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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Nikšić M, Minicozzi P, Weir HK, Zimmerman H, Schymura MJ, Rees JR, Coleman MP, Allemani C. Pancreatic cancer survival trends in the US from 2001 to 2014: a CONCORD-3 study. Cancer Commun (Lond) 2022; 43:87-99. [PMID: 36353792 PMCID: PMC9859729 DOI: 10.1002/cac2.12375] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/01/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Survival from pancreatic cancer is low worldwide. In the US, the 5-year relative survival has been slightly higher for women, whites and younger patients than for their counterparts, and differences in age and stage at diagnosis [Corrections added Nov 16, 2022, after first online publication: a new affiliation is added to Maja Nikšić] may contribute to this pattern. We aimed to examine trends in survival by race, stage, age and sex for adults (15-99 years) diagnosed with pancreatic cancer in the US. METHODS This population-based study included 399,427 adults registered with pancreatic cancer in 41 US state cancer registries during 2001-2014, with follow-up to December 31, 2014. We estimated age-specific and age-standardized net survival at 1 and 5 years. RESULTS Overall, 12.3% of patients were blacks, and 84.2% were whites. About 9.5% of patients were diagnosed with localized disease, but 50.5% were diagnosed at an advanced stage; slightly more among blacks, mainly among men. No substantial changes were seen over time (2001-2003, 2004-2008, 2009-2014). In general, 1-year net survival was higher in whites than in blacks (26.1% vs. 22.1% during 2001-2003, 35.1% vs. 31.4% during 2009-2014). This difference was particularly evident among patients with localized disease (49.6% in whites vs. 44.6% in blacks during 2001-2003, 60.1% vs. 55.3% during 2009-2014). The survival gap between blacks and whites with localized disease was persistent at 5 years after diagnosis, and it widened over time (from 24.0% vs. 21.3% during 2001-2003 to 39.7% vs. 31.0% during 2009-2014). The survival gap was wider among men than among women. CONCLUSIONS Gaps in 1- and 5-year survival between blacks and whites were persistent throughout 2001-2014, especially for patients diagnosed with a localized tumor, for which surgery is currently the only treatment modality with the potential for cure.
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Affiliation(s)
- Maja Nikšić
- Cancer Survival GroupDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineKeppel StreetLondonWC1E 7HTUK,Centre for Health Services StudiesUniversity of KentCanterburyCT2 7NFUK
| | - Pamela Minicozzi
- Cancer Survival GroupDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineKeppel StreetLondonWC1E 7HTUK
| | - Hannah K Weir
- Division of Cancer Prevention and ControlCenters for Disease Control and PreventionAtlantaGA30333USA
| | - Heather Zimmerman
- Montana Central Tumor RegistryChronic Disease Prevention and Health Promotion BureauPO Box 202951, 1400 BroadwayHelenaMT59620‐2951USA
| | - Maria J Schymura
- Bureau of Cancer EpidemiologyNew York State Cancer RegistryNew York State Department of Health150 BroadwayAlbanyNY12204‐2719USA
| | - Judith R Rees
- New Hampshire State Cancer RegistryNorris Cotton Cancer Center, and Department of EpidemiologyGeisel School of MedicineDartmouth CollegeDartmouth‐Hitchcock Medical CenterOne Medical Center DriveLebanonNH03756USA
| | - Michel P Coleman
- Cancer Survival GroupDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineKeppel StreetLondonWC1E 7HTUK,Cancer DivisionUniversity College London Hospitals NHS Foundation Trust250 Euston RoadLondonNW1 2PGUK
| | - Claudia Allemani
- Cancer Survival GroupDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineKeppel StreetLondonWC1E 7HTUK
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Montel L, Di Carlo V, Minicozzi P, Coleman MP, Allemani C. The people behind the numbers: women with breast cancer. Lancet Oncol 2022. [DOI: 10.1016/s1470-2045(22)00678-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vener C, Rossi S, Minicozzi P, Marcos-Gragera R, Poirel HA, Maynadié M, Troussard X, Pravettoni G, De Angelis R, Sant M. Clear Improvement in Real-World Chronic Myeloid Leukemia Survival: A Comparison With Randomized Controlled Trials. Front Oncol 2022; 12:892684. [PMID: 35912208 PMCID: PMC9333088 DOI: 10.3389/fonc.2022.892684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/19/2022] [Indexed: 12/04/2022] Open
Abstract
Tyrosine kinase inhibitors (TKIs) have been improving the prognosis of patients with chronic myeloid leukemia (CML), but there are still large differences in survival among European countries. This raises questions on the added value of results from population-based studies, which use real-world data, compared to results of randomized controlled trials (RCTs) involving patients with CML. There are also questions about the extent of the findings on RCTs effectiveness for patients in the general population. We compare survival data extracted from our previous systematic review and meta-analysis of CML RCTs with the latest updated population-based survival data of EUROCARE-6, the widest collaborative study on cancer survival in Europe. The EUROCARE-6 CML survival estimated in patients (15–64 years) diagnosed in 2000–2006 vs. 2007–2013 revealed that the prognostic improvement highlighted by RCTs was confirmed in real-world settings, too. The study shows, evaluating for the first time all European regions, that the optimal outcome figures obtained in controlled settings for CML are also achievable (and indeed achieved) in real-world settings with prompt introduction of TKIs in daily clinical practice. However, some differences still persist, particularly in Eastern European countries, where overall survival values are lower than elsewhere, probably due to a delayed introduction of TKIs. Our results suggest an insufficient adoption of adequate protocols in daily clinical practice in those countries where CML survival values remain lower in real life than the values obtained in RCTs. New high-resolution population-based studies may help to identify failures in the clinical pathways followed there.
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Affiliation(s)
- Claudia Vener
- Analytical Epidemiology and Health Impact Unit, Department of Research, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Silvia Rossi
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Research, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, Italy.,Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), Universitat de Girona, Girona, Spain.,Biomedical Network Research Centers of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Group of Descriptive and Analytical Epidemiology of Cancer, Josep Carreras Leukemia Research Institute, Girona, Spain
| | | | - Marc Maynadié
- Côte d'Or Hematological Malignancies Registry, Dijon, France
| | - Xavier Troussard
- Basse Normandie Cancer Registry, Centre Hospitalier Universitaire (CHU) de Caen, Normandie, Caen, France
| | | | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Department of Research, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, Italy
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5
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Ssenyonga N, Stiller C, Nakata K, Shalkow J, Redmond S, Bulliard JL, Girardi F, Fowler C, Marcos-Gragera R, Bonaventure A, Saint-Jacques N, Minicozzi P, De P, Rodríguez-Barranco M, Larønningen S, Di Carlo V, Mägi M, Valkov M, Seppä K, Wyn Huws D, Coleman MP, Allemani C. Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000-14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries. Lancet Child Adolesc Health 2022; 6:409-431. [PMID: 35468327 DOI: 10.1016/s2352-4642(22)00095-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/28/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). METHODS We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. FINDINGS 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010-14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010-14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000-14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. INTERPRETATION This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. FUNDING Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.
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Affiliation(s)
- Naomi Ssenyonga
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, Wellington House, London, UK
| | - Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute 3-1-69, Otemae, Chuo-ku, Osaka City, Osaka, Japan
| | - Jaime Shalkow
- Instituto Nacional de Pediatría, Insurgentes Cuicuilco, Coyoacán, Ciudad de México, Mexico
| | - Sheilagh Redmond
- Institute of Social and Preventive Medicine, Bern University, Bern, Switzerland
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland; Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK; Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Christine Fowler
- Classification and Terminology, Technology and Digital Services, Ministry of Health, Wellington, New Zealand
| | | | - Audrey Bonaventure
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; CRESS, Université de Paris, INSERM, UMR 1153, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, NS, Canada
| | - Pamela Minicozzi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, ON, Canada
| | - Miguel Rodríguez-Barranco
- Granada Cancer Registry, Escuela Andaluza de Salud Pública (EASP), Cuesta del Observatorio 4, Granada, Spain
| | | | - Veronica Di Carlo
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Margit Mägi
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | | | - Karri Seppä
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Dyfed Wyn Huws
- Welsh Cancer Intelligence and Surveillance Unit, Public Health Wales, Cardiff, UK
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
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6
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Henderson RH, French D, Maughan T, Adams R, Allemani C, Minicozzi P, Coleman MP, McFerran E, Sullivan R, Lawler M. The economic burden of colorectal cancer across Europe: a population-based cost-of-illness study. Lancet Gastroenterol Hepatol 2021; 6:709-722. [PMID: 34329626 DOI: 10.1016/s2468-1253(21)00147-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/21/2021] [Accepted: 04/26/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Colorectal cancer is one of the leading causes of cancer morbidity and mortality in Europe. We aimed to ascertain the economic burden of colorectal cancer across Europe using a population-based cost-of-illness approach. METHODS In this population-based cost-of-illness study, we obtained 2015 activity and costing data for colorectal cancer in 33 European countries (EUR-33) from global and national sources. Country-specific aggregate data were acquired for health-care, mortality, morbidity, and informal care costs. We calculated primary, outpatient, emergency, and hospital care, and systemic anti-cancer therapy (SACT) costs, as well as the costs of premature death, temporary and permanent absence from work, and unpaid informal care due to colorectal cancer. Colorectal cancer health-care costs per case were compared with colorectal cancer survival and colorectal cancer personnel, equipment, and resources across EUR-33 using univariable and multivariable regression. We also compared hospital care and SACT costs against 2009 data for the 27 EU countries. FINDINGS The economic burden of colorectal cancer across Europe in 2015 was €19·1 billion. The total non-health-care cost of €11·6 billion (60·6% of total economic burden) consisted of loss of productivity due to disability (€6·3 billion [33·0%]), premature death (€3·0 billion [15·9%]), and opportunity costs for informal carers (€2·2 billion [11·6%]). The €7·5 billion (39·4% of total economic burden) of direct health-care costs consisted of hospital care (€3·3 billion [43·4%] of health-care costs), SACT (€1·9 billion [25·6%]), and outpatient care (€1·3 billion [17·7%]), primary care (€0·7 billion [9·3%]), and emergency care (€0·3 billion [3·9%]). The mean cost for managing a patient with colorectal cancer varied widely between countries (€259-36 295). Hospital-care costs as a proportion of health-care costs varied considerably (24·1-84·8%), with a decrease of 21·2% from 2009 to 2015 in the EU. Overall, hospital care was the largest proportion (43·4%) of health-care expenditure, but pharmaceutical expenditure was far higher than hospital-care expenditure in some countries. Countries with similar gross domestic product per capita had widely varying health-care costs. In the EU, overall expenditure on pharmaceuticals increased by 213·7% from 2009 to 2015. INTERPRETATION Although the data analysed include non-homogenous sources from some countries and should be interpreted with caution, this study is the most comprehensive analysis to date of the economic burden of colorectal cancer in Europe. Overall spend on health care in some countries did not seem to correspond with patient outcomes. Spending on improving outcomes must be appropriately matched to the challenges in each country, to ensure tangible benefits. Our results have major implications for guiding policy and improving outcomes for this common malignancy. FUNDING Department for Employment and Learning of Northern Ireland, Medical Research Council, Cancer Research UK, Health Data Research UK, and DATA-CAN.
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Affiliation(s)
- Raymond Hugo Henderson
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK; Queen's Management School, Queen's University Belfast, Belfast, UK; Diaceutics, Belfast, UK.
| | - Declan French
- Queen's Management School, Queen's University Belfast, Belfast, UK
| | - Timothy Maughan
- MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
| | - Richard Adams
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Pamela Minicozzi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Ethna McFerran
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - Richard Sullivan
- Institute of Cancer Policy, King's College London & King's Health Partners Comprehensive Cancer Centre, UK
| | - Mark Lawler
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
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7
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Prades J, Arnold D, Brunner T, Cardone A, Carrato A, Coll-Ortega C, De Luze S, Garel P, Goossens ME, Grilli R, Harris M, Louagie M, Malats N, Minicozzi P, Partelli S, Pastorekova S, Petrulionis M, Price R, Sclafani F, Smolkova B, Borras JM. Bratislava Statement: consensus recommendations for improving pancreatic cancer care. ESMO Open 2021; 5:e001051. [PMID: 33188052 PMCID: PMC7668355 DOI: 10.1136/esmoopen-2020-001051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/07/2020] [Indexed: 11/18/2022] Open
Abstract
Pancreatic cancer is one of the most lethal tumours, and it is the fourth cause of cancer death in Europe. Despite its important public health impact, no effective treatments exist, nor are there high-visibility research efforts to improve care. This alarming situation is emblematic of a larger group of cancer diseases, known as neglected cancers. To address the impact of these diseases, the European Commission-supported Innovative Partnership for Action Against Cancer launched a multi-stakeholder initiative to determine key steps that healthcare systems can rapidly implement to improve their response. A working group comprising 20 representatives from European medical societies, patient associations, cancer plan organisations and other relevant European healthcare stakeholders was organised. A consensus process based on the results of different studies, discussion of research outcomes, and development and endorsement of draft statements resulted in 22 consensus recommendations (the Bratislava Statement). The statement argues that substantial improvements can be achieved in patient outcomes by centralising pancreatic cancer care around state-of-the-art reference centres, staffed by expert multidisciplinary teams capable of providing high-quality care. This organisational model requires a specific care framework encompassing primary, palliative and survivorship care, and a policy environment prioritising the use of quality criteria and performance assessments as well as research investments dedicated to prevention, risk prediction, early detection and diagnosis. In order to address the challenges posed by neglected cancers in general and pancreatic cancer in particular, a specific control strategy tailored to this reality is required.
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Affiliation(s)
- Joan Prades
- Catalonian Cancer Strategy, Department of Health, Barcelona, Spain; University of Barcelona (IDIBELL), Barcelona, Spain.
| | - Dirk Arnold
- Med. Onkologie, Tumorzentrum Hamburg, AK Altona, Hamburg, Germany; European Society of Medical Oncology (ESMO), Lugano, Ticino, Switzerland
| | - Thomas Brunner
- Department of Radiation Oncology, University of Magdeburg, Magdeburg, Germany; European Society for Radiotherapy & Oncology (ESTRO), Brussels, Belgium
| | - Antonella Cardone
- Pancreatic Cancer Europe, Brussels, Belgium; European Cancer Patient Coalition (ECPC), Brussels, Belgium
| | - Alfredo Carrato
- Pancreatic Cancer Europe, Brussels, Belgium; IRYCIS, CIBERONIC, Madrid, Spain
| | | | - Samuel De Luze
- Institut National du Cancer, Billancourt, Île-de-France, France
| | - Pascal Garel
- European Hospital and Healthcare Federation, Brussels, Belgium
| | - Maria E Goossens
- Cancer Centre-OD Public Health and Surveillance, Sciensano, Brussels, Belgium
| | | | | | - Marleen Louagie
- Belgian National Institute for Health and Disability Insurance, Brussels, Belgium
| | - Núria Malats
- Pancreatic Cancer Europe, Brussels, Belgium; Spanish National Cancer Research Centre (CNIO), CIBERONC, Madrid, Spain
| | - Pamela Minicozzi
- London School of Hygiene & Tropical Medicine, London, UK; Analytical Epidemiology and Health Impact Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Partelli
- Università Vita Salute San Raffaele, Milano, Lombardia, Italy; European Society of Surgical Oncology (ESSO), Brussels, Belgium
| | - Silvia Pastorekova
- Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Marius Petrulionis
- Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania; Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Richard Price
- The European Cancer Organisation (ECCO), Brussels, Belgium
| | - Francesco Sclafani
- Department of Medical Oncology, Institut Jules Bordet, Bruxelles, Belgium; European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Bozena Smolkova
- Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Josep M Borras
- Catalonian Cancer Strategy, Department of Health, Barcelona, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalunya, Spain
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8
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Bouvier AM, Jooste V, Sanchez-Perez MJ, Bento MJ, Rocha Rodrigues J, Marcos-Gragera R, Carmona-Garcia MC, Luque-Fernandez MA, Minicozzi P, Bouvier V, Innos K, Sant M. Differences in the management and survival of metastatic colorectal cancer in Europe. A population-based study. Dig Liver Dis 2021; 53:639-645. [PMID: 33637435 DOI: 10.1016/j.dld.2021.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/08/2021] [Accepted: 01/24/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The management regarding metastatic colorectal cancer throughout Europe is not well known. AIMS To draw a European comparison of the management and prognosis of metastatic colorectal cancers. METHODS Factors associated with chemotherapy administration were identified through logistic regressions. Net survival was estimated and crude probabilities of death related to cancer and other causes using a flexible cumulative hazard model. RESULTS Among the 13 227 patients with colorectal cancer diagnosed between 2010 and 2013 in cancer registries from 10 European countries, 3140 were metastatic. 62% of metastatic patients received chemotherapy. Compared to Spain, the related adjusted odds ratios ranged from 0.7 to 4.0 (P<0.001) according to country. The 3-year net survival by country ranged between 16% and 37%. The survival gap between countries diminished from 21% to 10% when adjusting for chemotherapy, age and sex. Geographical differences in the crude probability of death related to cancer were large for patients <70 or ≥80 years at diagnosis. CONCLUSION Heterogeneity in the application of European guidelines partly explain these differences. General health between populations, accessibility to a reference centre, or provision of health care could also be involved. Further population-based studies are warranted to disentangle between these possible explanations.
