognosis and varies with gender, but the factor related to the worst survival is stage. Although the study reflects data from a decade ago, and major changes occurred in diagnosis, staging and treatment, particularly for advanced disease, as LC mortality is strongly correlated with late stage diagnosis, all efforts should be made to secure early diagnosis and improve survival prospects.
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Affiliation(s)
- T Guerreiro
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal.
| | - G Forjaz
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA; Azores Oncological Centre, Azores, Portugal
| | - L Antunes
- Cancer Epidemiology Group, IPO Porto Research (CI-IPOP), Portuguese Institute of Oncology Francisco Gentil, Porto, Portugal
| | - J Bastos
- Portuguese Institute of Oncology Francisco Gentil, Coimbra, Portugal
| | - A Mayer
- Portuguese Institute of Oncology Francisco Gentil, Lisbon, Portugal
| | - P Aguiar
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Research Center, NOVA University of Lisbon, Portugal
| | - A Araújo
- University Hospital Center of Porto, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - C Nunes
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Research Center, NOVA University of Lisbon, Portugal
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Ohbiki M, Ito Y, Inamoto Y, Miyamura K, Uchida N, Fukuda T, Fujiwara H, Nishida T, Hayashi M, Tanaka M, Kawakita T, Ikegame K, Katayama Y, Ara T, Ichinohe T, Kiyoi H, Matsuo K, Atsuta Y. Improved Long-Term Net Survival after Allogeneic Hematopoietic Cell Transplantation in Patients with Hematologic Malignancies over Two Decades. Transplant Cell Ther 2023; 29:768.e1-768.e10. [PMID: 37739224 DOI: 10.1016/j.jtct.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/01/2023] [Accepted: 09/16/2023] [Indexed: 09/24/2023]
Abstract
Allogeneic (allo-) hematopoietic cell transplantation (HCT) has evolved as a curative therapy for hematologic malignancies and diseases, with practice changes over the past 2 decades. This study aimed to evaluate the change in 5-year net survival (NS) of allo-HCT recipients in a population-based cohort over the past 2 decades, which allows the estimation of a more HCT-specific long-term survival rate by considering background mortality changes. This study included 42,064 patients with hematologic malignancies who underwent their first allo-HCT in Japan between 2000 and 2018 and were reported to the Transplant Registry Unified Management Program. We compared the 5-year NS after allo-HCT in 4 consecutive HCT periods (2000 to 2004, 2005 to 2008, 2009 to 2012, and 2013 to 2018). The 5-year NS of the latest period was estimated using the period analysis method. Adjusted excess hazard ratios (EHRs) for 5-year NS over the HCT period were analyzed using an EHR model. In addition to the analysis of all hematologic malignancies, adjusted 5-year NS for each major hematologic malignancy, including acute myelogenous leukemia, acute lymphoblastic leukemia (ALL), myelodysplastic syndrome, adult T cell leukemia/lymphoma, chronic myeloid leukemia (CML), and malignant lymphoma, was analyzed. The probability of adjusted 5-year NS after HCT improved significantly over time: 35% in 2000 to 2004, 39% in 2005 to 2008, 45% in 2009 to 2012, and 49% in 2013 to 2018. The adjusted EHRs were .90 (95% confidence interval [CI], .86 to .93) in the 2005 to 2008 period, .77 (95% CI, .74 to .80) in the 2009 to 2012 period, and .65 (95% CI, .63 to .68) in the 2013 to 2018 period, with the 2000 to 2004 period as the reference. The 5-year NS improved among all hematologic malignancies, with a significant improvement in CML and ALL. The changes in 5-year NS from the 2000 to 2004 period to the 2013 to 2018 period ranged from 46% to 66% in CML and from 41% to 59% in ALL. In addition to the large improvement of 1-year NS, smaller but continued improvement in NS between 1 and 5 years after transplantation was observed. NS at 5 years conditional on being alive at 1 year increased from 64% in 2000 to 2004 to 73% in 2013 to 2018. Even after subtracting the background mortality in the general population, we found a significant improvement in long-term allo-HCT-specific survival rates for patients with hematologic malignancies over the past 2 decades in Japan.
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Affiliation(s)
- Marie Ohbiki
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan; Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yoshihiro Inamoto
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Koichi Miyamura
- Department of Hematology, Inuyama Chuo General Hospital, Inuyama, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Tranomon Hospital, Tokyo, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroki Fujiwara
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Tetsuya Nishida
- Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | | | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Toshiro Kawakita
- Department of Hematology, National, Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Kazuhiro Ikegame
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Yuta Katayama
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Takahide Ara
- Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention/Introduction, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Yoshiko Atsuta
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan; Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan.
