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. 2011 Jan 8;377(9760):127-38.
doi: 10.1016/S0140-6736(10)62231-3. Epub 2010 Dec 21.

Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995-2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data

M P Coleman  1 , D Forman, H Bryant, J Butler, B Rachet, C Maringe, U Nur, E Tracey, M Coory, J Hatcher, C E McGahan, D Turner, L Marrett, M L Gjerstorff, T B Johannesen, J Adolfsson, M Lambe, G Lawrence, D Meechan, E J Morris, R Middleton, J Steward, M A Richards; ICBP Module 1 Working Group
Collaborators, Affiliations

Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995-2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data

M P Coleman et al. Lancet. .

Abstract

Background: Cancer survival is a key measure of the effectiveness of health-care systems. Persistent regional and international differences in survival represent many avoidable deaths. Differences in survival have prompted or guided cancer control strategies. This is the first study in a programme to investigate international survival disparities, with the aim of informing health policy to raise standards and reduce inequalities in survival.

Methods: Data from population-based cancer registries in 12 jurisdictions in six countries were provided for 2·4 million adults diagnosed with primary colorectal, lung, breast (women), or ovarian cancer during 1995-2007, with follow-up to Dec 31, 2007. Data quality control and analyses were done centrally with a common protocol, overseen by external experts. We estimated 1-year and 5-year relative survival, constructing 252 complete life tables to control for background mortality by age, sex, and calendar year. We report age-specific and age-standardised relative survival at 1 and 5 years, and 5-year survival conditional on survival to the first anniversary of diagnosis. We also examined incidence and mortality trends during 1985-2005.

Findings: Relative survival improved during 1995-2007 for all four cancers in all jurisdictions. Survival was persistently higher in Australia, Canada, and Sweden, intermediate in Norway, and lower in Denmark, England, Northern Ireland, and Wales, particularly in the first year after diagnosis and for patients aged 65 years and older. International differences narrowed at all ages for breast cancer, from about 9% to 5% at 1 year and from about 14% to 8% at 5 years, but less or not at all for the other cancers. For colorectal cancer, the international range narrowed only for patients aged 65 years and older, by 2-6% at 1 year and by 2-3% at 5 years.

Interpretation: Up-to-date survival trends show increases but persistent differences between countries. Trends in cancer incidence and mortality are broadly consistent with these trends in survival. Data quality and changes in classification are not likely explanations. The patterns are consistent with later diagnosis or differences in treatment, particularly in Denmark and the UK, and in patients aged 65 years and older.

Funding: Department of Health, England; and Cancer Research UK.

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Figures

Figure 1
Figure 1
Structure of cohort and period approaches to survival analysis for patients diagnosed during 1995–2007 and followed up to Dec 31, 2007 *Calendar years from which the probabilities of conditional survival in each follow-up interval are combined to produce cumulative survival estimates. Numbers in the cells indicate the minimum number of years of follow-up completed by patients surviving to the end of a specific calendar year (columns) who were diagnosed in the index year (rows). Cohort approach: all patients diagnosed in a specific period were followed up for at least 5 years (full lines). Period approach: survival estimates from most recent follow-up data (shaded orange).
Figure 2
Figure 2
Age-standardised 1-year and 5-year relative survival trends 1995–2007, by cancer and country Data are for adults (15–99 years) diagnosed with colorectal, lung, breast, or ovarian cancer in 1995–99 and 2000–02 (cohort approach), and short-term prediction of survival for those diagnosed in 2005–07 (period approach). Ovarian cancer data were not supplied by Sweden.
Figure 3
Figure 3
3-year moving-average world-standardised incidence and mortality rates per 100 000 population per year, 1985–2005, by country, for breast cancer in women and colorectal cancer in men and women combined Incidence for Canada excludes Quebec; colorectal cancer includes cancers of the anus and anal canal; lung cancer includes cancers of the trachea. Incidence data labelled UK are for England only; mortality data labelled UK are for England and Wales only.
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References

    1. Coleman MP, Quaresma M, Berrino F, the CONCORD Working Group Cancer survival in five continents: a worldwide population-based study (CONCORD) Lancet Oncol. 2008;9:730–756. - PubMed
    1. Berrino F, De Angelis R, Sant M, the EUROCARE Working Group Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995–99: results of the EUROCARE-4 study. Lancet Oncol. 2007;8:773–783. - PubMed
    1. Berrino F, Sant M, Verdecchia A, editors. Survival of cancer patients in Europe: the EUROCARE study (IARC Scientific Publications number 132) International Agency for Research on Cancer; Lyon: 1995.
    1. Berrino F, Capocaccia R, Estève J, editors. Survival of cancer patients in Europe: the EUROCARE-2 study (IARC Scientific Publications number 151) International Agency for Research on Cancer; Lyon: 1999. - PubMed
    1. Sant M, Aareleid T, Berrino F. EUROCARE-3: survival of cancer patients diagnosed 1990–94—results and commentary. Ann Oncol. 2003;14(suppl 5):61–118. - PubMed

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