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  • 1
    Keywords: CANCER ; SURVIVAL ; PROSTATE ; COMMON ; SITES ; TIME ; PATIENT ; IMPACT ; BREAST ; AGE ; WOMEN ; MEN ; REGISTRY ; cancer registries ; RELATIVE SURVIVAL ; LONG ; CANCERS ; cancer survival ; neoplasm ; subsequent cancer ; OLDER ; EUROCARE-4 ; PROPORTION ; Multiple tumours
    Abstract: In international comparisons of cancer registry based survival it is common practice to restrict the analysis to first primary tumours and exclude multiple cancers. The probability of correctly detecting subsequent cancers depends on the registry's running time, which results in different proportions of excluded patients and may lead to biased comparisons. We evaluated the impact on the age-standardised relative survival estimates of also including multiple primary tumours. Data from 2,919,023 malignant cancers from 69 European cancer registries participating in the EUROCARE-4 collaborative study were used. A total of 183,683 multiple primary tumours were found, with an overall proportion of 6.3% over all the considered cancers, ranging from 0.4% (Naples, Italy) to 12.9% (Iceland). The proportion of multiple tumours varied greatly by type of tumour, being higher for those with high incidence and long survival (breast, prostate and colon-rectum). Five-year relative survival was lower when including patients with multiple cancers. For all cancers combined the average difference was -0.4 percentage points in women and -0.7 percentage points in men, and was greater for older registries. Inclusion of multiple tumours led to lower survival in 44 out of 45 cancer sites analysed, with the greatest differences found for larynx (-1.9%), oropharynx (-1.5%), and penis (-1.3%). Including multiple primary tumours in survival estimates for international comparison is advisable because it reduces the bias due to different observation periods, age, registration quality and completeness of registration. The general effect of inclusion is to reduce survival estimates by a variable amount depending on the proportion of multiple primaries and cancer site. (C) 2008 Elsevier Ltd. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 19121933
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  • 2
    Keywords: CANCER ; SURVIVAL ; Germany ; COHORT ; MORTALITY ; POPULATION ; SITES ; PATIENT ; prognosis ; AGE ; RATES ; LONG-TERM SURVIVAL ; NETHERLANDS ; GASTRIC-CANCER ; time trends ; EUROPE ; COMORBIDITY ; cancer registries ; PERIOD ANALYSIS ; RELATIVE SURVIVAL ; HELICOBACTER-PYLORI INFECTION ; EMPIRICAL-EVALUATION ; cancer survival ; UP-TO-DATE ; EUROCARE-4
    Abstract: Period analysis has been shown to provide more up-to-date estimates of long-term cancer survival rates than traditional cohort-based analysis. Here, we provide detailed period estimates of 5- and 10-year relative survival by cancer site, country, sex and age for calendar years 2000-2002. In addition, pan-European estimates of 1-, 5- and 10-year relative survival are provided. Overall, survival estimates were mostly higher than previously available cohort estimates. For most cancer sites, survival in countries from Northern Europe, Central Europe and Southern Europe was substantially higher than in the United Kingdom and Ireland and in countries from Eastern Europe. Furthermore, relative survival was also better in female than in male patients and decreased with age for most cancer sites. (C) 2008 Elsevier Ltd. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 19091549
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  • 3
    Abstract: BACKGROUND: Survival for ovarian cancer is the poorest of all gynaecological cancer sites. Our aim was to present the most up-to-date survival estimate for ovarian cancer by age and morphology and to answer the question whether survival for ovarian cancer improved in Europe during the 1990s. MATERIAL AND METHODS: This analysis was performed with data from the EUROCARE database. We considered all adult women diagnosed with ovarian cancer between 1995 and 2002 and life status followed up until the end of 2003. A total of 97 691 cases were contributed by 72 European cancer registries in 24 countries. We estimated the most up-to-date relative survival for a mean of 23 661 patients followed up in 2000-2003 using the period hybrid approach and described the relative survival trends from the beginning of 1990s. RESULTS AND CONCLUSION: Overall, the European age-standardised one-year, five-year and five-year conditional on surviving one-year relative survival were 67.2% (95% CI 66.6-67.8), 36.1% (95% CI 35.4-36.8) and 53.7% (95% CI 52.8-54.7), respectively. Five-year relative survival was 58.6% (95% CI 57.4-59.8), 37.1% (95% CI 36.1-38.1) and 20.5% (95% CI 19.1-21.9) in women aged 15-54, 55-74 and 75-99 years, respectively. The age-standardised five-year relative survival was 38.1% (95% CI 36.9-39.3) for serous tumours and 51.9% (95% CI 49.0-54.9) for mucinous cancers and the crude five-year relative survival was 85.6% (95% CI 81.2-90.0) for germ cell cancers. Overall, the age-standardised five-year relative survival increased from 32.4% (95% CI 31.7-33.2) in 1991-1993 to 36.3% (95% CI 35.5-37.0) in 2000-2003. There is a need to better understand the reasons for the wide variation in survival of ovarian cancer in Europe. Actions aiming to harmonise the protocols for therapy should contribute to narrowing the wide gap in survival and research on screening and early detection of ovarian cancer should be enforced.
    Type of Publication: Journal article published
    PubMed ID: 22313338
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  • 4
    Keywords: brain ; CANCER ; SURVIVAL ; LUNG ; DIAGNOSIS ; SUPPORT ; DEATH ; DISEASE ; EPIDEMIOLOGY ; RISK ; SITES ; kidney ; colon ; SKIN ; BREAST ; hormone ; LYMPHOMA ; PATTERNS ; HEALTH ; HUMANS ; AGE ; WOMEN ; MEN ; BLADDER ; MELANOMA ; REGION ; HEAD ; RISK ASSESSMENT ; non-hodgkin's lymphoma ; MULTIPLE-MYELOMA ; multiple myeloma ; ADULT ; pancreas ; RELATIVE SURVIVAL ; elderly ; survival analysis ; leukaemia ; age of onset ; female ; Male ; BONE ; UNIT ; CANCERS ; population-based ; Aged ; Middle Aged ; cancer survival ; Aged,80 and over ; INVESTIGATE ; EUROCARE-4 ; Young Adult ; Europe/epidemiology ; Neoplasms/*mortality ; Adolescent ; Age Distribution ; *Sex Factors ; Diagnosis-Related Groups ; Residence Characteristics ; Sex Distribution
    Abstract: We analysed 1.6 million population-based EUROCARE-4 cancer cases (26 cancer sites, excluding sex-specific sites, and breast) from 23 countries to investigate the role of sex in cancer survival according to age at diagnosis, site, and European region. For 15 sites (salivary glands, head and neck, oesophagus, stomach, colon and rectum, pancreas, lung, pleura, bone, melanoma of skin, kidney, brain, thyroid, Hodgkin disease and non-Hodgkin's lymphoma) age- and region-adjusted relative survival was significantly higher in women than men. By multivariable analysis, women had significantly lower relative excess risk (RER) of death for the sites listed above plus multiple myeloma. Women significantly had higher RER of death for biliary tract, bladder and leukaemia. For all cancers combined women had a significant 5% lower RER of death. Age at diagnosis was the main determinant of the women's advantage, which, however, decreased with increasing age, becoming negligible in the elderly, suggesting that sex hormone patterns may have a role in women's superior ability to cope with cancer.
    Type of Publication: Journal article published
    PubMed ID: 19109009
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