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Mariotto AB, Botta L, Bernasconi A, Zou Z, Gatta G, Capocaccia R. Prediction of Risk of Metastatic Recurrence for Female Breast Cancer Patients in the Presence of Competing Causes of Death. Cancer Epidemiol Biomarkers Prev 2023; 32:1683-1689. [PMID: 37707367 PMCID: PMC10979392 DOI: 10.1158/1055-9965.epi-23-0544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/09/2023] [Accepted: 09/12/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND To estimate risk of recurrence for women diagnosed with nonmetastatic breast cancer considering the risks of other causes mortality. METHODS We extend a method based on the diagnosis-metastasis-death pathway to include risks of other causes mortality. We estimate three probabilities as cumulative incidence of: (i) being alive and recurrence-free, (ii) death for other causes before a recurrence, and (iii) recurrence. We apply the method to female breast cancer relative survival from the Surveillance, Epidemiology, and End Results Program registries (2000-2018) data. RESULTS The cumulative incidence of recurrence shows a higher increase with more advanced cancer stage and is less influenced by age at diagnosis. At 5 years from diagnosis, the cumulative incidence of recurrence is less than 3% for those diagnosed with stage I, 10% to 13% for those diagnosed with stage II, and 37% to 47% for those diagnosed with stage III breast cancer. The estimates of recurrence considering versus ignoring the risks of dying from other causes were generally consistent, except for older women with more advanced stage, and longer time since diagnosis. In these groups, the net probability of recurrence, excluding the risks of dying from other causes, were overestimated. CONCLUSIONS For patients with cancer who are older or long-term survivors, it is important to include the risks of other cause mortality as the crude cumulative incidence of recurrence is a more appropriate measure. IMPACT These estimates are important in clinical decision making, as higher competing mortality may preclude the benefits of aggressive treatments.
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Affiliation(s)
- Angela B. Mariotto
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Alice Bernasconi
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Zhaohui Zou
- Information Management Services Inc., Calverton, Maryland, USA
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Riccardo Capocaccia
- Independent Researcher (formerly affilliated with Istituto Superiore di Sanita), Rome, Italy
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Wang X, Liu X, Zhong QZ, Wu T, Wu YP, Yang Y, Chen B, Jing H, Tang Y, Jin J, Liu YP, Song YW, Fang H, Lu NN, Li N, Zhai YR, Zhang WW, Wang SL, Chen F, Qi SN, Li YX. Decreased lymphoma-related deaths and improved long-term relative survival with radiotherapy for early-stage diffuse large B-cell lymphoma in the rituximab era. Radiother Oncol 2023; 188:109902. [PMID: 37678622 DOI: 10.1016/j.radonc.2023.109902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND We aimed to investigate the incidence of lymphoma-related death (LRD) and the long-term net survival benefit of radiotherapy (RT) for early-stage diffuse large B-cell lymphoma (DLBCL) in the rituximab era. METHODS 10,841 adults diagnosed with early-stage DLBCL between 2002-2015 were retrospectively analyzed using data from the Surveillance, Epidemiology, and End Results database. Primary therapy was categorized into combined-modality treatment (CMT, n = 3,631) and chemotherapy alone (n = 7,210). Competing risk analysis was used to evaluate the cumulative incidence of mortality. Inverse probability of treatment weighting (IPTW) was used to balance groups. The net survival benefit of RT was estimated through relative survival (RS), standardized mortality ratio (SMR), and transformed Cox regression, while controlling for background mortality. RESULTS Patients initially treated with CMT had a lower cumulative incidence of LRD compared to those who received chemotherapy alone (HR 0.63, 95%CI: 0.57-0.69; P < 0.001). The 10-year overall survival (OS), RS, and SMR for CMT were 66.1%, 85.0%, and 1.71 respectively, which were significantly better than those for chemotherapy alone (53.0%; 69.8%; 2.62; all P < 0.001). IPTW and multivariable analysis revealed that the addition of RT led to better OS (HR 0.67, 95%CI: 0.62-0.71; P < 0.001) and RS (HR 0.69, 95%CI: 0.65-0.74; P < 0.001). Moreover, compared with chemotherapy alone, the benefit of OS and RS for CMT increased over time within 10 years of diagnosis. CONCLUSION RT reduced LRD and improved the long-term net survival in early-stage DLBCL in the rituximab era. Further prospective studies are warranted to assess the specific patient population that would benefit the most from consolidative RT in early-stage DLBCL.