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Affiliation(s)
- Anne-Marie Bouvier
- Digestive cancer registry of Burgundy, Dijon, France; Dijon University Hospital, Dijon, France; INSERM UMR 1231, Dijon, France; University of Burgundy, Dijon, France.
| | - Valérie Jooste
- Digestive cancer registry of Burgundy, Dijon, France; Dijon University Hospital, Dijon, France; INSERM UMR 1231, Dijon, France; University of Burgundy, Dijon, France
| | - Maria José Sanchez-Perez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Maria José Bento
- Cancer Epidemiology Group, IPO Porto Research Center (CI-IPOP), Porto, Portugal; Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal; Institute of Biomedical Sciences Abel Salazar, University of Porto, (ICBAS-UP), Porto, Portugal
| | - Jessica Rocha Rodrigues
- Cancer Epidemiology Group, IPO Porto Research Center (CI-IPOP), Porto, Portugal; Portuguese Oncology Institute of Porto, Porto, Portugal
| | - 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; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; Biomedical Network Research Centers of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Maria Carmen Carmona-Garcia
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Dr. Josep Trueta, Girona, Spain; Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Miguel Angel Luque-Fernandez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Véronique Bouvier
- Digestive tumors registry of Calvados, Caen, France; U1086 INSERM UCN, ANTICIPE, Caen, France; Caen University Hospital, Caen, France
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Dal Maso L, Panato C, Tavilla A, Guzzinati S, Serraino D, Mallone S, Botta L, Boussari O, Capocaccia R, Colonna M, Crocetti E, Dumas A, Dyba T, Franceschi S, Gatta G, Gigli A, Giusti F, Jooste V, Minicozzi P, Neamtiu L, Romain G, Zorzi M, De Angelis R, Francisci S. Cancer cure for 32 cancer types: results from the EUROCARE-5 study. Int J Epidemiol 2021; 49:1517-1525. [PMID: 32984907 DOI: 10.1093/ije/dyaa128] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Few studies have estimated the probability of being cured for cancer patients. This study aims to estimate population-based indicators of cancer cure in Europe by type, sex, age and period. METHODS 7.2 million cancer patients (42 population-based cancer registries in 17 European countries) diagnosed at ages 15-74 years in 1990-2007 with follow-up to 2008 were selected from the EUROCARE-5 dataset. Mixture-cure models were used to estimate: (i) life expectancy of fatal cases (LEF); (ii) cure fraction (CF) as proportion of patients with same death rates as the general population; (iii) time to cure (TTC) as time to reach 5-year conditional relative survival (CRS) >95%. RESULTS LEF ranged from 10 years for chronic lymphocytic leukaemia patients to <6 months for those with liver, pancreas, brain, gallbladder and lung cancers. It was 7.7 years for patients with prostate cancer at age 65-74 years and >5 years for women with breast cancer. The CF was 94% for testis, 87% for thyroid cancer in women and 70% in men, 86% for skin melanoma in women and 76% in men, 66% for breast, 63% for prostate and <10% for liver, lung and pancreatic cancers. TTC was <5 years for testis and thyroid cancer patients diagnosed below age 55 years, and <10 years for stomach, colorectal, corpus uteri and melanoma patients of all ages. For breast and prostate cancers, a small excess (CRS < 95%) remained for at least 15 years. CONCLUSIONS Estimates from this analysis should help to reduce unneeded medicalization and costs. They represent an opportunity to improve patients' quality of life.
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Affiliation(s)
- Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Andrea Tavilla
- National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Sandra Mallone
- National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Olayidé Boussari
- Registre Bourguignon des Cancers Digestifs, INSERM UMR 1231, CHU de Dijon, Université de Bourgogne, Dijon, France
| | | | | | - Emanuele Crocetti
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, ItalyAzienda Usl della Romagna, Forlì, Italy
| | - Agnes Dumas
- National Institute for Health and Medical Research (INSERM), Paris, France
| | - Tadek Dyba
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Silvia Franceschi
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Anna Gigli
- Institute for Research on Population and Social Policies, National Research Council, Rome, Italy
| | | | - Valerie Jooste
- Registre Bourguignon des Cancers Digestifs, INSERM UMR 1231, CHU de Dijon, Université de Bourgogne, Dijon, France
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Luciana Neamtiu
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Gaëlle Romain
- Registre Bourguignon des Cancers Digestifs, INSERM UMR 1231, CHU de Dijon, Université de Bourgogne, Dijon, France
| | - Manuel Zorzi
- Veneto Tumour Registry, Azienda Zero, Padua, Italy
| | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, Italian National Institute of Health (ISS), Rome, Italy
| | - Silvia Francisci
- National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy
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10
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Di Carlo V, Estève J, Johnson C, Girardi F, Weir HK, Wilson RJ, Minicozzi P, Cress RD, Lynch CF, Pawlish KS, Rees JR, Coleman MP, Allemani C. Trends in short-term survival from distant-stage cutaneous melanoma in the United States, 2001-2013 (CONCORD-3). JNCI Cancer Spectr 2021; 4:pkaa078. [PMID: 33409455 PMCID: PMC7771008 DOI: 10.1093/jncics/pkaa078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/13/2020] [Accepted: 08/19/2020] [Indexed: 11/24/2022] Open
Abstract
Background Survival from metastatic cutaneous melanoma is substantially lower than for localized disease. Treatments for metastatic melanoma have been limited, but remarkable clinical improvements have been reported in clinical trials in the last decade. We described the characteristics of US patients diagnosed with cutaneous melanoma during 2001-2013 and assessed trends in short-term survival for distant-stage disease. Methods Trends in 1-year net survival were estimated using the Pohar Perme estimator, controlling for background mortality with life tables of all-cause mortality rates by county of residence, single year of age, sex, and race for each year 2001-2013. We fitted a flexible parametric survival model on the log-hazard scale to estimate the effect of race on the hazard of death because of melanoma and estimated 1-year net survival by race. Results Only 4.4% of the 425 915 melanomas were diagnosed at a distant stage, cases diagnosed at a distant stage are more commonly men, older patients, and African Americans. Age-standardized, 1-year net survival for distant-stage disease was stable at approximately 43% during 2001-2010. From 2010 onward, survival improved rapidly, reaching 58.9% (95% confidence interval = 56.6% to 61.2%) for patients diagnosed in 2013. Younger patients experienced the largest improvement. Survival for distant-stage disease increased in both Blacks and Whites but was consistently lower in Blacks. Conclusions One-year survival for distant-stage melanoma improved during 2001-2013, particularly in younger patients and those diagnosed since 2010. This improvement may be a consequence of the introduction of immune-checkpoint-inhibitors and other targeted treatments for metastatic and unresectable disease. Persistent survival inequalities exist between Blacks and Whites, suggesting differential access to treatment.
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Affiliation(s)
- Veronica Di Carlo
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Jacques Estève
- Université Claude Bernard, Hospices Civils de Lyon, Service de Biostatistique, Lyon Cedex 03, France
| | | | - Fabio Girardi
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Hannah K Weir
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Reda J Wilson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pamela Minicozzi
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Rosemary D Cress
- Public Health Institute, Cancer Registry of Greater California, Sacramento, CA, USA
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | | | - Judith R Rees
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Michel P Coleman
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Franchi M, Trama A, Merlo I, Minicozzi P, Tarantini L, Garau D, Kirchmayer U, Di Martino M, Romero M, De Carlo I, Scondotto S, Apolone G, Corrao G. Cardiovascular Risk After Adjuvant Trastuzumab in Early Breast Cancer: An Italian Population-Based Cohort Study. Oncologist 2020; 25:e1492-e1499. [PMID: 32770690 PMCID: PMC7543336 DOI: 10.1634/theoncologist.2020-0216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/20/2020] [Indexed: 11/17/2022] Open
Abstract
Background Although trastuzumab (T) represents the standard of care for the adjuvant treatment of HER2‐positive early‐stage breast cancer, contrasting results are available about the cardiac toxicity associated to its use. We conducted a multiregional population‐based cohort investigation aimed to assess both the short‐ and long‐term cardiovascular (CV) outcomes in women with early breast cancer treated with T‐based or standard adjuvant chemotherapy (CT). Materials and Methods We used health care use databases of six Italian regions, overall accounting for 42% of the Italian population. The study cohort was made by all women surgically treated for breast cancer who started a first‐line adjuvant T‐based or CT treatment. Patients treated with T were 1:2 matched to those treated with CT based on date of treatment start, age, and presence of CV risk factors. Short‐ and long‐term CV outcomes (heart failure and cardiomyopathy) were measured, respectively, after 1 year and at the end of follow‐up. Results Among 28,599 women who met the inclusion criteria, 6,208 T users were matched to 12,416 CT users. After a mean follow‐up of 5.88 years, short‐ and long‐term cumulative CV risk were 0.8% and 2.6% in patients treated with T and 0.2% and 2.8% in those treated with CT, respectively. Adjusted hazard ratios were 4.6 (95% confidence interval [CI], 2.6–8.0) for short‐term and 1.2 (95% CI, 0.9–1.6) for long‐term CV risk. Discussion In our large real‐world investigation, T‐associated cardiotoxicity was limited to the treatment period. The addition of T to adjuvant CT did not result in long‐term worsening of CV events. Implications for Practice Adjuvant trastuzumab‐based chemotherapy represents the backbone therapy in patients with HER2‐positive early breast cancer. Although well tolerated, cardiovascular events can manifest during or after therapy because of treatment‐related toxicities. In this wide multicenter and unselected cohort, long‐term symptomatic cardiotoxicity was low and limited to the treatment period. The findings suggest that developing tools that would be adequately able to predict cardiac toxicity at an early stage remains an important area in which additional research efforts are needed. With breast cancer patients experiencing longer survival, emphasizing their overall health through management of late and long‐term treatment effects is becoming increasingly important. This article reports a multiregional real‐world population‐based cohort investigation carried out to compare short‐term and long‐term cardiovascular risk of symptomatic cardiovascular events in women with localized breast cancer treated with trastuzumab‐based or standard adjuvant therapy in clinical practice.
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Affiliation(s)
- Matteo Franchi
- National Centre for Healthcare Research and PharmacoepidemiologyMilanItaly
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano‐BicoccaMilanItaly
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Ivan Merlo
- National Centre for Healthcare Research and PharmacoepidemiologyMilanItaly
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano‐BicoccaMilanItaly
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
- Cancer Survival Group, Department of Non‐Communicable Disease Epidemiology, London School of Hygiene and Tropical MedicineLondon
| | - Luigi Tarantini
- Department of Cardiology, Azienda Ospedale San Martino, ASL n. 1BellunoItaly
| | | | - Ursula Kirchmayer
- Department of Epidemiology ASL Roma 1, Lazio Regional Health ServiceRomeItaly
| | - Mirko Di Martino
- Department of Epidemiology ASL Roma 1, Lazio Regional Health ServiceRomeItaly
| | - Marilena Romero
- Department of Medical, Oral and Biotechnological Sciences, Section of Pharmacology and Toxicology, University of ChietiItaly
| | - Ilenia De Carlo
- Regional Centre of Pharmacovigilance, Regional Health Authority, Marche RegionItaly
| | - Salvatore Scondotto
- Department of Health Services and Epidemiological Observatory, Regional Health Authority, Sicily RegionPalermoItaly
| | - Giovanni Apolone
- Scientific Director, Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Giovanni Corrao
- National Centre for Healthcare Research and PharmacoepidemiologyMilanItaly
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano‐BicoccaMilanItaly
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12
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Minicozzi P, Vicentini M, Innos K, Castro C, Guevara M, Stracci F, Carmona-Garcia M, Rodriguez-Barranco M, Vanschoenbeek K, Rapiti E, Katalinic A, Marcos-Gragera R, Van Eycken L, Sánchez MJ, Bielska-Lasota M, Rossi PG, Sant M. Comorbidities, timing of treatments, and chemotherapy use influence outcomes in stage III colon cancer: A population-based European study. Eur J Surg Oncol 2020; 46:1151-1159. [PMID: 32147427 DOI: 10.1016/j.ejso.2020.02.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/21/2020] [Accepted: 02/18/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION For stage III colon cancer (CC), surgery followed by chemotherapy is the main curative approach, although optimum times between diagnosis and surgery, and surgery and chemotherapy, have not been established. MATERIALS AND METHODS We analysed a population-based sample of 1912 stage III CC cases diagnosed in eight European countries in 2009-2013 aiming to estimate: (i) odds of receiving postoperative chemotherapy, overall and within eight weeks of surgery; (ii) risks of death/relapse, according to treatment, Charlson Comorbidity Index, time from diagnosis to surgery for emergency and elective cases, and time from surgery to chemotherapy; and (iii) time-trends in chemotherapy use. RESULTS Overall, 97% of cases received surgery and 65% postoperative chemotherapy, with 71% of these receiving chemotherapy within eight weeks of surgery. Risks of death and relapse were higher for cases starting chemotherapy with delay, but better than for cases not given chemotherapy. Fewer patients with high comorbidities received chemotherapy than those with low (P < 0.001). Chemotherapy timing did not vary (P = 0.250) between high and low comorbidity cases. Electively-operated cases with low comorbidities received surgery more promptly than high comorbidity cases. Risks of death and relapse were lower for elective cases given surgery after four weeks than cases given surgery within a week. High comorbidities were always independently associated with poorer outcomes. Chemotherapy use increased over time. CONCLUSIONS Our data indicate that promptly-administered postoperative chemotherapy maximizes its benefit, and that careful assessment of comorbidities is important before treatment. The survival benefit associated with slightly delayed elective surgery deserves further investigation.
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Affiliation(s)
- Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Clara Castro
- Cancer Epidemiology Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal; EpiUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Marcela Guevara
- Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Fabrizio Stracci
- Department of Experimental Medicine, Section of Public Health, University of Perugia, Perugia, Italy; Umbria Cancer Registry, Perugia, Italy
| | - MaCarmen Carmona-Garcia
- Medical Oncology Department, Catalan Institute of Oncology, Universitary Hospital Dr Josep Trueta, Girona, Spain; Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Miguel Rodriguez-Barranco
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Andalusian School of Public Health (EASP), Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | | | - Elisabetta Rapiti
- Geneva Cancer Registry, Global Health Institute, University of Geneva, Switzerland
| | | | - Rafael Marcos-Gragera
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain; School of Medicine, University of Girona (UdG), Girona, Spain; Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health Government of Catalonia, Catalan Institute of Oncology, Girona, Spain
| | | | - Maria José Sánchez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Andalusian School of Public Health (EASP), Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Universidad de Granada (UGR), Granada, Spain
| | | | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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13
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Bielska-Lasota M, Rossi S, Krzyżak M, Haelens A, Domenic A, De Angelis R, Maciejczyk A, Rodríguez-Barranco M, Zadnik V, Minicozzi P. Reasons for low cervical cancer survival in new accession European Union countries: a EUROCARE-5 study. Arch Gynecol Obstet 2019; 301:591-602. [PMID: 31853712 DOI: 10.1007/s00404-019-05412-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 12/07/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis (local, regional and metastatic), morphology (mainly squamous versus glandular tumours) and patients' age. METHODS We analysed 101,714 CC women diagnosed in 2000-2007 and followed-up to December 2008. Age-standardised 5-year relative survival (RS) and the excess risks of cancer death in the 5 years after diagnosis were computed. RESULTS EE women were older and less commonly diagnosed with glandular tumours. Proportions of local stage cancers were similar across Europe, while morphology- and stage-specific RS (especially for non-metastatic disease) were lower in Eastern Europe. Adjusting for age and morphology, excess risk of local stage CC death for EE patients remained higher than that for other European women. CONCLUSION Stage, age and morphology alone do not explain worse survival in Eastern Europe: less effective care may play a role, probably partly due to fewer or inadequate resources being allocated to health care in this area, compared to the rest of Europe.