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Affiliation(s)
- Xin Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Xin Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Qiu-Zi Zhong
- Beijing Hospital, National Geriatric Medical Center, Beijing, China
| | - Tao Wu
- Affiliated Hospital of Guizhou Medical University, Guizhou Cancer Hospital, Guiyang, Guizhou, China
| | - Yun-Peng Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Yong Yang
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Bo Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Hao Jing
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Yuan Tang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Jing Jin
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China; Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Shenzhen 518116, China
| | - Yue-Ping Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Yong-Wen Song
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Hui Fang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Ning-Ning Lu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Ning Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Yi-Rui Zhai
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Wen-Wen Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Shu-Lian Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China
| | - Fan Chen
- Affiliated Hospital of Qinghai University, Qinghai, China
| | - Shu-Nan Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China.
| | - Ye-Xiong Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Collaborative Innovation Center for Cancer Medicine, Beijing 100021, China.
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Wilkinson AN, Ellison LF, Billette JM, Seely JM. Impact of Breast Cancer Screening on 10-Year Net Survival in Canadian Women Age 40-49 Years. J Clin Oncol 2023; 41:4669-4677. [PMID: 37540825 PMCID: PMC10564321 DOI: 10.1200/jco.23.00348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/26/2023] [Accepted: 06/15/2023] [Indexed: 08/06/2023] Open
Abstract
PURPOSE In Canada, some provincial/territorial mammography screening programs include women age 40-49 years, whereas others do not. This study examines the impact of this dichotomy on the 10-year breast cancer (BC) net survival (NS) among women age 40-49 years and 50-59 years at diagnosis. METHODS Using the Canadian Cancer Registry data record linked to death information, we evaluated the cohort of Canadian women age 40-49 years and 50-59 years diagnosed with BC from 2002 to 2007. We compared 10-year NS estimates in the jurisdictions with organized screening programs that included women age 40-49 years, designated as screeners (Northwest Territories, British Columbia, Alberta, Nova Scotia, and Prince Edward Island), with comparator programs that did not (Yukon, Manitoba, Saskatchewan, Ontario, Quebec, New Brunswick, and Newfoundland and Labrador). RESULTS BC was the primary cause of 10-year mortality in women age 40-49 years diagnosed with BC (90.7% of deaths). Among these women, the 10-year NS for screeners (84.8%; 95% CI, 83.8 to 85.8) was 1.9 percentage points (pp) higher than that for comparators (82.9%; 95% CI, 82.3 to 83.5; P = .001). The difference in favor of screeners was significant among women age 45-49 years (2.6 pp; P = .001) but not among women age 40-44 years (0.9 pp; P = .328). Similarly, the incidence-based BC mortality rate was significantly lower in screener jurisdictions among women age 40-49 years and 45-49 years, but not for 40-44 years. Provincial/territorial NS increased significantly with higher mammography screening participation (P = .003). The BC incidence rate was virtually identical in screener and comparator jurisdictions among women age 40-49 years (P = .976) but was significantly higher for comparators among women age 50-59 years (P < .001). CONCLUSION Screening programs that included women in their 40s were associated with a significantly higher BC 10-year NS in women age 40-49 years, but not an increased rate of BC diagnosis. These results may inform screening guidelines for women age 40-49 years.
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Affiliation(s)
| | - Larry F. Ellison
- Centre for Population Health Data at Statistics Canada, Government of Canada, Ottawa, Canada
| | - Jean-Michel Billette
- Centre for Population Health Data at Statistics Canada, Government of Canada, Ottawa, Canada
| | - Jean M. Seely
- University of Ottawa, Department of Radiology, Ottawa Hospital Research Institute, Ottawa, Canada
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Wells M, Rutherford MJ, Lambert PC. Fair comparisons of cause-specific and relative survival by accounting for the systematic removal of patients from risk-sets. Cancer Epidemiol 2023; 86:102408. [PMID: 37591148 DOI: 10.1016/j.canep.2023.102408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND In population-based cancer studies it is common to try to isolate the impact of cancer by estimating net survival. Net survival is defined as the probability of surviving cancer in the absence of any other-causes of death. Net survival can be estimated either in the cause-specific or relative survival framework. Cause-specific survival considers deaths from the cancer as the event of interest. Relative survival incorporates general population expected mortality rates to represent the other-cause mortality rate. Estimation approaches in both frameworks are impacted by the systematic removal of patients from the risk-set, commonly referred to as informative censoring in the cause-specific framework. In the relative survival framework, the Pohar Perme estimator combats the effect of this systematic removal of patients through weighting. When the two frameworks have been compared, informative censoring is rarely accounted for in the cause-specific framework. METHODS We investigate the use of weighted cause-specific Kaplan-Meier estimates to overcome the impact of informative censoring and compared approaches to defining weights. Individuals remaining in the risk-set are upweighted using their predicted other-cause survival obtained through various model-based approaches. We also compare weights derived from expected mortality rates. We applied the approaches to US cancer registry data and conducted a simulation study. RESULTS Using weighted cause-specific estimates provides a better estimate of marginal net survival. The unweighted Kaplan-Meier estimates have a similar bias to the Ederer II method for relative survival. Weighted Kaplan-Meier estimates are unbiased and similar to the Pohar Perme estimator. There was little variation between the several weighting approaches. CONCLUSION In comparisons of cause-specific and relative survival, it is important to compare "like-with-like", therefore, a weighted approach should be considered for both frameworks. If researchers are interested in obtaining net measures in a cause-specific framework, then weighting is needed to account for informative censoring.
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Affiliation(s)
- Molly Wells
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, University Road, LE1 7RH, Leicester, UK.
| | - Mark J Rutherford
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, University Road, LE1 7RH, Leicester, UK
| | - Paul C Lambert
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, University Road, LE1 7RH, Leicester, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 24105 Stockholm, Sweden
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43
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Ho VKY, Anten MM, Garst A, Bos EM, Snijders TJ, Eekers DBP, Seute T. Epidemiology of adult meningioma: Report from the Dutch Brain Tumour Registry (2000-2019). Eur J Neurol 2023; 30:3244-3255. [PMID: 37433563 DOI: 10.1111/ene.15979] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND AND PURPOSE Meningiomas are the most common primary tumours of the central nervous system. This study aimed to provide comprehensive nationwide estimates on the incidence, prevalence and prognostic impact of meningioma diagnosis in the Netherlands. METHODS Adult patients diagnosed with meningioma in 2000-2019 were selected from the Dutch Brain Tumour Registry (DBTR), part of the Netherlands Cancer Registry (NCR). Time trends in age-adjusted incidence and prevalence rates were evaluated using the estimated annual percentage change (EAPC). Relative survival rates were calculated using the Pohar Perme estimator. Case completeness of the DBTR/NCR was estimated through record linkage with one of the Dutch neuro-oncology centres. RESULTS From a total of 23,454 cases of meningioma, 11,306 (48.2%) were histologically confirmed and 12,148 (51.8%) were radiological diagnoses. Over time, the incidence of diagnosis increased from 46.9 per 1,000,000 inhabitants (European Standardized Rate [ESR]) to 107.3 (EAPC 4.7%, p < 0.01), with an increase in the incidence of radiological diagnoses from 14.0 to 70.2 per 1,000,000 ESR (EAPC 9.1%, p < 0.01). The prevalence of meningioma was estimated at 1012/1,000,000 on 1 January 2020, with almost 17,800 individuals having had a diagnosis of meningioma. Relative survival rate at 10 years for grade 1 meningiomas was 91.0% (95% confidence interval [CI] 89.4%-92.3%), 71.3% (95% CI 66.8%-75.2%) for grade 2 meningiomas and 36.4% (95% CI 27.3%-45.6%) for grade 3 meningiomas. Local case completeness was estimated at 97.6% for histologically confirmed meningiomas and 84.5% for radiological diagnoses. CONCLUSION With a near-complete registry, meningioma prevalence was estimated at over 1000 per 1,000,000 inhabitants.