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Affiliation(s)
- Magdalena Bielska-Lasota
- Department of Health Promotion and Chronic Diseases Prevention, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Silvia Rossi
- Department of Oncology and Molecular Medicine, Istituto Superiore Di Sanità, Rome, Italy
| | - Michalina Krzyżak
- Department of Hygiene, Epidemiology and Ergonomics, Medical University of Bialystok, Bialystok, Poland
| | - Annemie Haelens
- Research Department, Belgian Cancer Registry, Brussels, Belgium
| | | | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, Istituto Superiore Di Sanità, Rome, Italy
| | | | - Miguel Rodríguez-Barranco
- Andalusian School of Public Health, Instituto de Investigación Biosanitaria de Granada (Ibs.Granada), Granada, Spain.,Centro de Investigación Biomédica en Red de Epidemiologia Y Salud Pública (CIBERESP), Madrid, Spain
| | - Vesna Zadnik
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy. .,Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
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14
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Di Cosimo S, Trama A, Merlo I, Minicozzi P, Tarantini L, Apolone G, Corrao G, Franchi M. Long term follow-up (F/U) report of symptomatic cardiac events (SCEs) in 2,809 breast cancer (BC) patients (pts) treated with adjuvant trastuzumab (T) in real world (RW) practice. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Mangone L, Mancuso P, Tagliabue G, Filiberti RA, Carrozzi G, Iacovacci S, Mazzucco W, Tumino R, Minicozzi P, Sant M, Giorgi Rossi P. Neoadjuvant therapy for breast cancer. Tumori Journal 2019; 105:488-493. [DOI: 10.1177/0300891619869505] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: To evaluate the frequency of neoadjuvant therapy (NT) in women with stage I–III breast cancer in Italy and whether it is influenced by biological characteristics, screening history, and geographic area. Methods: Data from the High Resolution Study conducted in 7 Italian cancer registries were used; they are a representative sample of incident cancers in the study period (2009–2013). Included were 3546 women aged <85 years (groups <50, 50–69, 70–64, and 75+) with stage I–III breast cancer at diagnosis who underwent surgery. Women were classified as receiving NT if they received chemotherapy, target therapy, and/or hormone therapy before the first surgical treatment. Logistic models were built to test the association with biological and contextual variables. Results: Only 8.2% of women (290 cases) underwent NT; the treatment decreases with increasing age (14.5% in age <50 and 2.2% in age 75+), is more frequent in women with negative receptors (14.8%), HER2-positive (15.7%), and triple-negative (15.6%). The multivariable analysis showed the probability of receiving NT is higher in stage III (odds ratio [OR] 3.83; 95% confidence interval [CI] 2.83–5.18), luminal B (OR 1.87; 95% CI 1.27–2.76), triple-negatives (OR 1.88; 95% CI 1.15–3.08), and in symptomatic cancers (OR 1.98; 95% CI 1.13–3.48). Use of NT varied among geographic areas: Reggio Emilia had the highest rates (OR 2.29; 95% CI 1.37–3.82) while Palermo had the lowest (OR 0.41; 95% CI 0.24–0.68). Conclusions: The use of NT in Italy is limited and variable. There are no signs of greater use in hospitals with more advanced care.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Giovanna Tagliabue
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | | | - Walter Mazzucco
- Department of Health Promotion and of Maternal and Childhood Sciences, University of Palermo, Palermo, Italy
| | - Rosario Tumino
- Histopathology Department and Cancer Registry, Provincial Health Authority, ASP Ragusa, Ragusa, Italy
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
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16
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Guevara M, Rodríguez-Barranco M, Puigdemont M, Minicozzi P, Yanguas-Bayona I, Porras-Povedano M, Rubió-Casadevall J, Sánchez Pérez MJ, Marcos-Gragera R, Ardanaz E. Disparities in the management of cutaneous malignant melanoma. A population-based high-resolution study. Eur J Cancer Care (Engl) 2019; 28:e13043. [PMID: 30993764 DOI: 10.1111/ecc.13043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/18/2019] [Accepted: 03/25/2019] [Indexed: 12/11/2022]
Abstract
Population-based cancer registry data from three Spanish areas were used to assess the patterns of care and adherence to guidelines for cutaneous malignant melanoma. We included 934 cases diagnosed in 2009-2013. Completeness of the pathology reports, imaging for detecting distant metastasis and the use of sentinel lymph node biopsy (SLNB) were analysed. The proportion of pathology reports that mentioned the essential pathological features required for T staging was 93%, ranging across geographic areas from 81% to 98% (p < 0.001). The percentage of low-risk patients who underwent no imaging studies, as proposed by guidelines, or only chest imaging ranged among areas from 0.6% to 84% (p < 0.001). Of the patients with clinically node-negative melanoma >1 mm thick and no distant metastases, 68% underwent SLNB, varying by area from 61% to 78% (p = 0.017). This study revealed wide geographic variation in different aspects of melanoma care. The use of a standardised structured pathology report could strengthen the completeness of reporting. Improvement strategies should also include efforts to reduce overuse of imaging in low-risk patients and to increase the adherence to guidelines recommendations on the use of SLNB.
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Affiliation(s)
- Marcela Guevara
- Navarra Public Health Institute - IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Biomedical Research Institute of Granada (ibs.Granada), University of Granada, Granada, Spain
| | - Montse Puigdemont
- Epidemiology Unit and Girona Cancer Registry, Descriptive Epidemiology, Genetics and Cancer Prevention Group, IdIbGi, Catalan Institute of Oncology, Girona, Spain
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | | | - Jordi Rubió-Casadevall
- Medical Oncology Department, Catalan Institute of Oncology, Descriptive Epidemiology, Genetics and Cancer Prevention Group, IdIbGi, University of Girona, Girona, Spain
| | - María José Sánchez Pérez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Biomedical Research Institute of Granada (ibs.Granada), University of Granada, Granada, Spain
| | - Rafael Marcos-Gragera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology Unit and Girona Cancer Registry, Descriptive Epidemiology, Genetics and Cancer Prevention Group, IdIbGi, Catalan Institute of Oncology, Girona, Spain
| | - Eva Ardanaz
- Navarra Public Health Institute - IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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17
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Huang L, Jansen L, Balavarca Y, Molina-Montes E, Babaei M, van der Geest L, Lemmens V, Van Eycken L, De Schutter H, Johannesen TB, Fristrup CW, Mortensen MB, Primic-Žakelj M, Zadnik V, Becker N, Hackert T, Mägi M, Cassetti T, Sassatelli R, Grützmann R, Merkel S, Gonçalves AF, Bento MJ, Hegyi P, Lakatos G, Szentesi A, Moreau M, van de Velde T, Broeks A, Sant M, Minicozzi P, Mazzaferro V, Real FX, Carrato A, Molero X, Besselink MG, Malats N, Büchler MW, Schrotz-King P, Brenner H. Resection of pancreatic cancer in Europe and USA: an international large-scale study highlighting large variations. Gut 2019; 68:130-139. [PMID: 29158237 DOI: 10.1136/gutjnl-2017-314828] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/24/2017] [Accepted: 11/11/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Resection can potentially cure resectable pancreatic cancer (PaC) and significantly prolong survival in some patients. This large-scale international study aimed to investigate variations in resection for PaC in Europe and USA and determinants for its utilisation. DESIGN Data from six European population-based cancer registries and the US Surveillance, Epidemiology, and End Results Program database during 2003-2016 were analysed. Age-standardised resection rates for overall and stage I-II PaCs were computed. Associations between resection and demographic and clinical parameters were assessed using multivariable logistic regression models. RESULTS A total of 153 698 records were analysed. In population-based registries in 2012-2014, resection rates ranged from 13.2% (Estonia) to 21.2% (Slovenia) overall and from 34.8% (Norway) to 68.7% (Denmark) for stage I-II tumours, with great international variations. During 2003-2014, resection rates only increased in USA, the Netherlands and Denmark. Resection was significantly less frequently performed with more advanced tumour stage (ORs for stage III and IV versus stage I-II tumours: 0.05-0.18 and 0.01-0.06 across countries) and increasing age (ORs for patients 70-79 and ≥80 versus those <60 years: 0.37-0.63 and 0.03-0.16 across countries). Patients with advanced-stage tumours (stage III-IV: 63.8%-81.2%) and at older ages (≥70 years: 52.6%-59.5%) receiving less frequently resection comprised the majority of diagnosed cases. Patient performance status, tumour location and size were also associated with resection application. CONCLUSION Rates of PaC resection remain low in Europe and USA with great international variations. Further studies are warranted to explore reasons for these variations.
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Affiliation(s)
- Lei Huang
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Yesilda Balavarca
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Esther Molina-Montes
- Geneticand Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), CIBERONC, ISCIII, Madrid, Spain
| | - Masoud Babaei
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lydia van der Geest
- Netherlands Cancer Registry (NCR), Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands
| | - Valery Lemmens
- Netherlands Cancer Registry (NCR), Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands
| | | | | | - Tom B Johannesen
- Registry Department, The Cancer Registry of Norway (CRN), Oslo, Norway
| | | | - Michael B Mortensen
- Danish Pancreatic Cancer Group, HPB Section, Department of Surgery, Odense University Hospital, Odense, Denmark
| | - Maja Primic-Žakelj
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Vesna Zadnik
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Thilo Hackert
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Margit Mägi
- Estonian Cancer Registry, National Institute for Health Development, Tallinn, Estonia
| | - Tiziana Cassetti
- Pancreatic Cancer Registry of Reggio Emilia Province, Unit of Gastroenterology and Digestive Endoscopy AUSL-RE, Local Health Authority-IRCCS, Reggio Emilia, Italy
| | - Romano Sassatelli
- Pancreatic Cancer Registry of Reggio Emilia Province, Unit of Gastroenterology and Digestive Endoscopy AUSL-RE, Local Health Authority-IRCCS, Reggio Emilia, Italy
| | - Robert Grützmann
- Department of Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Susanne Merkel
- Department of Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Ana F Gonçalves
- Departments of Epidemiology, Portuguese Oncology Institute of Porto (IPOP), Porto, Portugal
| | - Maria J Bento
- Departments of Epidemiology, Portuguese Oncology Institute of Porto (IPOP), Porto, Portugal
| | - Péter Hegyi
- Institute for Translational Medicine, University of Pécs, Pécs, Hungary
| | - Gábor Lakatos
- Department of Oncology, St. Istvan and St. Laszlo Hospital and Out-Patient Department, Budapest, Hungary
| | - Andrea Szentesi
- Institute for Translational Medicine, University of Pécs, Pécs, Hungary
| | - Michel Moreau
- Department of Surgical Oncology, Jules Bordet Institute (IJB), Brussels, Belgium
| | - Tony van de Velde
- Biometrics Department, The Netherlands Cancer Institute (NKI), Amsterdam, Netherlands
| | - Annegien Broeks
- Biometrics Department, The Netherlands Cancer Institute (NKI), Amsterdam, Netherlands
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Vincenzo Mazzaferro
- Hepato-Biliary Surgery Unit, Istituto Nazionale dei Tumori (INT), and University of Milan, Milan, Italy
| | - Francisco X Real
- Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre (CNIO), CIBERONC, Madrid, Spain.,Department de Ciencies Experimentals i de la, Universitat Pompeu Fabra, Barcelona, Spain
| | - Alfredo Carrato
- Department of Oncology, Ramon y Cajal University Hospital, IRYCIS, Alcala University, CIBERONC, Madrid, Spain
| | - Xavier Molero
- Hospital Universitari Vall d'Hebron, Exocrine Pancreas Research Unit and Vall d'Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Campus de la UAB, Barcelona, Spain.,CIBEREHD and CIBERESP, Madrid, Spain
| | - Marc G Besselink
- Dutch Pancreatic Cancer Group, Academic Medical Centre Amsterdam, Amsterdam, Netherlands
| | - Núria Malats
- Geneticand Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), CIBERONC, ISCIII, Madrid, Spain
| | - Markus W Büchler
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
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Minicozzi P, Van Eycken L, Molinie F, Innos K, Guevara M, Marcos-Gragera R, Castro C, Rapiti E, Katalinic A, Torrella A, Žagar T, Bielska-Lasota M, Giorgi Rossi P, Larrañaga N, Bastos J, Sánchez MJ, Sant M. Comorbidities, age and period of diagnosis influence treatment and outcomes in early breast cancer. Int J Cancer 2018; 144:2118-2127. [PMID: 30411340 DOI: 10.1002/ijc.31974] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/26/2018] [Accepted: 10/23/2018] [Indexed: 12/17/2022]
Abstract
Survival for breast cancer (BC) is lower in eastern than northern/central Europe, and in older than younger women. We analysed how comorbidities at diagnosis affected whether selected standard treatments (STs) were given, across Europe and over time, also assessing consequences for survival/relapse. We analysed 7581 stage I/IIA cases diagnosed in 9 European countries in 2009-2013, and 4 STs: surgery; breast-conserving surgery plus radiotherapy (BCS + RT); reconstruction after mastectomy; and prompt treatment (≤6 weeks after diagnosis). Covariate-adjusted models estimated odds of receiving STs and risks of death/relapse, according to comorbidities. Pearson's R assessed correlations between odds and risks. The z-test assessed the significance of time-trends. Most women received surgery: 72% BCS; 24% mastectomy. Mastectomied patients were older with more comorbidities than BCS patients (p < 0.001). Women given breast reconstruction (25% of mastectomies) were younger with fewer comorbidities than those without reconstruction (p < 0.001). Women treated promptly (45%) were younger than those treated later (p = 0.001), and more often without comorbidities (p < 0.001). Receiving surgery/BCS + RT correlated strongly (R = -0.9), but prompt treatment weakly (R = -0.01/-0.02), with reduced death/relapse risks. The proportion receiving BCS + RT increased significantly (p < 0.001) with time in most countries. This appears to be the first analysis of the influence of comorbidities on receiving STs, and of consequences for outcomes. Increase in BCS + RT with time is encouraging. Although women without comorbidities usually received STs, elderly patients often received non-standard less prompt treatments, irrespective of comorbidities, with increased risk of mortality/relapse. All women, particularly the elderly, should receive ST wherever possible to maximise the benefits of modern evidence-based treatments.
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Affiliation(s)
- Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | - Florence Molinie
- Loire-Atlantique/Vendée Cancer Registry, Nantes, France.,SIRIC-ILIAD, CHU Nantes, Nantes, France
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Marcela Guevara
- Navarra Cancer Registry, Public Health Institute of Navarra, IDISNA, Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rafael Marcos-Gragera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Epidemiology Unit and Girona Cancer Registry, Department of Health, Catalan Institute of Oncology (ICO), Girona, Spain
| | - Clara Castro
- Department of Epidemiology, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal.,EpiUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Elisabetta Rapiti
- Geneva Cancer Registry, Global Health Institute, University of Geneva, Geneva, Switzerland
| | - Alexander Katalinic
- University of Lübeck, Institute for Social Medicine and Epidemiology, Lübeck, Germany
| | - Ana Torrella
- Castellón Cancer Registry, Epidemiology Unit, Public Health Department, Castellón, Spain
| | - Tina Žagar
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Magdalena Bielska-Lasota
- Department of Health Promotion and Prevention of Chronic Diseases, National Institute of Public Health (NIH), Warsaw, Poland
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Nerea Larrañaga
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Public Health Department of Gipuzkoa, Donostia, Spain
| | - Joana Bastos
- EpiUnit, Institute of Public Health, University of Porto, Porto, Portugal.,Portuguese Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal
| | - Maria José Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Andalusian School of Public Health, Granada Cancer Registry, Granada, Spain.,Biomedical Research Institute of Granada (ibs. Granada), Granada, Spain
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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Minicozzi P, Cassetti T, Vener C, Sant M. Analysis of incidence, mortality and survival for pancreatic and biliary tract cancers across Europe, with assessment of influence of revised European age standardisation on estimates. Cancer Epidemiol 2018; 55:52-60. [PMID: 29777994 DOI: 10.1016/j.canep.2018.04.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Pancreatic (PC) and biliary tract (BTC) cancers have higher incidence and mortality in Europe than elsewhere. We analysed time-trends in PC/BTC incidence, mortality, and survival across Europe. Since the European standard population (ESP) was recently revised to better represent European age structure, we also assessed the effect of adopting the revised ESP to age-standardise incidence and mortality data. METHODS We analysed PCs/BTCs (≥15 years) diagnosed in 2000-2007 and followed-up to end of 2008, in 29 European countries across five regions: UK/Ireland, and northern, central, southern, and eastern Europe. Incidence, mortality, and 5-year relative survival were compared between regions, by age, sex, and period of diagnosis. RESULTS Variation in age-standardised incidence (PC 12-15/100,000; BTC 2-6) and mortality (PC 10-14; BTC 1-5) was modest. Eastern Europe had highest incidence and mortality, and lowest survival; northern and southern Europe had highest age-specific incidence (most age groups) for PC and BTC, respectively. Incidence and survival increased slightly from 2000 to 2007, particularly in elderly patients and women, but survival remained poor (≤8% for PC; 13-18% for BTC). Use of the revised ESP for age-standardisation did not impact European regional incidence and mortality rankings. CONCLUSION Poor survival for PC and BTC, together with increasing incidence, indicate that action is required. Countries with higher incidence had higher risk factor frequency, suggesting that prevention initiatives targeting risk factors should be promoted. Improvements in diagnosis and treatment are also required. Our results provide a baseline from which to monitor evolution of the PC/BTC burden in Europe.
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Affiliation(s)
- Pamela Minicozzi
- Analytic Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
| | - Tiziana Cassetti
- Department of Gastroenterology and Digestive Endoscopy, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy
| | - Claudia Vener
- Analytic Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy; Laboratory of Medical Statistics and Biometry "GA Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Milena Sant
- Analytic Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
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Di Salvo F, Baili P, Vicentini M, Tumino R, Vercelli M, Pirino D, Contiero P, Foschi R, Minicozzi P, Rossi PG, de Lorenzo F, Micheli A, Marani E, Orengo MA, Rossi PG, Mangone L, Pellegri C, Di Felice E, Cascone G, Cilia S, Morana G, Nicita C, Rollo C, Sigona A, Spata E, Spata G, Budroni M, Cesaraccio R, Contiero P, Maghini A, Tagliabue G, De Lorenzo F, Del Campo L, Polacchi F, Aurora F, Vittone D, Compagni A, Fattore G, Casella I, Cifalà A, Sant M, Gatta G, Trama A, Anselmi V, Casoli C. Cancer Rehabilitation Services: An Italian Population-based Cohort Study. Tumori Journal 2018. [DOI: 10.1177/1578.17224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Francesca Di Salvo
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Paolo Baili
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | | | - Marina Vercelli
- Liguria Region Cancer Registry, IRCCS AOU S Martino - Istituto Nazionale per la Ricerca sul Cancro, Genoa
- Department of Health Sciences, University of Genoa, Genoa
| | | | | | - Roberto Foschi
- Evaluation Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Paolo Giorgi Rossi
- Servizio Interaziendale di Epidemiologia, AUSL Reggio Emilia, Reggio Emilia
| | | | - Andrea Micheli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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21
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Minicozzi P, Walsh PM, Sánchez MJ, Trama A, Innos K, Marcos-Gragera R, Dimitrova N, Botta L, Johannesen TB, Rossi S, Sant M. Is low survival for cancer in Eastern Europe due principally to late stage at diagnosis? Eur J Cancer 2018. [PMID: 29518726 DOI: 10.1016/j.ejca.2018.01.084] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Cancer survival has persistently been shown to be worse for Eastern European and UK/Ireland patients than those of other European regions. This is often attributed to later stage at diagnosis. However, few stage-specific survival comparisons are available, so it is unclear whether poorer quality treatment or other factors also contribute. For the first time, European cancer registries have provided stage-at-diagnosis data to EUROCARE, enabling population-based stage-specific survival estimates across Europe. DATA AND METHODS In this retrospective observational study, stage at diagnosis (as TNM, condensed TNM, or Extent of Disease) was analysed for patients (≥15 years) from 15 countries grouped into 4 regions (Northern Europe: Norway; Central Europe: Austria, France, Germany, Switzerland, The Netherlands; Southern Europe: Croatia, Italy, Slovenia, and Spain; and Eastern Europe: Bulgaria, Estonia, Lithuania, Poland, and Slovakia), diagnosed with 7 malignant cancers in 2000-2007, and followed to end of 2008. A new variable (reconstructed stage) was created which used all available stage information. Age-standardised 5-year relative survival (RS) by reconstructed stage was estimated and compared between regions. Excess risks of cancer death in the 5 years after diagnosis were also estimated, taking age, sex and stage into account. RESULTS Low proportions of Eastern European patients were diagnosed with local stage cancers and high proportions with metastatic stage cancers. Stage-specific RS (especially for non-metastatic disease) was generally lower for Eastern European patients. After adjusting for age, sex, and stage, excess risks of death remained higher for Eastern European patients than for European patients in general. CONCLUSIONS Late diagnosis alone does not explain worse cancer survival in Eastern Europe: greater risk of cancer death together with worse stage-specific survival suggest less effective care, probably in part because fewer resources are allocated to health care than in the rest of Europe. We recommend that Eastern European cancer registries and other involved bodies to draw attention to poor cancer survival, so as to stimulate research and inform policies to improve outcomes.
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Affiliation(s)
- Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
| | - Paul M Walsh
- National Cancer Registry, Cork Airport Business Park, Cork, Ireland
| | - Maria-José Sánchez
- Andalusian School of Public Health, Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Granada, Spain; Centro de Investigación Biomédica en red de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry (Oncology Coordination Plan), Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute, Girona, Spain
| | - Nadya Dimitrova
- National Hospital of Oncology, Bulgarian National Cancer Registry, Sofia, Bulgaria
| | - Laura Botta
- Evaluative Epidemiology Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tom B Johannesen
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Silvia Rossi
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
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Minicozzi P, Cirilli C, Federico M, Capocaccia R, Budroni M, Candela P, Falcini F, Fusco M, Giacomin A, La Rosa F, Traina A, Tumino R, Sant M. Differences in Stage and Treatment of Breast Cancer across Italy Point to Inequalities in access to and Availability of Proper Care. Tumori 2018; 98:204-9. [DOI: 10.1177/030089161209800204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background Population-based cancer registry studies of patterns of care can help elucidate reasons for differences in breast cancer survival across Italy documented by previous studies. The aims of the present study were to investigate across-country variation in stage at presentation and standard care for breast cancer cases diagnosed in Italy in the early 2000s. Methods Samples of adult (≥15 years) women with breast cancer diagnosed in 2003–2005 were randomly selected in 9 Italian cancer registries. Logistic regression models were used to estimate the odds of receiving breast-conserving surgery plus radiotherapy (BCS + RT) in each cancer registry, age group, and disease stage category compared with the entire sample (reference); the z test was used to evaluate differences in proportions of stage at diagnosis, employment of chemotherapy in node-positive (N+) disease, and use of endocrine treatment in estrogen-receptor positive (ER+) and negative (ER-) tumors across Italy. Results Stage at diagnosis was earlier in northern/central registries than in southern areas. Compared with the reference, the odds of receiving BCS + RT was significantly lower in Trapani, Sassari and Naples (southern Italy) after adjusting for age and stage at diagnosis. Among N+ patients, 73% received adjuvant chemotherapy (range, 51% [Biella, northern Italy] to 87% [Ragusa, southern Italy]). Eighty percent of ER+ cancers (range, 50% [Biella, northern Italy] to 97% [Ragusa, southern Italy]) and 18% of ER-cancers (range, 6% [Modena, northern Italy] to 28% [Umbria, central Italy]) were treated with hormonal therapy. Conclusions Disparities in stage distributions and conservative surgery in breast cancer persist across Italy. On a positive note, we found lower variations in the use of systemic treatment between Italian regions.
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Affiliation(s)
- Pamela Minicozzi
- Department of Preventive and Predictive Medicine, Analytical Epidemiology Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan
| | - Claudia Cirilli
- Modena Cancer Registry and Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena
| | - Massimo Federico
- Modena Cancer Registry and Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena
| | - Riccardo Capocaccia
- National Center for Epidemiology, Surveillance and Health Promotion, Department of Cancer Epidemiology, Istituto Superiore di Sanità, Rome
| | | | | | | | - Mario Fusco
- Campania Cancer Registry, Local Health Unit 4, Brusciano (Naples)
| | - Adriano Giacomin
- Piedmont Cancer Registry, Province of Biella, Epidemiology Unit, Local Health Unit, Biella
| | - Francesco La Rosa
- Department of Surgical and Medical Specialities and Public Health, University of Perugia, Perugia
| | - Adele Traina
- Palermo Breast Cancer Registry and Experimental Oncology, Department of Oncology, ARNAS Civic Hospital, Palermo
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, MP Arezzo Hospital, Ragusa, Italy
| | - Milena Sant
- Department of Preventive and Predictive Medicine, Analytical Epidemiology Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan
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Minicozzi P, Caldarella A, Giacomin A, de Leon MP, Cesaraccio R, Falcini F, Fusco M, Iachetta F, Pellegri C, Tumino R, Capocaccia R, Sant M. Looking at Differences in Stage and Treatment of Colorectal Cancers across Italy: A EUROCARE-5 High Resolution Study. Tumori 2018; 98:671-7. [DOI: 10.1177/030089161209800601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Aims and background The high incidence and the estimate of a five-year relative survival of 59% for colorectal cancer in Italy were the main reasons to investigate the management of Italian patients with colorectal cancer diagnosed in the early 2000s. Methods Samples of adult (≥15 years) patients diagnosed in 2003–2005 with a colorectal cancer were randomly selected in 8 Italian population-based cancer registries. The z test was used to evaluate differences in proportions of Dukes stage, patients with at least 12 examined lymph nodes, and of cases treated with curative surgery plus chemotherapy or plus radiotherapy and diagnosed with colon or rectal tumors, respectively. Logistic regression models were used to estimate odds ratios of receiving the selected treatment in each cancer registry, age group and stage category, by anatomical subsite. Results A total of 3,938 colorectal cancer patients were analyzed. About 40% of the cases were over 75 years of age at diagnosis and at Dukes A + B stages. Higher proportions of early stages were found in the northern cancer registries. High percentages of resection with a curative intent were observed in Reggio Emilia (northern Italy), in 15 to 74-year-old patients, and at Dukes B stage. At least 12 lymph nodes were more frequently examined in the north of the country. After adjusting for age and stage, no significant differences were seen in the odds ratios of receiving surgery plus chemotherapy between cancer registries, whereas surgery plus radiotherapy was more frequent in Napoli (southern Italy) and less frequent in Biella (northern Italy). Conclusions Some disparities in staging and treatment of colorectal cancer patients persist across Italy. National oncological plans still need to reduce inequalities in provision and access to proper care.
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Affiliation(s)
- Pamela Minicozzi
- Department of Preventive and Predictive Medicine, Descriptive Studies and Health Planning Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan
| | | | - Adriano Giacomin
- Piedmont Cancer Registry, Province of Biella (CPO), Epidemiology Unit, Local Health Unit, Biella
| | - Maurizio Ponz de Leon
- Department of Internal Medicine, Division of Internal Medicine, University of Modena and Reggio Emilia, Modena
| | | | - Fabio Falcini
- Romagna Cancer Registry, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (Forlì)
| | - Mario Fusco
- Campania Cancer Registry, Local Health Unit 4, Brusciano (Naples)
| | - Francesco Iachetta
- Modena Cancer Registry, Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena
| | - Carlotta Pellegri
- Reggio Emilia Cancer Registry, Santa Maria Nuova Hospital, IRCCS, Reggio Emilia
| | - Rosario Tumino
- Ragusa Cancer Registry and Histopathology Unit, “MP Arezzo” Civic Hospital, Ragusa, Provincial Health Unit, Ragusa
| | - Riccardo Capocaccia
- National Center for Epidemiology, Surveillance and Health Promotion, Department of Cancer Epidemiology, Istituto Superiore di Sanità, Rome, Italy
| | - Milena Sant
- Department of Preventive and Predictive Medicine, Descriptive Studies and Health Planning Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan
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Minicozzi P, Innos K, Sánchez MJ, Trama A, Walsh PM, Marcos-Gragera R, Dimitrova N, Botta L, Visser O, Rossi S, Tavilla A, Sant M, Hackl M, Zielonke N, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Dušek L, Zvolský M, Mägi M, Aareleid T, Malila N, Seppä K, Bouvier A, Faivre J, Bossard N, Uhry Z, Colonna M, Stabenow R, Luttmann S, Eberle A, Brenner H, Nennecke A, Engel J, Schubert-Fritschle G, Heidrich J, Holleczek B, Katalinic A, Clough-Gorr K, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Ferretti S, Barchielli A, Caldarella A, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Capocaccia R, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Maso LD, De Angelis R, Caldora M, Carrani E, Francisci S, Knijn A, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Natali M, Filiberti R, Marani E, Autelitano M, Spagnoli G, Cirilli C, Fusco M, Vitale M, Traina A, Staiti R, Vitale F, Cusimano R, Michiara M, Tumino R, Falcini F, Caiazzo A, Maspero S, Fanetti A, Zanetti R, Rosso S, Rugge M, Tognazzo S, Pildava S, Smailyte G, Johannesen T, Rachtan J, Góźdź S, Mężyk R, Błaszczyk J, Kępska K, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Antunes L, Miranda A, Mayer-da-Silva A, Safaei Diba C, Primic-Zakelj M, Almar E, Mateos A, Lopez de Munain A, Larrañaga N, Torrella-Ramos A, Díaz García J, Jimenez-Chillaron R, Marcos-Gragera R, Vilardell L, Moreno-Iribas C, Ardanaz E, Lambe M, Mousavi M, Bouchardy C, Usel M, Ess S, Frick H, Lorez M, Ess S, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, Damhuis R, Otter R, Coleman M, Allemani C, Rachet B, Rashbass J, Broggio J, Verne J, Gavin A, Fitzpatrick D, Huws D, White C. Quality analysis of population-based information on cancer stage at diagnosis across Europe, with presentation of stage-specific cancer survival estimates: A EUROCARE-5 study. Eur J Cancer 2017; 84:335-353. [DOI: 10.1016/j.ejca.2017.07.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/04/2017] [Accepted: 07/11/2017] [Indexed: 11/28/2022]
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Di Salvo F, Caranci N, Spadea T, Zengarini N, Minicozzi P, Amash H, Fusco M, Stracci F, Falcini F, Cirilli C, Candela G, Cusimano R, Tumino R, Sant M. Socioeconomic deprivation worsens the outcomes of Italian women with hormone receptor-positive breast cancer and decreases the possibility of receiving standard care. Oncotarget 2017; 8:68402-68414. [PMID: 28978126 PMCID: PMC5620266 DOI: 10.18632/oncotarget.19447] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 04/26/2017] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Socioeconomic factors influence access to cancer care and survival. This study investigated the role of socioeconomic status on the risk of breast cancer recurrence and on the delivery of appropriate cancer care (sentinel lymph node biopsy and breast-conserving surgery plus radiotherapy), by patients' age and hormone receptor status. METHODS 3,462 breast cancer cases diagnosed in 2003-2005 were selected from 7 Italian cancer registries and assigned to a socioeconomic tertile on the basis of the deprivation index of their census tract. Multivariable models were applied to assess the delivery of sentinel lymph node biopsy and of breast-conserving surgery plus radiotherapy within socioeconomic tertiles. RESULTS In the 1,893 women younger than 65 years, the 5-year risk of recurrence was higher in the most deprived group than in the least deprived, but this difference was not significant (16.4% vs. 12.9%, log-rank p=0.08); no difference was seen in women ≥65 years. Among the 2,024 women with hormone receptor-positive cancer, the 5-year risk was significantly higher in the most deprived group than in the least deprived one (13.0% vs. 8.9%, p=0.04); no difference was seen in cases of hormone receptor-negative cancer. The most deprived women were less likely than the least deprived women to receive sentinel lymph node biopsy (adjusted odds ratio (ORa), 0.69; 95% CI, 0.56-0.86) and to undergo breast-conserving surgery plus radiotherapy (ORa=0.66; 95% CI, 0.51-0.86). Conclusions: Socioeconomic inequalities affect the risk of recurrence, among patients with hormone receptor-positive cancer, and the opportunity to receive standard care.