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Affiliation(s)
- Vincent K Y Ho
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Monique M Anten
- Department of Neurology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Anniek Garst
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Eelke M Bos
- Department of Neurosurgery, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Tom J Snijders
- Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Daniëlle B P Eekers
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Tatjana Seute
- Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands
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Guzmán-Gallego EA, Arias-Ortiz NE, Rodríguez-Betancourt JD. Colorectal cancer survival in Manizales, Colombia, 2008-2017: a population-based study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2023; 26:e230040. [PMID: 37729347 PMCID: PMC10511025 DOI: 10.1590/1980-549720230040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/09/2023] [Accepted: 06/21/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE To determine 5-year survival in patients with colorectal cancer (CRC) according to patient and tumor characteristics. METHODS Longitudinal study based on incident cases of invasive CRC between 2008 and 2017 captured by the Manizales Population-based Cancer Registry (n=850). Patients were followed up to August 24th, 2021. Cause-specific survival and net survival were calculated for sociodemographic and tumor characteristics, and Cox multivariate was fitted. RESULTS Fifty-five percent of cases occurred in women. The most frequent histological type was adenocarcinoma (78.2%). The most frequent locations were rectum (32.0%), ascending colon (16.6%), and sigmoid (16.2%). Twenty-five percent of cases were diagnosed in stage IV. There were 567 deaths due to CRC. The 5-year specific survival was 45.8% (95%CI 42.4-49.3), with independent effects for age (HR=1.83; 95%CI 1.26-2.65 age >75 years vs. <50 years) and advanced clinical stage (HR=2.5 and HR 5.7 for stages III and IV vs. stage I, respectively). Lower survival was observed in patients of medium socioeconomic status compared with higher socioeconomic status (HR=1.52; 95%CI 1.08-2.14), but not in patients of low socioeconomic status. No independent effects were observed for the health insurance regime. CONCLUSIONS In Manizales, approximately 5 out of 10 patients with invasive CRC die in the first five years after diagnosis, with a lower survival in patients older than 75 years, from medium socioeconomic level and diagnosed in advanced clinical stages.
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Affiliation(s)
| | - Nelson Enrique Arias-Ortiz
- Universidad de Caldas, Health Research Institute, Research group on Health Promotion and Disease Prevention – Manizales, Colombia
| | - Juan David Rodríguez-Betancourt
- Universidad de Caldas, Health Research Institute, Research group on Health Promotion and Disease Prevention – Manizales, Colombia
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Dabán-López P, Fernández-Martínez NF, Petrova D, Rodríguez-Barranco M, Jiménez-Moleón JJ, Gutierrez J, Sánchez MJ. Epidemiology of human papillomavirus-associated anogenital cancers in Granada: a three-decade population-based study. Front Public Health 2023; 11:1205170. [PMID: 37780447 PMCID: PMC10537955 DOI: 10.3389/fpubh.2023.1205170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction HPV infection is a common risk factor for all anogenital cancers. However, there are important differences in the epidemiology of anogenital cancers and these have not been compared considering diverse epidemiological indicators over a long period of time. To fill this gap, we investigated incidence, mortality, and survival trends of anogenital cancers over a period of three decades. Methods We conducted an observational registry-based study using data from the population-based cancer registry of Granada in southern Spain. We collected data on all incident cases of anogenital cancer (cervical, anal, penile, vulvar, and vaginal cancer) diagnosed between 1985 and 2017. We calculated crude and age-standardized incidence and mortality rates, and 1, 3, and 5-year overall and net survival. We further conducted time-trend analysis calculating annual percent changes (APC) for each cancer site. Results The incidence of anogenital cancers decreased slightly during the past 30 years, with the exception of vulvar cancer, where a slight increase was observed. Mortality decreased significantly for cervical cancer over the study period but increased non-significantly for the remaining cancer sites. Survival rates were similar to those reported in comparable countries and increased for cervical and vulvar cancer. Discussion Cervical cancer was the greatest contributor to the burden of anogenital cancers and showed a marked improvement in all indicators in comparison to the remaining cancer sites.
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Affiliation(s)
- Pablo Dabán-López
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario San Cecilio, Granada, Spain
| | - Nicolás Francisco Fernández-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jose Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Javier Gutierrez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario San Cecilio, Granada, Spain
| | - María-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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Myklebust TÅ, Aagnes B, Nilssen Y, Rutherford M, Lambert PC, Andersson TML, Johansson ALV, Dickman PW, Møller B. Improving communication of cancer survival statistics-feasibility of implementing model-based algorithms in routine publications. Br J Cancer 2023; 129:819-828. [PMID: 37433898 PMCID: PMC10449893 DOI: 10.1038/s41416-023-02360-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Routine reporting of cancer patient survival is important, both to monitor the effectiveness of health care and to inform about prognosis following a cancer diagnosis. A range of different survival measures exist, each serving different purposes and targeting different audiences. It is important that routine publications expand on current practice and provide estimates on a wider range of survival measures. We examine the feasibility of automated production of such statistics. METHODS We used data on 23 cancer sites obtained from the Cancer Registry of Norway (CRN). We propose an automated way of estimating flexible parametric relative survival models and calculating estimates of net survival, crude probabilities, and loss in life expectancy across many cancer sites and subgroups of patients. RESULTS For 21 of 23 cancer sites, we were able to estimate survival models without assuming proportional hazards. Reliable estimates of all desired measures were obtained for all cancer sites. DISCUSSION It may be challenging to implement new survival measures in routine publications as it can require the application of modeling techniques. We propose a way of automating the production of such statistics and show that we can obtain reliable estimates across a range of measures and subgroups of patients.