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Affiliation(s)
- Francesca Di Salvo
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Nicola Caranci
- Agenzia Sanitaria e Sociale Regione Emilia Romagna, Bologna, Italy
| | - Teresa Spadea
- Servizio Sovrazonale di Epidemiologia ASL Torino 3, Grugliasco, Italy
| | - Nicolas Zengarini
- Servizio Sovrazonale di Epidemiologia ASL Torino 3, Grugliasco, Italy
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Hade Amash
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Mario Fusco
- Naples Cancer Registry, ASL Napoli 3 Sud, Brusciano, Italy
| | - Fabrizio Stracci
- Umbria Cancer Registry, Public Health Department, University of Perugia, Perugia, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | - Claudia Cirilli
- Modena Cancer Registry, Public Health Department AUSL Modena, Modena, Italy
| | - Giuseppina Candela
- Trapani Cancer Registry, Health Prevention Department ASL 9 Trapani, Trapani, Italy
| | - Rosanna Cusimano
- Palermo Cancer Registry, Health Science Department University of Palermo, Palermo, Italy
| | - Rosario Tumino
- Ragusa Cancer Registry, Health Prevention Department ASP Ragusa, Ragusa, Italy
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Gatta G, Peris-Bonet R, Visser O, Stiller C, Marcos-Gragera R, Sánchez MJ, Lacour B, Kaatsch P, Berrino F, Rutkowski S, Botta L, Hackl M, Zielonke N, Oberaigner W, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Storm H, Engholm G, Mägi M, Aareleid T, Malila N, Seppä K, Faivre J, Bossard N, Uhry Z, Colonna M, Clavel J, Lacour B, Desandes E, Brenner H, Kaatsch P, Katalinic A, Garami M, Jakab Z, Comber H, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Sutera Sardo A, Mancuso P, Ferretti S, Barchielli A, Caldarella A, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Capocaccia R, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Zucchetto A, De Angelis R, Caldora M, Carrani E, Francisci S, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Busco S, Filiberti R, Marani E, Ricci P, Pascucci C, Autelitano M, Spagnoli G, Cirilli C, Fusco M, Vitale M, Usala M, Vitale F, Ravazzolo B, Michiara M, Merletti F, Maule M, Tumino R, Mangone L, Di Felice E, Falcini F, Iannelli A, Sechi O, Cesaraccio R, Piffer S, Madeddu A, Tisano F, Maspero S, Fanetti A, Candela P, Scuderi T, Stracci F, Bianconi F, Tagliabue G, Contiero P, Rugge M, Guzzinati S, Pildava S, Smailyte G, Calleja N, Agius D, Johannesen T, Rachtan J, Góźdź S, Mężyk R, Błaszczyk J, Bębenek M, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Castro C, Miranda A, Mayer-da-Silva A, Safaei Diba C, Primic-Zakelj M, Errezola M, Bidaurrazaga J, Vicente Raneda M, Díaz García J, Marcos-Navarro A, Marcos-Gragera R, Izquierdo Font A, Sanchez M, Chang D, Navarro C, Chirlaque M, Moreno-Iribas C, Ardanaz E, Peris-Bonet R, Pardo Romaguera E, Galceran J, Carulla M, Lambe M, Mousavi M, Bouchardy C, Usel M, Ess S, Frick H, Lorez M, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, Aarts M, Otter R, Coleman M, Allemani C, Rachet B, Verne J, Stiller C, Gavin A, Donnelly C, Brewster D. Geographical variability in survival of European children with central nervous system tumours. Eur J Cancer 2017; 82:137-148. [DOI: 10.1016/j.ejca.2017.05.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/11/2017] [Accepted: 05/16/2017] [Indexed: 11/28/2022]
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Agresti R, Meneghini E, Baili P, Minicozzi P, Turco A, Cavallo I, Funaro F, Amash H, Berrino F, Tagliabue E, Sant M. Association of adiposity, dysmetabolisms, and inflammation with aggressive breast cancer subtypes: a cross-sectional study. Breast Cancer Res Treat 2016; 157:179-89. [PMID: 27117160 DOI: 10.1007/s10549-016-3802-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/19/2016] [Indexed: 12/22/2022]
Abstract
Obesity and metabolic syndrome are risk and prognostic factors for breast cancer (BC) and are associated with chronic inflammation. We investigated the association between distinct BC subtypes and markers of adiposity, dysmetabolisms, and inflammation. We analyzed 1779 patients with primary invasive BC treated at a single institution, for whom anthropometric and clinical-pathological data were archived. BC subtypes were classified by immunohistochemical staining of ER, PR, HER2, and Ki67, and their relations with the study markers were assessed by multinomial logistic regression. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated taking luminal A as reference. All subtypes more aggressive than luminal A were significantly more frequent in younger (<45 years) than older women. Before menopause, luminal B HER2-negative tumors were positively associated with large waist (OR 2.55, 95 % CI 1.53-4.24) and insulin resistance (OR 1.90, 95 % CI 1.05-3.41); luminal B HER2-positive tumors with large waist (OR 2.11, 95 % CI 1.03-4.35) and triple-negative tumors with overweight (OR 3.04, 95 % CI 1.43-6.43) and high C-reactive protein (p trend = 0.026). In postmenopausal women aged <65, luminal B HER2-negative (OR 1.94, 95 % CI 1.16-3.24) and luminal B HER2-positive tumors (OR 2.48, 95 % CI 1.16-5.27) were positively related with metabolic syndrome. Dysmetabolisms and inflammation may be related to different BC subtypes. Before menopause, triple-negative cancers were related to obesity and chronic inflammation, and aggressive luminal subtypes to abdominal adiposity. After menopause, in women aged <65 these latter subtypes were related to metabolic syndrome. Control of adiposity and dysmetabolism can reduce the risk of aggressive BC subtypes, improving the prognosis.
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Affiliation(s)
- Roberto Agresti
- Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Elisabetta Meneghini
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy.
| | - Paolo Baili
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Pamela Minicozzi
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Alberto Turco
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Ilaria Cavallo
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Francesco Funaro
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Hade Amash
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Franco Berrino
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Elda Tagliabue
- Molecular Targeting Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Milena Sant
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
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Vaglio S, Minicozzi P, Romoli R, Boscaro F, Pieraccini G, Moneti G, Moggi-Cecchi J. Sternal Gland Scent-Marking Signals Sex, Age, Rank, and Group Identity in Captive Mandrills. Chem Senses 2015; 41:177-86. [PMID: 26708734 DOI: 10.1093/chemse/bjv077] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2015] [Indexed: 11/15/2022] Open
Abstract
Mandrills are one of the few Old World primates to show scent-marking. We combined ethological and chemical approaches to improve our understanding of this behavior in 3 zoo-managed groups. We observed the olfactory behavior performed by adults and adolescents (N = 39) for 775h. We investigated the volatile components of sternal scent-marks using gas chromatography-mass spectrometry and compared volatile profiles with traits of the signaler. Males marked more than females and within each sex the frequency of scent-marking was related to age and dominance status, but alpha males scent-marked most frequently and particularly in specific areas at the enclosure boundaries. We identified a total of 77 volatile components of sternal gland secretion, including compounds functioning as male sex pheromones in other mammals, in scent-marks spontaneously released on filter paper by 27 male and 18 female mandrills. We confirmed our previous findings that chemical profiles contain information including sex, male age and rank, and we also found that odor may encode information about group membership in mandrills. Our results support the hypotheses that scent-marking signals the status of the dominant male as well as playing territorial functions but also suggest that it is part of sociosexual communication.
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Affiliation(s)
- Stefano Vaglio
- Department of Anthropology & Behaviour, Ecology and Evolution Research Centre, Durham University, Durham DH1 3LE, UK, School of Biology, Chemistry and Forensic Science, University of Wolverhampton, Wolverhampton WV1 1LY, UK, Laboratory of Anthropology, Department of Biology, Florence University, Florence 50122, Italy,
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy and
| | - Riccardo Romoli
- Mass Spectrometry Center (CISM), Florence University, Florence 50139, Italy
| | - Francesca Boscaro
- Mass Spectrometry Center (CISM), Florence University, Florence 50139, Italy
| | | | - Gloriano Moneti
- Mass Spectrometry Center (CISM), Florence University, Florence 50139, Italy
| | - Jacopo Moggi-Cecchi
- Laboratory of Anthropology, Department of Biology, Florence University, Florence 50122, Italy
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Mounier M, Bossard N, Remontet L, Belot A, Minicozzi P, De Angelis R, Capocaccia R, Iwaz J, Monnereau A, Troussard X, Sant M, Maynadié M, Giorgi R. Changes in dynamics of excess mortality rates and net survival after diagnosis of follicular lymphoma or diffuse large B-cell lymphoma: comparison between European population-based data (EUROCARE-5). Lancet Haematol 2015; 2:e481-91. [PMID: 26686258 DOI: 10.1016/s2352-3026(15)00155-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/14/2015] [Accepted: 08/17/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND Since 2001, the World Health Organization classification of tumours of haematopoietic and lymphoid tissues and the International Classification of Diseases for Oncology (third edition) have improved data collection for lymphoma subtypes in most European cancer registries and allowed reporting on the major non-Hodgkin lymphoma subtypes. Treatment of non-Hodgkin lymphoma has changed profoundly, benefiting patients with follicular lymphoma or diffuse large B-cell lymphoma. We aimed to compare dynamics of cancer mortality in patients with follicular lymphoma or diffuse large B-cell lymphoma in five large European areas using data for survival from the largest number of collaborative European population-based cancer registries (EUROCARE). METHODS We considered follicular lymphoma and diffuse large B-cell lymphoma cases in patients aged older than 15 years diagnosed between Jan 1, 1996, and Dec 31, 2004, and recorded in 43 cancer registries in five areas: Scotland and Wales, and northern, central, eastern, and southern Europe. We excluded cases incidentally diagnosed at autopsy or known from death certificates only. The vital status could be updated on Dec 31, 2008, in all registries but the French ones (Dec 31, 2007). We obtained changes in net survival with the Pohar-Perme estimator and excess mortality rate with a flexible parametric model according to age and year of diagnosis. FINDINGS We identified 13,988 follicular lymphoma and 25,320 diffuse large B-cell lymphoma cases. We noted improvements in 5-year net survival for all ages between the 1999-2001 and 2002-04 periods for both cancers (except for follicular lymphoma in Scotland and Wales and diffuse large B-cell lymphoma in eastern Europe). For follicular lymphoma, 5-year net survival in northern Europe was 64% (95% CI 58-71) in 1999-2001 versus 75% (69-80) for 2002-04, for Scotland and Wales, it was 71% (66-76) versus 68% (64-72), for central Europe, it was 64% (61-67) versus 72% (70-75), for southern Europe, it was 67% (63-70) versus 73% (70-76), and for eastern Europe, it was 50% (43-57) versus 61% (54-69). For diffuse large B-cell lymphoma, 5-year net survival in northern Europe was 41% (35-49) versus 58% (54-62), in Scotland and Wales, it was 44% (41-48) versus 52% (49-54), in central Europe, it was 46% (44-47) versus 50% (48-51), in southern Europe, it was 44% (42-47) versus 50% (48-52), and in eastern Europe, it was 47% (41-54) versus 46% (43-50). We noted the largest area disparity during the 2002-04 period between eastern and northern Europe. We noted a significant effect of the year of diagnosis on the excess mortality rate for all ages in all areas, except for diffuse large B-cell lymphoma in eastern Europe. The excess mortality rate was not constant during the follow-up period: we noted a high rate early for both lymphomas, except for follicular lymphoma in northern Europe. INTERPRETATION Although survival for follicular lymphoma and diffuse large B-cell lymphoma is improving, the results from this study should foster the search for more and better means of improvement of access to adequate care than that at present, as there remains variation in survival between European regions. Study of the dynamics of the excess mortality rate seems to be a useful clinical indicator to help the practitioner's choice of optimum management of patients. FUNDING Compagnia di San Paolo, Fondazione Cariplo Italy, Italian Ministry of Health, European Commission, Registre des Hémopathies Malignes de Côte d'Or, and French Agence Nationale de la Recherche.
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Affiliation(s)
- Morgane Mounier
- Registre des Hémopathies Malignes de Côte d'Or, Université de Bourgogne Franche-Comté, Dijon, France; Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Centre national de la recherche scientifique unités mixtes de recherche 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique Santé, Villeurbanne, France; Institut national de la santé et de la recherche médicale unités mixtes de recherche S 912 Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Faculté de Médecine, Marseille, France; Aix Marseille Université unités mixtes de recherche S 912 Institut de recherche pour le développement, Marseille, France
| | - Nadine Bossard
- Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Centre national de la recherche scientifique unités mixtes de recherche 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique Santé, Villeurbanne, France; Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
| | - Laurent Remontet
- Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Centre national de la recherche scientifique unités mixtes de recherche 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique Santé, Villeurbanne, France; Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
| | - Aurélien Belot
- Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberta De Angelis
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Riccardo Capocaccia
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Jean Iwaz
- Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Centre national de la recherche scientifique unités mixtes de recherche 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique Santé, Villeurbanne, France; Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
| | - Alain Monnereau
- Registre des hémopathies malignes de la Gironde, Institut Bergonié, Bordeaux, France; Centre Institut national de la santé et de la recherche médicale U897, Centre d'Investigation Clinique 1401, Bordeaux, France
| | - Xavier Troussard
- Registre régional des hémopathies malignes de la Basse Normandie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan, Italy
| | - Marc Maynadié
- Registre des Hémopathies Malignes de Côte d'Or, Université de Bourgogne Franche-Comté, Dijon, France; Service d'Hématologie Biologique, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Roch Giorgi
- Institut national de la santé et de la recherche médicale unités mixtes de recherche S 912 Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Faculté de Médecine, Marseille, France; Aix Marseille Université unités mixtes de recherche S 912 Institut de recherche pour le développement, Marseille, France.
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Rossi S, Baili P, Capocaccia R, Caldora M, Carrani E, Minicozzi P, Pierannunzio D, Santaquilani M, Trama A, Allemani C, Belot A, Buzzoni C, Lorez M, De Angelis R. The EUROCARE-5 study on cancer survival in Europe 1999-2007: Database, quality checks and statistical analysis methods. Eur J Cancer 2015; 51:2104-2119. [PMID: 26421815 DOI: 10.1016/j.ejca.2015.08.001] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 08/03/2015] [Accepted: 08/05/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Since 25years the EUROCARE study monitors the survival of cancer patients in Europe through centralised collection, quality check and statistical analysis of population-based cancer registries (CRs) data. The European population covered by the study increased remarkably in the latest round. The study design and statistical methods were also changed to improve timeliness and comparability of survival estimates. To interpret the EUROCARE-5 results on adult cancer patients better here we assess the impact of these changes on data quality and on survival comparisons. METHODS In EUROCARE-5 the survival differences by area were studied applying the complete cohort approach to data on nearly nine million cancer patients diagnosed in 2000-2007 and followed up to 2008. Survival time trends were analysed applying the period approach to data on about 10 million cancer cases diagnosed from 1995 to 2007 and followed up to 2008. Differently from EUROCARE-4, multiple primary cancers were included and relative survival was estimated with the Ederer II method. RESULTS EUROCARE-5 covered a population of 232 million resident persons, corresponding to 50% of the 29 participating countries. The population coverage increased particularly in Eastern Europe. Cases identified from death certificate only (DCO) were on average 2.9%, range 0-12%. Microscopically confirmed cases amounted to over 85% in most CRs. Compared to previous methods, including multiple cancers and using the Ederer II estimator reduced survival estimates by 0.4 and 0.3 absolute percentage points, on average. CONCLUSIONS The increased population size and registration coverage of the EUROCARE-5 study ensures more robust and comparable estimates across European countries. This enlargement did not impact on data quality, which was generally satisfactory. Estimates may be slightly inflated in countries with high or null DCO proportions, especially for poor prognosis cancers. The updated methods improved the comparability of survival estimates between recently and long-term established registries and reduced biases due to informative censoring.