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Affiliation(s)
- Tor Åge Myklebust
- Department of Registration, Cancer Registry Norway, Oslo, Norway.
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway.
| | - Bjarte Aagnes
- Department of Registration, Cancer Registry Norway, Oslo, Norway
| | - Yngvar Nilssen
- Department of Registration, Cancer Registry Norway, Oslo, Norway
| | - Mark Rutherford
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
- International Agency for Research on Cancer, Lyon, France
| | - Paul C Lambert
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Therese M L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna L V Johansson
- Department of Registration, Cancer Registry Norway, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul W Dickman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bjørn Møller
- Department of Registration, Cancer Registry Norway, Oslo, Norway
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Jonasson K, Sjövall J, Holmberg E, Beran M, Niklasson M, Kristiánsson S, Sandström K, Wennerberg J. Squamous cell carcinoma of the mobile tongue in young adults: A Swedish head & neck cancer register (SweHNCR) population-based analysis of prognosis in relation to age and stage. Oral Oncol 2023; 144:106485. [PMID: 37451141 DOI: 10.1016/j.oraloncology.2023.106485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
Increased incidence of squamous cell carcinoma (SCC) of the tongue has been reported in young adults (YA) in several countries since the 1980s and confirmed in later studies. The etiology is unclear, the prognosis has been debated, and conflicting results have been published. Some studies show better survival in young adults than in older patients, some worse, and others no difference. Most studies are based on selected series or include other sites in the oral cavity. The definition of "YA" is arbitrary and varies between studies. It is thus difficult to use in general conclusions. This work uses data from the population-based Swedish Head and Neck Cancer register (SweHNCR), which has > 98% coverage. SweHNCR data includes age, gender, TNM, treatment intention, treatment given, lead times, performance status, and to a lesser degree, smoking habits. The current Swedish population is around 10 million. We analyzed outcomes for 1416 patients diagnosed with SCC of the oral tongue from 2008 to 2017 using 18-39 years to define YA age because it is the range most commonly used. We found no significant difference in relative survival (a proxy for diagnosis-specific survival) between age groups of patients treated with curative intent for SCC of the oral tongue. The stage at time of diagnosis was equally distributed among the age groups. Excess mortality rate correlated mainly with stage, subsite of the tongue, performance status, and lead time to treatment.
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Affiliation(s)
| | - Johanna Sjövall
- Dept of Otolaryngology/H&N Surgery, Department of Clinical Sciences, Lund, Lund University and Skåne University Hospital, Lund, Sweden.