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Affiliation(s)
- Silvia Rossi
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy.
| | - Paolo Baili
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy
| | - Riccardo Capocaccia
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy; Department of Preventive and Predictive Medicine, Evaluative epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy
| | - Massimiliano Caldora
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Eugenio Carrani
- Servizio informatico, documentazione, biblioteca ed attività editoriali, Settore I - Informatica Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Pamela Minicozzi
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy
| | - Daniela Pierannunzio
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Mariano Santaquilani
- Servizio informatico, documentazione, biblioteca ed attività editoriali, Settore I - Informatica Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Annalisa Trama
- Department of Preventive and Predictive Medicine, Evaluative epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy
| | - Claudia Allemani
- Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK
| | - Aurelien Belot
- Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK; Service de Biostatistique, Hospices Civils de Lyon, F-69003 Lyon, France; Université de Lyon, F-69000 Lyon, France; Université de Lyon 1, F-69100 Villeurbanne, France; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, F-69100 Villeurbanne, France
| | - Carlotta Buzzoni
- Registro Tumori Toscano, Istituto per lo studio e la prevenzione oncologica, Via Cosimo il Vecchio 2, 50141 Florence, Italy
| | - Matthias Lorez
- Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zürich, Seilergraben 49, CH-8001 Zürich, Switzerland
| | - Roberta De Angelis
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
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Marcos-Gragera R, Mallone S, Kiemeney LA, Vilardell L, Malats N, Allory Y, Sant M, Hackl M, Zielonke N, Oberaigner W, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Zvolský M, Dušek L, Storm H, Engholm G, Mägi M, Aareleid T, Malila N, Seppä K, Velten M, Troussard X, Bouvier V, Launoy G, Guizard A, Faivre J, M. Bouvier A, Arveux P, Maynadié M, Woronoff A, Robaszkiewicz M, Baldi I, Monnereau A, Tretarre B, Bossard N, Belot A, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Meyer M, Stabenow R, Luttmann S, Eberle A, Brenner H, Nennecke A, Engel J, Schubert-Fritschle G, Kieschke J, Heidrich J, Holleczek B, Katalinic A, Jónasson J, Tryggvadóttir L, Comber H, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Sutera Sardo A, Mazzei A, Ferretti S, Crocetti E, Manneschi G, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Zucchetto A, De Angelis R, Caldora M, Capocaccia R, Carrani E, Francisci S, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Busco S, Bonelli L, Vercelli M, Gennaro V, Ricci P, Autelitano M, Randi G, Ponz De Leon M, Marchesi C, Cirilli C, Fusco M, Vitale M, Usala M, Traina A, Zarcone M, Vitale F, Cusimano R, Michiara M, Tumino R, Giorgi Rossi P, Vicentini M, Falcini F, Iannelli A, Sechi O, Cesaraccio R, Piffer S, Madeddu A, Tisano F, Maspero S, Fanetti A, Zanetti R, Rosso S, Candela P, Scuderi T, Stracci F, Rocca A, Tagliabue G, Contiero P, Dei Tos A, Tognazzo S, Pildava S, Smailyte G, Calleja N, Micallef R, Johannesen T, Rachtan J, Gózdz S, Mezyk R, Blaszczyk J, Kepska K, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Antunes L, Miranda A, Mayer-da-Silva A, Nicula F, Coza D, Safaei Diba C, Primic-Zakelj M, Almar E, Mateos A, Errezola M, Larrañaga N, Torrella-Ramos A, Díaz García J, Marcos-Navarro A, Marcos-Gragera R, Vilardell L, Sanchez M, Molina E, Navarro C, Chirlaque M, Moreno-Iribas C, Ardanaz E, Galceran J, Carulla M, Lambe M, Khan S, Mousavi M, Bouchardy C, Usel M, Ess S, Frick H, Lorez M, Ess S, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, Aben K, Coleman M, Allemani C, Rachet B, Verne J, Easey N, Lawrence G, Moran T, Rashbass J, Roche M, Wilkinson J, Gavin A, Fitzpatrick D, Brewster D, Huws D, White C, Otter R. Urinary tract cancer survival in Europe 1999–2007: Results of the population-based study EUROCARE-5. Eur J Cancer 2015; 51:2217-2230. [DOI: 10.1016/j.ejca.2015.07.028] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 07/02/2015] [Accepted: 07/20/2015] [Indexed: 12/22/2022]
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De Angelis R, Minicozzi P, Sant M, Dal Maso L, Brewster DH, Osca-Gelis G, Visser O, Maynadié M, Marcos-Gragera R, Troussard X, Agius D, Roazzi P, Meneghini E, Monnereau A, Hackl M, Zielonke N, Oberaigner W, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Zvolský M, Dušek L, Storm H, Engholm G, Mägi M, Aareleid T, Malila N, Seppä K, Velten M, Troussard X, Bouvier V, Launoy G, Guizard A, Faivre J, Bouvier A, Arveux P, Maynadié M, Woronoff A, Robaszkiewicz M, Baldi I, Monnereau A, Tretarre B, Bossard N, Belot A, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Meyer M, Stabenow R, Luttmann S, Eberle A, Brenner H, Nennecke A, Engel J, Schubert-Fritschle G, Kieschke J, Heidrich J, Holleczek B, Katalinic A, Jónasson J, Tryggvadóttir L, Comber H, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Sutera Sardo A, Mancuso P, Ferretti S, Crocetti E, Caldarella A, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Dal Maso L, De Angelis R, Caldora M, Capocaccia R, Carrani E, Francisci S, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Busco S, Bonelli L, Vercelli M, Gennaro V, Ricci P, Autelitano M, Randi G, Ponz De Leon M, Marchesi C, Cirilli C, Fusco M, Vitale M, Usala M, Traina A, Staiti R, Vitale F, Ravazzolo B, Michiara M, Tumino R, Giorgi Rossi P, Di Felice E, Falcini F, Iannelli A, Sechi O, Cesaraccio R, Piffer S, Madeddu A, Tisano F, Maspero S, Fanetti A, Zanetti R, Rosso S, Candela P, Scuderi T, Stracci F, Bianconi F, Tagliabue G, Contiero P, Dei Tos A, Guzzinati S, Pildava S, Smailyte G, Calleja N, Agius D, Johannesen T, Rachtan J, Gózdz S, Mezyk R, Blaszczyk J, Bebenek M, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Castro C, Miranda A, Mayer-da-Silva A, Nicula F, Coza D, Safaei Diba C, Primic-Zakelj M, Almar E, Ramírez C, Errezola M, Bidaurrazaga J, Torrella-Ramos A, Díaz García J, Jimenez-Chillaron R, Marcos-Gragera R, Izquierdo Font A, Sanchez M, Chang D, Navarro C, Chirlaque M, Moreno-Iribas C, Ardanaz E, Galceran J, Carulla M, Lambe M, Khan S, Mousavi M, Bouchardy C, Usel M, Ess S, Frick H, Lorez M, Ess S, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, Lemmens V, Coleman M, Allemani C, Rachet B, Verne J, Easey N, Lawrence G, Moran T, Rashbass J, Roche M, Wilkinson J, Gavin A, Donnelly C, Brewster D, Huws D, White C, Otter R. Survival variations by country and age for lymphoid and myeloid malignancies in Europe 2000–2007: Results of EUROCARE-5 population-based study. Eur J Cancer 2015; 51:2254-2268. [DOI: 10.1016/j.ejca.2015.08.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 08/06/2015] [Accepted: 08/11/2015] [Indexed: 12/28/2022]
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Trama A, Foschi R, Larrañaga N, Sant M, Fuentes-Raspall R, Serraino D, Tavilla A, Van Eycken L, Nicolai N, Hackl M, Zielonke N, Oberaigner W, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Zvolský M, Dušek L, Storm H, Engholm G, Mägi M, Aareleid T, Malila N, Seppä K, Velten M, Troussard X, Bouvier V, Launoy G, Guizard A, Faivre J, Bouvier A, Arveux P, Maynadié M, Woronoff A, Robaszkiewicz M, Baldi I, Monnereau A, Tretarre B, Bossard N, Belot A, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Meyer M, Stabenow R, Luttmann S, Eberle A, Brenner H, Nennecke A, Engel J, Schubert-Fritschle G, Kieschke J, Heidrich J, Holleczek B, Katalinic A, Jónasson J, Tryggvadóttir L, Comber H, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Sutera Sardo A, Mancuso P, Ferretti S, Crocetti E, Caldarella A, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Dal Maso L, De Angelis R, Caldora M, Capocaccia R, Carrani E, Francisci S, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Busco S, Bonelli L, Vercelli M, Gennaro V, Ricci P, Autelitano M, Randi G, Ponz De Leon M, Marchesi C, Cirilli C, Fusco M, F. Vitale M, Usala M, Traina A, Staiti R, Vitale F, Ravazzolo B, Michiara M, Tumino R, Giorgi Rossi P, Di Felice E, Falcini F, Iannelli A, Sechi O, Cesaraccio R, Piffer S, Madeddu A, Tisano F, Maspero S, Fanetti A, Zanetti R, Rosso S, Candela P, Scuderi T, Stracci F, Bianconi F, Tagliabue G, Contiero P, Dei Tos A, Guzzinati S, Pildava S, Smailyte G, Calleja N, Agius D, Johannesen T, Rachtan J, Gózdz S, Mezyk R, Blaszczyk J, Bebenek M, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Castro C, Miranda A, Mayer-da-Silva A, Nicula F, Coza D, Safaei Diba C, Primic-Zakelj M, Almar E, Ramírez C, Errezola M, Bidaurrazaga J, Torrella-Ramos A, Díaz García J, Jimenez-Chillaron R, Marcos-Gragera R, Izquierdo Font A, J. Sanchez M, Chang D, Navarro C, Chirlaque M, Moreno-Iribas C, Ardanaz E, Galceran J, Carulla M, Lambe M, Khan S, Mousavi M, Bouchardy C, Usel M, M. Ess S, Frick H, Lorez M, Ess S, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, Verhoeven R, Coleman M, Allemani C, Rachet B, Verne J, Easey N, Lawrence G, Moran T, Rashbass J, Roche M, Wilkinson J, Gavin A, Donnelly C, Brewster D, Huws D, White C, Otter R. Survival of male genital cancers (prostate, testis and penis) in Europe 1999–2007: Results from the EUROCARE-5 study. Eur J Cancer 2015; 51:2206-2216. [DOI: 10.1016/j.ejca.2015.07.027] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/09/2015] [Accepted: 07/20/2015] [Indexed: 11/26/2022]
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Sant M, Chirlaque Lopez MD, Agresti R, Sánchez Pérez MJ, Holleczek B, Bielska-Lasota M, Dimitrova N, Innos K, Katalinic A, Langseth H, Larrañaga N, Rossi S, Siesling S, Minicozzi P. Survival of women with cancers of breast and genital organs in Europe 1999-2007: Results of the EUROCARE-5 study. Eur J Cancer 2015; 51:2191-2205. [PMID: 26421822 DOI: 10.1016/j.ejca.2015.07.022] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 07/08/2015] [Accepted: 07/20/2015] [Indexed: 01/30/2023]
Abstract
BACKGROUND Survival differences across Europe for patients with cancers of breast, uterus, cervix, ovary, vagina and vulva have been documented by previous EUROCARE studies. In the present EUROCARE-5 study we update survival estimates and investigate changes in country-specific and over time survival, discussing their relationship with incidence and mortality dynamics for cancers for which organised screening programs are ongoing. METHODS We analysed cases archived in over 80 population-based cancer registries in 29 countries grouped into five European regions. We used the cohort approach to estimate 5-year relative survival (RS) for adult (⩾15years) women diagnosed 2000-2007, by age, country and region; and the period approach to estimate time trends (1999-2007) in RS for breast and cervical cancers. RESULTS In 2000-2007, 5-year RS was 57% overall, 82% for women diagnosed with breast, 76% with corpus uteri, 62% with cervical, 38% with ovarian, 40% with vaginal and 62% with vulvar cancer. Survival was low for patients resident in Eastern Europe (34% ovary-74% breast) and Ireland and the United Kingdom [Ireland/UK] (31-79%) and high for those resident in Northern Europe (41-85%) except Denmark. Survival decreased with advancing age: markedly for women with ovarian (71% 15-44years; 20% ⩾75years) and breast (86%; 72%) cancers. Survival for patients with breast and cervical cancers increased from 1999-2001 to 2005-2007, remarkably for those resident in countries with initially low survival. CONCLUSIONS Despite increases over time, survival for women's cancers remained poor in Eastern Europe, likely due to advanced stage at diagnosis and/or suboptimum access to adequate care. Low survival for women living in Ireland/UK and Denmark could indicate late detection, possibly related also to referral delay. Poor survival for ovarian cancer across the continent and over time suggests the need for a major research effort to improve prognosis for this common cancer.
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Affiliation(s)
- Milena Sant
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Maria Dolores Chirlaque Lopez
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Roberto Agresti
- Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Italy
| | - Maria José Sánchez Pérez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitariam, University Hospitals of Granada, Granada, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Magdalena Bielska-Lasota
- Department of Health Promotion and Postgraduate Education, National Institute of Public Health - National Institute of Higiene, Warsaw, Poland
| | - Nadya Dimitrova
- Bulgarian National Cancer Registry, National Hospital of Oncology, Sofia, Bulgaria
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | | | - Hilde Langseth
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Department of Research, Oslo, Norway
| | - Nerea Larrañaga
- Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy
| | - Sabine Siesling
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands; MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Pamela Minicozzi
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Crocetti E, Mallone S, Robsahm TE, Gavin A, Agius D, Ardanaz E, Lopez MDC, Innos K, Minicozzi P, Borgognoni L, Pierannunzio D, Eisemann N. Survival of patients with skin melanoma in Europe increases further: Results of the EUROCARE-5 study. Eur J Cancer 2015; 51:2179-2190. [PMID: 26421821 DOI: 10.1016/j.ejca.2015.07.039] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/08/2015] [Accepted: 07/20/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND In Europe skin melanoma (SM) survival has increased over time. The aims were to evaluate recent trends and differences between countries and regions of Europe. METHODS Relative survival (RS) estimates and geographical comparisons were based on 241,485 patients aged 15years and over with a diagnosis of invasive SM in Europe (2000-2007). Survival time trends during 1999-2007 were estimated using the period approach, for 213,101 patients. Age, gender, sub-sites and morphology subgroups were considered. RESULTS In European patients, estimated 5-year RS was 83% (95% confidence interval, CI 83-84%). The highest values were found for patients resident in Northern (88%; 87-88%) and Central (88%; 87-88%) Europe, followed by Ireland and United Kingdom (UK) (86%; 85-86%) and Southern Europe (83%; 82-83%). The lowest survival was in Eastern Europe (74%; 74-75%). Within regions the intercountry absolute difference in percentage points of RS varied from 4% (North) to 34% (East). RS decreased markedly with patients' age and was higher in women than men. Differences according to SM morphology and skin sub-sites also emerged. Survival has slightly increased from 1999 to 2007, with a small improvement in Northern and the most pronounced improvement in Eastern Europe. DISCUSSION SM survival is high and still increasing in European patients. The gap between Northern and Southern and especially Eastern European countries, although still present, diminished over time. Differences in stage distribution at diagnosis may explain most of the geographical differences. However, part of the improvement in survival may be attributed to overdiagnosis from early diagnosis practices.
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Affiliation(s)
- Emanuele Crocetti
- UO Epidemiologia Clinica, Descrittiva e Registri - ISPO, Firenze, Italy.
| | - Sandra Mallone
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Trude Eid Robsahm
- Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queens University, Belfast, Northern Ireland, UK
| | - Domenic Agius
- Malta National Cancer Registry, Department of Health Information and Research, Pieta, Malta
| | - Eva Ardanaz
- Navarra Cancer Registry, Navarra Public Health Institute, Pamplona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Maria-Dolores Chirlaque Lopez
- Servicio de Epidemiología, Department of Epidemiology, Consejería de Sanidad, Murcia Health Authority, Murcia, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Kaire Innos
- Department of Epidemiology and Biostatistics National, Institute for Health Development, Tallinn, Estonia
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lorenzo Borgognoni
- SC Chirurgia Plastica e Ricostruttiva, Ospedale S.M. Annunziata - Azienda Sanitaria di Firenze Centro di Riferimento Regionale per il Melanoma, Istituto Toscano Tumori, Firenze, Italy
| | - Daniela Pierannunzio
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Nora Eisemann
- Institute of Cancer Epidemiology, University of Luebeck, Luebeck, Germany
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Lepage C, Capocaccia R, Hackl M, Lemmens V, Molina E, Pierannunzio D, Sant M, Trama A, Faivre J, Zielonke N, Oberaigner W, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Zvolský M, Dušek L, Storm H, Engholm G, Mägi M, Aareleid T, Malila N, Seppä K, Velten M, Troussard X, Bouvier V, Launoy G, Guizard A, Faivre J, Bouvier A, Arveux P, Maynadié M, Woronoff A, Robaszkiewicz M, Baldi I, Monnereau A, Tretarre B, Bossard N, Belot A, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Meyer M, Stabenow R, Luttmann S, Eberle A, Brenner H, Nennecke A, Engel J, Schubert-Fritschle G, Kieschke J, Heidrich J, Holleczek B, Katalinic A, Jónasson J, Tryggvadóttir L, Comber H, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Sutera Sardo A, Mancuso P, Ferretti S, Crocetti E, Caldarella A, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Dal Maso L, De Angelis R, Caldora M, Capocaccia R, Carrani E, Francisci S, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Busco S, Bonelli L, Vercelli M, Gennaro V, Ricci P, Autelitano M, Randi G, Ponz De Leon M, Marchesi C, Cirilli C, Fusco M, Vitale M, Usala M, Traina A, Staiti R, Vitale F, Ravazzolo B, Michiara M, Tumino R, Giorgi Rossi P, Di Felice E, Falcini F, Iannelli A, Sechi O, Cesaraccio R, Piffer S, Madeddu A, Tisano F, Maspero S, Fanetti A, Zanetti R, Rosso S, Candela P, Scuderi T, Stracci F, Bianconi F, Tagliabue G, Contiero P, Dei Tos A, Guzzinati S, Pildava S, Smailyte G, Calleja N, Agius D, Johannesen T, Rachtan J, Gózdz S, Mezyk R, Blaszczyk J, Bebenek M, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Castro C, Miranda A, Mayer-da-Silva A, Nicula F, Coza D, Safaei Diba C, Primic-Zakelj M, Almar E, Ramírez C, Errezola M, Bidaurrazaga J, Torrella-Ramos A, Díaz García J, Jimenez-Chillaron R, Marcos-Gragera R, Izquierdo Font A, Sanchez M, Chang D, Navarro C, Chirlaque M, Moreno-Iribas C, Ardanaz E, Galceran J, Carulla M, Lambe M, Khan S, Mousavi M, Bouchardy C, Usel M, Ess S, Frick H, Lorez M, Ess S, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, van der Geest L, Otter R, Coleman M, Allemani C, Rachet B, Verne J, Easey N, Lawrence G, Moran T, Rashbass J, Roche M, Wilkinson J, Gavin A, Donnelly C, Brewster D, Huws D, White C. Survival in patients with primary liver cancer, gallbladder and extrahepatic biliary tract cancer and pancreatic cancer in Europe 1999-2007: Results of EUROCARE-5. Eur J Cancer 2015; 51:2169-2178. [PMID: 26421820 DOI: 10.1016/j.ejca.2015.07.034] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/10/2015] [Accepted: 07/20/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND The EUROCARE study collects and analyses survival data from population-based cancer registries (CRs) in Europe in order to provide data on between-country differences in survival and time trends in survival. METHODS This study analyses data on liver cancer, gallbladder and extrahepatic biliary tract cancers ("biliary tract cancers"), and pancreatic cancer diagnosed in 2000-2007 from 88 CRs in 29 countries. Relative survival (RS) was estimated overall, by region, sex, age and period of diagnosis using the complete approach. Time trends in 5-year RS over 1999-2007 were also analysed using the period approach. RESULTS The prognosis of the studied cancers was poor. Age-standardised 5-year RS was 12% for liver cancer, 17% for biliary tract cancers and 7% for pancreatic cancer. There were some between-country differences in survival. In general, RS was low in Eastern Europe and high in Central and Southern Europe. For all sites, 5-year RS was similar in men and women and decreased with advancing age. No substantial changes in survival were reported for pancreatic cancer over the period 1999-2007. On average, there was a crude increase in 5-year RS of 3 percentage points between the periods 1999-2001 and 2005-2007 for liver cancer and biliary tract cancers. CONCLUSIONS The major changes in imaging techniques over the study period for the diagnosis of the three studied cancers did not result in an improvement in the prognosis of these cancers. In the near future, new innovative treatments might be the best way to improve the prognosis in these cancers.
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Affiliation(s)
- Côme Lepage
- Burgundy Cancer Registry, INSERM U866, Dijon, France; Department of Gastroenterology, University Hospital, Dijon, France; Burgundy University, Dijon, France.
| | | | - Monika Hackl
- Bundesanstalt statistical Osterreich, Vienna, Austria
| | - Valerie Lemmens
- Departement of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Esther Molina
- Escuela Andaluza de Salud Peblica, Insituto de Investigation biosanitaria, Hospitales Universitarios Universidad Granada, Spain
| | | | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Department of Preventive and Predictive medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Jean Faivre
- Burgundy Cancer Registry, INSERM U866, Dijon, France; Department of Gastroenterology, University Hospital, Dijon, France; Burgundy University, Dijon, France
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Holleczek B, Rossi S, Domenic A, Innos K, Minicozzi P, Francisci S, Hackl M, Eisemann N, Brenner H. On-going improvement and persistent differences in the survival for patients with colon and rectum cancer across Europe 1999-2007 - Results from the EUROCARE-5 study. Eur J Cancer 2015; 51:2158-2168. [PMID: 26421819 DOI: 10.1016/j.ejca.2015.07.024] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/09/2015] [Accepted: 07/19/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Previous population-based studies revealed major variation in survival for patients with colorectal cancer (CRC) in Europe by age and between different countries and regions, but also a sustained improvement in survival for patients with CRC in recent years. This EUROCARE-5 paper aims to update available knowledge from previous studies and to provide the latest survival estimates for CRC patients from Europe. METHODS The study analysed data of patients diagnosed with CRC from population-based cancer registries diagnosed in 29 European countries. Estimates of 1-year and 5-year relative survival (RS) were derived for patients diagnosed in 2000-2007 by European region, country and age at diagnosis. Additionally to these cohort estimates, time trends in 5-year RS were obtained for the calendar periods 1999-2001 and 2005-2007, using the period analysis methodology. RESULTS European average 5-year RS for patients diagnosed with colon and rectum cancer was 57% and 56%, respectively. The analyses showed persistent differences in cancer survival across Europe with lowest survival for CRC patients observed in Eastern Europe. The analyses further showed a strong gradient in age-specific survival. Even though the study revealed sustained improvement in patient survival between 1999-2001 and 2005-2007 (absolute increase of 4 and 6 percentage points for colon and rectum, respectively), the differences in the survival for CRC patients observed at the beginning of the millennium persisted over time. CONCLUSION Although survival for CRC patients in Europe improved markedly in the study period, significant geographic variations and a strong age gradient still persisted. Enhanced access to effective diagnostic procedures and treatment options might be the keys to reducing the existing disparities in the survival of CRC patients across Europe.
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Affiliation(s)
- Bernd Holleczek
- Saarland Cancer Registry, Präsident Baltz Straße 5, 66119 Saarbrücken, Germany.
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena, 299, 00161 Rome, Italy
| | - Agius Domenic
- Malta National Cancer Registry, DHIR, 95, G'Mangia Hill, G'Mangia, Malta
| | - Kaire Innos
- National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine Fondazione IRCCS, Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Silvia Francisci
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena, 299, 00161 Rome, Italy
| | - Monika Hackl
- Austrian National Cancer Registry, Statistics Austria, Vienna, Austria
| | - Nora Eisemann
- Institute of Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), INF 581, 69120 Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ), INF 581, 69120 Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
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Sant M, Francisci S, Minicozzi P, Otter R, Primic-Zakeli M, Gatta G, Rossi S, Baili P, Anderson L, Holleczek B, Lepage C, Crocetti E, Trama A, Marcos-Gragera R, Visser O, Berrino F, Capocaccia R, De Angelis R. 1LBA Is Europe doing better in cancer care since the 90s? The latestfindings from the EUROCARE-5 study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(15)30066-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tumino R, Minicozzi P, Frasca G, Allemani C, Crocetti E, Ferretti S, Giacomin A, Natali M, Mangone L, Falcini F, Capocaccia R, Sant M. Population-based method for investigating adherence to international recommendations for pathology reporting of primary cutaneous melanoma: Results of a EUROCARE-5 high resolution study. Cancer Epidemiol 2015; 39:424-9. [PMID: 25735220 DOI: 10.1016/j.canep.2015.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/05/2015] [Indexed: 10/23/2022]
Abstract
AIM Our study aim was to investigate the degree of adherence to international recommendations for cutaneous melanoma pathology reports at the population level by a EUROCARE high resolution study. METHODS The availability of nine characteristics - predominant cell type, tumour-infiltrating lymphocytes, mitotic index, histological subtype, growth phase, Clark level, Breslow thickness, ulceration, and sentinel-node biopsy - was examined on pathology reports of a random sample of 636 cases diagnosed in 2003-2005 in seven Italian cancer registries: Biella, Ferrara, Firenze, Latina, Ragusa, Reggio Emilia, Romagna. The odds of having (versus not having) information for all four core characteristics (last four listed above) were estimated. RESULTS Sentinel node biopsy was available most often, followed by Clark level, Breslow thickness, histological subtype and ulceration. Information on all nine characteristics was more often available in Biella and Ferrara (northern Italy) than elsewhere. Information on all four core items was available for 78% of cases. Odds of four-core-item availability were higher (than mean) in Biella and lower in Latina (centre) and Ragusa (south). CONCLUSIONS The availability of information important for staging and management was good overall on pathology reports, but varied with geography. It is likely to be improved by wider dissemination of reporting guidelines and adoption of a standardised synoptic reporting system.
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Affiliation(s)
- Rosario Tumino
- Ragusa Cancer Registry, Department of Medical Prevention, Provincial Health Unit, Ragusa, Italy; Histopathology Unit, "MP Arezzo" Civic Hospital, Ragusa, Italy.
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy.
| | - Graziella Frasca
- Ragusa Cancer Registry, Department of Medical Prevention, Provincial Health Unit, Ragusa, Italy.
| | - Claudia Allemani
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy.
| | | | - Stefano Ferretti
- Ferrara Cancer Registry, Department of Experimental and Diagnostic Medicine, Ferrara, Italy.
| | - Adriano Giacomin
- Piedmont Cancer Registry, Province of Biella (CPO), Epidemiology Unit, Biella, Italy.
| | | | - Lucia Mangone
- Statistical, Quality and Clinical Studies Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
| | - Fabio Falcini
- Romagna Cancer Registry, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Forlì, Italy.
| | - Riccardo Capocaccia
- National Centre for Epidemiology, Surveillance and Health Promotion, Department of Cancer Epidemiology, Istituto Superiore di Sanità, Roma, Italy.
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy.
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Di Salvo F, Baili P, Vicentini M, Tumino R, Vercelli M, Pirino D, Contiero P, Foschi R, Minicozzi P, Giorgi Rossi P, De Lorenzo F, Micheli A. Cancer rehabilitation services: an Italian population-based cohort study. Tumori 2014; 100:346-51. [PMID: 25076249 DOI: 10.1700/1578.17224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND In Italy more than 55% of cancer patients live for more than 5 years after diagnosis, sometimes with several cancer-related sequelae. For this reason rehabilitation must offer not only physical interventions but also psychological, clinical, social and nutritional support. The CAREMORE pilot study was designed to assess whether cancer registries could serve to collect information on rehabilitation services, to describe and quantify the services provided by the National Health Service, and to examine the allocation of rehabilitation services to cancer patients. METHODS AND STUDY DESIGN This was a pilot population-based cohort study. A sample of 1200 patients was identified from the databases of the Varese, Genoa, Reggio Emilia, Sassari and Ragusa cancer registries, all diagnosed in 2002 and followed for 5 years. For 4 cancer sites a list of rehabilitation items to be collected was drafted by a joint community of researchers and voluntary associations, with variables regarding rehabilitation data and follow-up. Data were analyzed by groups of patients, vital status, sex, and age. RESULTS This pilot study suggested it is useful to collect information on several rehabilitation services: disability benefits, home care, aids and other support; it was not possible to collect reliable information on nutritional and psychological rehabilitation. In all, 36% of the sample applied for disability benefits, but with important differences between cancer sites. Eleven percent of the sample obtained home care, with no substantial differences between cancer sites, and 16% received at least one aid, with percentages varying from 27% for rectal cancer to 8% for lymphoma patients. CONCLUSIONS The pilot study indicated that cancer registries could collect information on rehabilitation services. In the future it would be interesting to expand the roles of these registries to factors that influence quality of life, taking into account the possibility of collecting more information by actually interviewing patients.
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Minicozzi P, Bouvier AM, Faivre J, Sant M. Management of rectal cancers in relation to treatment guidelines: a population-based study comparing Italian and French patients. Dig Liver Dis 2014; 46:645-51. [PMID: 24746280 DOI: 10.1016/j.dld.2014.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 02/15/2014] [Accepted: 03/16/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Few studies have investigated rectal cancer management at the population level. We compared how rectal cancers diagnosed in Italy (2003-2005) and France (2005) were managed, and evaluated the extent to which management adhered to European guidelines. METHODS Samples of 3938 Italian and 2287 French colorectal cancer patients were randomly extracted from 8 and 12 cancer registries respectively. Rectal cancer patients (860 Italian, 559 French) were analysed. Logistic regression models estimated odds ratios (ORs) of being treated with curative intent, receiving sphincter-saving surgery, and receiving preoperative radiotherapy. RESULTS Similar proportions of Italian and French patients were treated with curative intent (70% vs. 67%; OR=0.92 [0.73-1.16]); the respective proportions receiving sphincter-saving surgery were 21% and 33% (OR=1.15 [0.86-1.53]). In about 50% of those treated with curative intent, ≥ 12 lymph nodes were harvested in both countries. The proportion receiving postoperative radiotherapy was higher in Italy than in France (25% vs. 11%, p<0.01), but French patients were more likely to receive preoperative radiotherapy (52% vs. 21%; OR=4.06 [2.79-5.91]). CONCLUSION The proportions of patients receiving preoperative radiotherapy and the numbers of lymph nodes sampled were low in both countries. Centralising treatment and potentiating screening would be practical ways of improving outcomes and adhering to guidelines.
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Affiliation(s)
- Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Anne-Marie Bouvier
- Digestive Cancers Registry of Burgundy, University Hospital Dijon, Inserm U866, University of Burgundy, Dijon, France; FRANCIM (French Network of Cancer Registries), France
| | - Jean Faivre
- Digestive Cancers Registry of Burgundy, University Hospital Dijon, Inserm U866, University of Burgundy, Dijon, France; FRANCIM (French Network of Cancer Registries), France
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Minicozzi P, Kaleci S, Maffei S, Allemani C, Giacomin A, Caldarella A, Iachetta F, Fusco M, Tumino R, Vicentini M, Falcini F, Cesaraccio R, Ponz de Leon M, Sant M. Disease presentation, treatment and survival for Italian colorectal cancer patients: a EUROCARE high resolution study. Eur J Public Health 2014; 24:98-100. [PMID: 23729484 DOI: 10.1093/eurpub/ckt056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We analysed presentation, treatment and survival in a representative population-based sample of 3753 Italian colorectal cancer cases, diagnosed 2003-05: 70% were >65 years, 44% stage I-II, 27% stage IV and 92% received surgery. Chemotherapy was given to 58% of stage III colon cases, radiotherapy to 25% of rectal cases. Four percent of surgical cases underwent endoscopic polypectomy, and in 57% ≥11 lymph nodes were examined. Five-year relative survival was good (60%), independent of sex and site. Adherence to treatment guidelines was satisfactory, but wider use of faecal blood testing and colonoscopy will anticipate stage at diagnosis and likely improve survival.
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Affiliation(s)
- Pamela Minicozzi
- 1 Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Gatta G, Botta L, Rossi S, Aareleid T, Bielska-Lasota M, Clavel J, Dimitrova N, Jakab Z, Kaatsch P, Lacour B, Mallone S, Marcos-Gragera R, Minicozzi P, Sánchez-Pérez MJ, Sant M, Santaquilani M, Stiller C, Tavilla A, Trama A, Visser O, Peris-Bonet R. Childhood cancer survival in Europe 1999-2007: results of EUROCARE-5--a population-based study. Lancet Oncol 2013; 15:35-47. [PMID: 24314616 DOI: 10.1016/s1470-2045(13)70548-5] [Citation(s) in RCA: 674] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Survival and cure rates for childhood cancers in Europe have greatly improved over the past 40 years and are mostly good, although not in all European countries. The EUROCARE-5 survival study estimates survival of children diagnosed with cancer between 2000 and 2007, assesses whether survival differences among European countries have changed, and investigates changes from 1999 to 2007. METHODS We analysed survival data for 157,499 children (age 0-14 years) diagnosed between Jan 1, 1978 and Dec 31, 2007. They came from 74 population-based cancer registries in 29 countries. We calculated observed, country-weighted 1-year, 3-year, and 5-year survival for major cancers and all cancers combined. For comparison between countries, we used the corrected group prognosis method to provide survival probabilities adjusted for multiple confounders (sex, age, period of diagnosis, and, for all cancers combined without CNS cancers, casemix). Age-adjusted survival differences by area and calendar period were calculated with period analysis and were given for all cancers combined and the major cancers. FINDINGS We analysed 59,579 cases. For all cancers combined for children diagnosed in 2000-07, 1-year survival was 90.6% (95% CI 90.2-90.9), 3-year survival was 81.0 % (95% CI 80.5-81.4), and 5-year survival was 77.9% (95% CI 77.4-78.3). For all cancers combined, 5-year survival rose from 76.1% (74.4-77.7) for 1999-2001, to 79.1% (77.3-80.7) for 2005-07 (hazard ratio 0.973, 95% CI 0.965-0.982, p<0.0001). The greatest improvements were in eastern Europe, where 5-year survival rose from 65.2% (95% CI 63.1-67.3) in 1999-2001, to 70.2% (67.9-72.3) in 2005-07. Europe-wide average yearly change in mortality (hazard ratio) was 0.939 (95% CI 0.919-0.960) for acute lymphoid leukaemia, 0.959 (0.933-0.986) for acute myeloid leukaemia, and 0.940 (0.897-0.984) for non-Hodgkin lymphoma. Mortality for all of Europe did not change significantly for Hodgkin's lymphoma, Burkitt's lymphoma, CNS tumours, neuroblastoma, Wilms' tumour, Ewing's sarcoma, osteosarcoma, and rhabdomyosarcoma. Disparities for 5-year survival persisted between countries and regions, ranging from 70% to 82% (for 2005-07). INTERPRETATION Several reasons might explain persisting inequalities. The lack of health-care resources is probably most important, especially in some eastern European countries with limited drug supply, lack of specialised centres with multidisciplinary teams, delayed diagnosis and treatment, poor management of treatment, and drug toxicity. In the short term, cross-border care and collaborative programmes could help to narrow the survival gaps in Europe. FUNDING Italian Ministry of Health, European Commission, Compagnia di San Paolo Foundation.