| | - Erik Holmberg
- Regional Cancer Centre West, Western Sweden Healthcare Region, Gothenburg, Sweden; The Swedish Head and Neck Cancer Register (SweHNCR), Sweden
| | - Martin Beran
- The Swedish Head and Neck Cancer Register (SweHNCR), Sweden; Department of ENT and Maxillofacial Surgery, NAL Medical Center Hospital, Trollhättan, Sweden
| | - Magnus Niklasson
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stefan Kristiánsson
- Department of Otorhinolaryngology, Head and Neck Surgery, Örebro University Hospital, Örebro, Sweden
| | - Karl Sandström
- Otolaryngology, Department of Surgical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
| | - Johan Wennerberg
- Dept of Otolaryngology/H&N Surgery, Department of Clinical Sciences, Lund, Lund University and Skåne University Hospital, Lund, Sweden
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Matz M, Valkov M, Šekerija M, Luttman S, Caldarella A, Coleman MP, Allemani C. Worldwide trends in esophageal cancer survival, by sub-site, morphology, and sex: an analysis of 696,974 adults diagnosed in 60 countries during 2000-2014 (CONCORD-3). Cancer Commun (Lond) 2023; 43:963-980. [PMID: 37488785 PMCID: PMC10508138 DOI: 10.1002/cac2.12457] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 05/04/2023] [Accepted: 06/11/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Esophageal cancer survival is poor worldwide, though there is some variation. Differences in the distribution of anatomical sub-site and morphological sub-type may help explain international differences in survival for all esophageal cancers combined. We estimated survival by anatomic sub-site and morphological sub-type to understand further the impact of topography and morphology on international comparisons of esophageal cancer survival. METHODS We estimated age-standardized one-year and five-year net survival among adults (15-99 years) diagnosed with esophageal cancer in each of 60 participating countries to monitor survival trends by calendar period of diagnosis (2000-2004, 2005-2009, 2010-2014), sub-site, morphology, and sex. RESULTS For adults diagnosed during 2010-2014, tumors in the lower third of the esophagus were the most common, followed by tumors of overlapping sub-site and sub-site not otherwise specified. The proportion of squamous cell carcinomas diagnosed during 2010-2014 was generally higher in Asian countries (50%-90%), while adenocarcinomas were more common in Europe, North America and Oceania (50%-60%). From 2000-2004 to 2010-2014, the proportion of squamous cell carcinoma generally decreased, and the proportion of adenocarcinoma increased. Over time, there were few improvements in age-standardized five-year survival for each sub-site. Age-standardized one-year survival was highest in Japan for both squamous cell carcinoma (67.7%) and adenocarcinoma (69.0%), ranging between 20%-60% in most other countries. Age-standardized five-year survival from squamous cell carcinoma and adenocarcinoma was similar for most countries included, around 15%-20% for adults diagnosed during 2010-2014, though international variation was wider for squamous cell carcinoma. In most countries, survival for both squamous cell carcinoma and adenocarcinoma increased by less than 5% between 2000-2004 and 2010-2014. CONCLUSIONS Esophageal cancer survival remains poor in many countries. The distributions of sub-site and morphological sub-type vary between countries, but these differences do not fully explain international variation in esophageal cancer survival.
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Affiliation(s)
- Melissa Matz
- Cancer Survival GroupDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondon WC1E 7HTGreater LondonUnited Kingdom
| | - Mikhail Valkov
- Department of RadiologyRadiotherapy and OncologyNorthern State Medical University, ArkhangelskArkhangelsk OblastRussia
| | - Mario Šekerija
- Croatian National Cancer RegistryCroatian Institute of Public Health, ZagrebZagreb CountyCroatia
| | | | - Adele Caldarella
- Tuscany Cancer RegistryIstituto per lo studio e la prevenzione oncologicaFlorenceTuscanyItaly
| | - Michel P Coleman
- Cancer Survival GroupDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondon WC1E 7HTGreater LondonUnited Kingdom
- Cancer DivisionUniversity College London Hospitals NHS Foundation Trust, London NW1 2BUGreater LondonUnited Kingdom
| | - Claudia Allemani
- Cancer Survival GroupDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondon WC1E 7HTGreater LondonUnited Kingdom
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Karavasiloglou N, Michalopoulou E, Limam M, Korol D, Wanner M, Rohrmann S. Net survival of women diagnosed with breast tumours: a population-based study in Switzerland. Swiss Med Wkly 2023; 153:40087. [PMID: 37769336 DOI: 10.57187/smw.2023.40087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
AIMS OF THE STUDY Although the incidence of breast carcinoma in situ has been increasing, the prognosis of breast carcinoma in situ patients has not been extensively investigated. Thus, we aimed to compare the characteristics of invasive breast tumours based on whether or not they were preceded by a breast carcinoma in situ and to estimate the 5-year net survival of patients diagnosed with different breast tumours. METHODS Data from women diagnosed with breast tumours between 2003 and 2016 were used in our analyses. Net survival analyses were performed using inverse probability of censoring weights (nonparametric Pohar Perme estimator). Under certain assumptions, differences in survival between the cancer population and the general population can be considered to be attributable to the cancer diagnosis (NS). RESULTS Descriptive observation of tumour characteristics indicated that invasive breast tumours following a breast carcinoma in situ were more frequently detected at an earlier stage and had less missing information in tumour-specific variables, compared to invasive breast tumours not preceded by a breast carcinoma in situ. Breast carcinoma in situ patients had a 5-year net survival of 1.02 (95% CI: 1.01-1.03), whereas patients diagnosed with invasive breast cancer without a recorded breast carcinoma in situ had a 5-year net survival of 0.89 (95% CI: 0.88-0.90). Patients diagnosed first with breast carcinoma in situ and then with invasive breast cancer had a 5-year net survival of 0.92 (95% CI: 0.85-1.01). CONCLUSION Invasive breast tumours that were preceded by a breast carcinoma in situ were detected more frequently at an earlier stage, compared to those that were not. The estimated 5-year net survival of patients with breast tumours was good.
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Affiliation(s)
- Nena Karavasiloglou
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry of the Cantons of Zurich, Zug, Schaffhausen, and Schwyz, University Hospital Zurich, Zurich, Switzerland
- European Food Safety Authority, Parma, Italy
| | - Eleftheria Michalopoulou
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry of the Cantons of Zurich, Zug, Schaffhausen, and Schwyz, University Hospital Zurich, Zurich, Switzerland
| | - Manuela Limam
- Cancer Registry of the Cantons of Zurich, Zug, Schaffhausen, and Schwyz, University Hospital Zurich, Zurich, Switzerland
| | - Dimitri Korol
- Cancer Registry of the Cantons of Zurich, Zug, Schaffhausen, and Schwyz, University Hospital Zurich, Zurich, Switzerland
| | - Miriam Wanner
- Cancer Registry of the Cantons of Zurich, Zug, Schaffhausen, and Schwyz, University Hospital Zurich, Zurich, Switzerland
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry of the Cantons of Zurich, Zug, Schaffhausen, and Schwyz, University Hospital Zurich, Zurich, Switzerland
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Guevara M, Baztan M, Burgui R, Ovies A, Menéndez A, Eciolaza M, Moreno-Iribas C, Ardanaz E. [Survival of cancer patients in Navarre and comparison with Spain]. An Sist Sanit Navar 2023; 46:e1042. [PMID: 37594062 PMCID: PMC10498136 DOI: 10.23938/assn.1042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/25/2023] [Accepted: 06/01/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND To analyze the survival of adult cancer patients in Navarre, describe its trend, and compare the data for this Spanish Autonomous Community against that reported for Spain. METHODS Records of adult cancer patients were retrieved from the Navarre´s population-based cancer registry for two periods (1999-2007 and 2008-2016). The vital status had been updated to 2020. Observed survival, net survival and age-standardized net survival at five years with 95% confidence intervals were estimated overall and for twenty-nine cancer groups. RESULTS We analyzed 57,564 cases. Age-standardized net survival was 59.9% (59.1-60.8) and 63.8% (62.8-64.7) for males and females diagnosed with cancer during the 2008-2016 period, respectively. Age-standardized net survival ranged from 13.4% (10.4-17.4) for pancreatic cancer to 94.0% (88.1-100) for thyroid cancer in male patients, and from 11.9% (7.2-19.7) for liver cancer to 95.6% (92.6-98.6-%) for thyroid cancer in female patients. Compared with cases diagnosed in the 1999-2007 period, age-standardized net survival increased in 10 cancer groups, resulting in an overall increase of 5.1 (4.1-6.0) percentage points. The age-standardized net survival in Navarre was 2.7 (1.9-3.4) percentage points higher than that described for Spain for the 2008-2013 period. CONCLUSIONS In Navarre, the survival of cancer patients diagnosed during the 2008-2016 period improved significantly in comparison to the 1999-2007 period. Different factors may explain this improvement, including earlier diagnoses, more effective treatment options, and better healthcare processes. Overall, survival was higher in women than in men. Our results suggest a higher survival rate in Navarre than in Spain.
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Affiliation(s)
| | - Miren Baztan
- Instituto de Salud Pública y Laboral de Navarra. Departamento de Salud. Gobierno de Navarra. Pamplona. España..
| | | | - Alberto Ovies
- Instituto de Salud Pública y Laboral de Navarra. Departamento de Salud. Gobierno de Navarra. Pamplona. España..
| | - Aitziber Menéndez
- Instituto de Salud Pública y Laboral de Navarra. Departamento de Salud. Gobierno de Navarra. Pamplona. España..
| | - Maribel Eciolaza
- Instituto de Salud Pública y Laboral de Navarra. Departamento de Salud. Gobierno de Navarra. Pamplona. España..
| | | | - Eva Ardanaz
- Instituto de Salud Pública y Laboral de Navarra.
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