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Affiliation(s)
- Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Milano, Italy.
| | - Laura Botta
- Evaluative Epidemiology Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Milano, Italy
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy
| | - Tiiu Aareleid
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | | | - Jacqueline Clavel
- INSERM UMRS1018, Paris-Sud University, Villejuif, France; National Registry of Childhood Hematopoietic Malignancies, Villejuif, France
| | - Nadya Dimitrova
- Bulgarian National Cancer Registry, National Oncology Hospital, Sofia, Bulgaria
| | - Zsuzsanna Jakab
- Hungarian Childhood Cancer Registry, 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Peter Kaatsch
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Mainz, Germany
| | - Brigitte Lacour
- INSERM UMRS1018, Paris-Sud University, Villejuif, France; French National Registry of Childhood Solid Tumours, CHU, Nancy, France
| | - Sandra Mallone
- Centro Nazionale di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health and Catalan Institute of Oncology, Girona, Spain
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Milano, Italy
| | - Maria-José Sánchez-Pérez
- Escuela Andaluza de Salud Pública, Granada, Spain; CIBER de Epidemiología y Salud Pública, Madrid, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Milano, Italy
| | | | - Charles Stiller
- Childhood Cancer Research Group, University of Oxford, Oxford, UK
| | - Andrea Tavilla
- Centro Nazionale di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Milano, Italy
| | - Otto Visser
- Comprehensive Cancer Center the Netherlands, Utrecht, Netherlands
| | - Rafael Peris-Bonet
- Spanish National Registry of Childhood Tumours (RNTI-SEHOP), University of Valencia, Valencia, Spain
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Minicozzi P, Berrino F, Sebastiani F, Falcini F, Vattiato R, Cioccoloni F, Calagreti G, Fusco M, Vitale MF, Tumino R, Sigona A, Budroni M, Cesaraccio R, Candela G, Scuderi T, Zarcone M, Campisi I, Sant M. High fasting blood glucose and obesity significantly and independently increase risk of breast cancer death in hormone receptor-positive disease. Eur J Cancer 2013; 49:3881-8. [PMID: 24011933 DOI: 10.1016/j.ejca.2013.08.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/06/2013] [Accepted: 08/08/2013] [Indexed: 12/19/2022]
Abstract
PURPOSE We investigated the effect of fasting blood glucose and body mass index (BMI) at diagnosis on risk of breast cancer death for cases diagnosed in five Italian cancer registries in 2003-2005 and followed up to the end of 2008. METHODS For 1607 Italian women (≥15 years) with information on BMI or blood glucose or diabetes, we analysed the risk of breast cancer death in relation to glucose tertiles (≤84.0, 84.1-94.0, >94.0 mg/dl) plus diabetic and unspecified categories; BMI tertiles (≤23.4, 23.5-27.3, >27.3 kg/m(2), unspecified), stage (T1-3N0M0, T1-3N+M0 plus T4anyNM0, M1, unspecified), oestrogen (ER) and progesterone (PR) status (ER+PR+, ER-PR-, ER and PR unspecified, other), age, chemotherapy and endocrine therapy, using multiple regression models. Separate models for ER+PR+ and ER-PR- cases were also run. RESULTS Patients often had T1-3N0M0, ER+PR+ cancers and received chemotherapy or endocrine therapy; only 6% were M1 and 17% ER-PR-. Diabetic patients were older and had more often high BMI (>27 kg/m(2)), ER-PR-, M1 cancers than other patients. For ER+PR+ cases, with adjustment for other variables, breast cancer mortality was higher in women with high BMI than those with BMI 23.5-27.3 kg/m(2) (hazard ratio (HR)=2.9, 95% confidence interval (CI) 1.2-6.9). Breast cancer mortality was also higher in women with high (>94 mg/dl) blood glucose compared to those with glucose 84.1-94.0mg/dl (HR=2.6, 95% CI 1.2-5.7). CONCLUSION Our results provide evidence that in ER+PR+ patients, high blood glucose and high BMI are independently associated with increased risk of breast cancer death. Detection and correction of these factors in such patients may improve prognosis.
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Affiliation(s)
- Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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Gatta G, Mallone S, van der Zwan J, Trama A, Siesling S, Capocaccia R, Hackl M, Van Eycken E, Henau K, Hedelin G, Velten M, Launoy G, Guizard A, Bouvier A, Maynadié M, Woronoff AS, Buemi A, Colonna M, Ganry O, Grosclaude; P, Holleczek B, Ziegler H, Tryggvadottir L, Bellù F, Ferretti S, Serraino D, Dal Maso L, Bidoli E, Birri S, Zucchetto A, Zainer L, Vercelli M, Orengo M, Casella C, Quaglia A, Federico M, Rashid I, Cirilli C, Fusco M, Traina A, Michiara M, De Lisi V, Bozzani F, Giacomin A, Tumino R, La Rosa M, Spata E, Signora A, Mangone L, Falcini F, Giorgetti S, Ravaioli A, Senatore G, Iannelli A, Budroni M, Piffer S, Franchini S, Crocetti E, Caldarella A, Intrieri T, La Rosa F, Stracci F, Cassetti T, Contiero P, Tagliabue G, Zambon P, Guzzinati S, Berrino F, Baili P, Bella F, Ciampichini R, Gatta G, Margutti C, Micheli A, Minicozzi P, Sant M, Trama A, Caldora M, Capocaccia R, Carrani E, De Angelis R, Francisci S, Grande E, Inghelmann R, Lenz H, Martina L, Roazzi P, Santaquilani M, Simonetti A, Tavilla A, Verdecchia A, Langmark, F, Rachtan J, Mężyk R, Góżdź S, Siudowska U, Zwierko M, Bielska-Lasota M, Safaei Diba C, Primic-Zakelj M, Mateos A, Izarzugaza I, Torrella Ramos A, Zurriaga O, Marcos-Gragera R, Vilardell M, Izquierdo A, Ardanaz E, Moreno-Iribas C, Galceran J, Klint Å, Talbäck M, Jundt G, Usel M, Frick H, Ess S, Bordoni A, Konzelmann I, Dehler S, Siesling S, Visser O, Otter R, Coebergh J, Greenberg D, Wilkinson J, Roche M, Verne J, Meechan D, Poole J, Lawrence G, Gavin A, Brewster D, Black R, Steward J. Cancer prevalence estimates in Europe at the beginning of 2000. Ann Oncol 2013; 24:1660-6. [DOI: 10.1093/annonc/mdt030] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Allemani C, Minicozzi P, Berrino F, Bastiaannet E, Gavin A, Galceran J, Ameijide A, Siesling S, Mangone L, Ardanaz E, Hédelin G, Mateos A, Micheli A, Sant M. Predictions of survival up to 10 years after diagnosis for European women with breast cancer in 2000-2002. Int J Cancer 2013; 132:2404-12. [PMID: 23047687 DOI: 10.1002/ijc.27895] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 09/03/2012] [Indexed: 11/09/2022]
Abstract
Few studies have addressed longer-term survival for breast cancer in European women. We have made predictions of 10-year survival for European women diagnosed with breast cancer in 2000-2002. Data for 114,312 adult women (15-99 years) diagnosed with a first primary malignant cancer of the breast during 2000-2002 were collected in the EUROCARE-4 study from 24 population-based cancer registries in 14 European countries. We estimated relative survival at 1, 5, and 10 years after diagnosis for women who were alive at some point during 2000-2002, using the period approach. We also estimated 10-year survival conditional on survival to 1 and 5 years after diagnosis. Ten-year survival exceeded 70% in most regions, but was only 54% in Eastern Europe, with the highest value in Northern Europe (about 75%). Ten-year survival conditional on survival for 1 year was 2-6% higher than 10-year survival in all European regions, and geographic differences were smaller. Ten-year survival for women who survived at least 5 years was 88% overall, with the lowest figure in Eastern Europe (79%) and the highest in the UK (91%). Women aged 50-69 years had higher overall survival than older and younger women (79%). Six cancer registries had adequate information on stage at diagnosis; in these jurisdictions, 10-year survival was 89% for local, 62% for regional and 10% for metastatic disease. Data on stage are not collected routinely or consistently, yet these data are essential for meaningful comparison of population-based survival, which provides vital information for improving breast cancer control.
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Affiliation(s)
- Claudia Allemani
- Analytical Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Bella F, Minicozzi P, Giacomin A, Crocetti E, Federico M, Ponz de Leon M, Fusco M, Tumino R, Mangone L, Giuliani O, Budroni M, Sant M. Impact of diabetes on overall and cancer-specific mortality in colorectal cancer patients. J Cancer Res Clin Oncol 2013; 139:1303-10. [PMID: 23633003 DOI: 10.1007/s00432-013-1439-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 04/15/2013] [Indexed: 12/12/2022]
Abstract
PURPOSE Diabetes is associated with increased risk of developing colorectal cancer (CRC), but its effect on overall and cancer-specific mortality in CRC patients has been little investigated. The aim of this study was to assess the influence of diabetes on overall and cancer-specific mortality in Italian CRC patients. METHODS Cases of adult (≥15 years) CRC, diagnosed in 2003-2005, most followed-up to the end of 2008, were randomly selected from the Italian Cancer Registries database. Diabetic status, sex, age, tumor stage, subsite, treatment, morphology, and grade were obtained by consultation of patient clinical records. Poisson multivariable regression models, adjusted for potential confounding variables, were used to estimate hazard ratios (HRs) for all-cause and CRC-specific mortality, according to diabetic status. RESULTS A total of 1,039 CRC cases with known fasting glucose or diabetic status, archived in 7 cancer registries, was analyzed. Compared to non-diabetics, diabetics (specific diagnosis or glucose ≥126 mg/dl) were older and less likely to receive adjuvant therapy. Diabetics were at higher risk of all-cause death [HR 1.41; 95 % confidence interval (CI) 1.18-1.70] and CRC death (HR 1.36; 95 % CI 1.11-1.67), with no differences by sex or subsite. CONCLUSIONS Diabetes was significantly associated with increased overall and CRC-specific mortality. Our findings indicate that diabetes is a negative prognostic factor for CRC and suggest that in patients with CRC, diabetes prevention and treatments that stabilize the condition and control its complications might reduce mortality. Further studies are required to ascertain the mechanisms linking diabetes to greater mortality in CRC patients.
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Affiliation(s)
- Francesca Bella
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy.
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Mangone L, Minicozzi P, Vicentini M, Giacomin A, Caldarella A, Cirilli C, Falcini F, Giorgi Rossi P, Sant M. Key factors influencing lung cancer survival in northern Italy. Cancer Epidemiol 2013; 37:226-32. [PMID: 23510644 DOI: 10.1016/j.canep.2013.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 02/05/2013] [Accepted: 02/13/2013] [Indexed: 02/08/2023]
Abstract
AIM Lung cancer is a major cause of cancer death worldwide. The aims of this study were to analyze presentation, treatment and survival for lung cancer in northern Italy, and identify factors influencing survival. METHODS A total of 1180 lung cancer cases diagnosed in four north Italian cancer registries (Biella, Modena, Reggio Emilia, Romagna) in 2003-2005 were analyzed. Information on morphology, stage, diagnostic examinations, chemotherapy, radiotherapy, and surgical treatment was collected from clinical records. Three-year relative survival and relative excess risks of death were estimated. RESULTS Overall, 10% of cases were stage I, 50% stage IV, and 12% stage unknown. Romagna - where sophisticated diagnostic examinations were performed more often - had proportionately more microscopically verified cases and resected cases than Biella. Romagna had also high proportions of cases given chemotherapy and radiotherapy. Three-year survival was 14%, range 10% (Biella) to 19% (Romagna); 69% for stage I, 3% for stage IV. Stage I survival was higher in Romagna (82%) than Reggio Emilia and Biella (60-61%) but for operated stage I cases, survival was similar (88%) in Romagna and Biella. The fully adjusted model showed a higher risk of death in Biella (1.23, 95%CI 1.02-1.48) than Modena (reference). CONCLUSIONS Stage and surgery are key factors influencing survival. Centralizing lung cancer treatment to improve diagnostic work-up may improve outcomes.
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Affiliation(s)
- Lucia Mangone
- Statistical, Quality and Clinical Studies Unit, IRCCS Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123 Reggio Emilia, Italy.
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Minicozzi P, Caldarella A, Giacomin A, Ponz de Leon M, Cesaraccio R, Falcini F, Fusco M, Iachetta F, Pellegri C, Tumino R, Capocaccia R, Sant M. Looking at differences in stage and treatment of colorectal cancers across Italy: a EUROCARE-5 high resolution study. Tumori 2013. [PMID: 23389351 DOI: 10.1700/1217.13488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND The high incidence and the estimate of a five-year relative survival of 59% for colorectal cancer in Italy were the main reasons to investigate the management of Italian patients with colorectal cancer diagnosed in the early 2000s. METHODS Samples of adult (≥15 years) patients diagnosed in 2003-2005 with a colorectal cancer were randomly selected in 8 Italian population-based cancer registries. The z test was used to evaluate differences in proportions of Dukes stage, patients with at least 12 examined lymph nodes, and of cases treated with curative surgery plus chemotherapy or plus radiotherapy and diagnosed with colon or rectal tumors, respectively. Logistic regression models were used to estimate odds ratios of receiving the selected treatment in each cancer registry, age group and stage category, by anatomical subsite. RESULTS A total of 3,938 colorectal cancer patients were analyzed. About 40% of the cases were over 75 years of age at diagnosis and at Dukes A + B stages. Higher proportions of early stages were found in the northern cancer registries. High percentages of resection with a curative intent were observed in Reggio Emilia (northern Italy), in 15 to 74-year-old patients, and at Dukes B stage. At least 12 lymph nodes were more frequently examined in the north of the country. After adjusting for age and stage, no significant differences were seen in the odds ratios of receiving surgery plus chemotherapy between cancer registries, whereas surgery plus radiotherapy was more frequent in Napoli (southern Italy) and less frequent in Biella (northern Italy). CONCLUSIONS Some disparities in staging and treatment of colorectal cancer patients persist across Italy. National oncological plans still need to reduce inequalities in provision and access to proper care.
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Affiliation(s)
- Pamela Minicozzi
- Department of Preventive and Predictive Medicine, Descriptive Studies and Health Planning Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Venezian 1, Milan, Italy.
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50
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Baili P, Vicentini M, Tumino R, Vercelli M, Lorenzo M, Foschi R, Guzzinati S, Dal Maso L, Minicozzi P, de Lorenzo F, Micheli A, di Salvo F. A method for differentiating cancer prevalence according to health status, exemplified using a population-based sample of Italian colorectal cancer cases. Acta Oncol 2013; 52:294-302. [PMID: 23215872 DOI: 10.3109/0284186x.2012.743679] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
UNLABELLED Cancer prevalence is the proportion of a population diagnosed with cancer. We present a method for differentiating prevalence into the proportions expected to survive without relapse, die of cancer within a year, and die of cancer within 10 years or survive with relapse at the end of the 10th year. MATERIAL AND METHODS The method was applied to samples of colorectal cancer cases, randomly extracted from four Italian cancer registries (CRs). The CRs collected data on treatments, local relapses, distant relapses, and causes of death: 1) over the entire follow-up to 31 December 2007 for 601 cases diagnosed in 2002 (cohort approach); 2) over a single year (2007) for five cohorts of cases defined by year of diagnosis (from 1997 to 2001), alive at 1 January 2007 (total 298 cases). The cohorts were combined into a fictitious cohort with 10 years survival experience. For each year j after diagnosis the health status of cases alive at the beginning of j was estimated at the end of the 10th year. From these estimates the 10-year colorectal cancer prevalence was differentiated. RESULTS We estimated: 74.7% alive without relapse or not undergoing treatment at the end of 10 years; 8.1% had died of colorectal cancer within a year; 11.4% had died of colorectal cancer 1-10 years after diagnosis or had relapsed or were undergoing treatment at the end of the 10th year; and 5.8% had died of other causes. CONCLUSIONS We have introduced a new method for estimating the healthcare and rehabilitation demands of cancer survivors based on CR data plus treatment and relapse data specifically collected for samples of cases archived by CRs.
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Affiliation(s)
- Paolo Baili
- Descriptive Studies and Health Planning Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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