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  • 1
    Keywords: CANCER ; SURVIVAL ; Germany ; SYSTEM ; POPULATION ; SITES ; PATIENT ; IMPACT ; prognosis ; BREAST ; HEALTH ; COLORECTAL-CANCER ; leukemia ; DATABASE ; LONG-TERM SURVIVAL ; UNITED-STATES ; GASTRIC-CANCER ; TRENDS ; REGISTRY ; cancer registries ; PATIENT SURVIVAL ; PERIOD ANALYSIS ; CANCERS ; EMPIRICAL-EVALUATION ; cancer survival ; UP-TO-DATE ; therapeutic ; Filipino-Americans ; Philippines ; developing countries
    Abstract: Despite the availability of population-based cancer survival data from the developed and developing countries, comparisons remain very few. Such comparisons are important to assess the magnitude of survival discrepancies and to disentangle the impact of ethnic background and health care access on cancer survival. Using the SEER 13 database and databases from the Manila and Rizal Cancer Registries in the Philippines, a 5-year relative survival for 9 common cancers in 1998-2002 of Filipino-American cancer patients were compared with both cancer patients from the Philippines, having the same ethnicity, and Caucasians in the United States, being exposed to a similar societal environment and the same health care system. Survival estimates were much higher for the Filipino-Americans than the Philippine resident population, with particularly large differences (more than 20-30% units) for cancers with good prognosis if diagnosed and treated early (colorectal, breast and cervix), or those with expensive treatment regimens (leukaemias). Filipino-Americans and Caucasians showed very similar survival for all cancer sites except stomach cancer (30.7 vs 23.2%) and leukaemias (37.8 vs 48.4%). The very large differences in the survival estimates of Filipino-Americans and the Philippine resident population highlight the importance of the access to and utilisation of diagnostic and therapeutic facilities in developing countries. Survival differences in stomach cancer and leukaemia between Filipino-Americans and Caucasians in the United States most likely reflect biological factors rather than the differences in access to health care
    Type of Publication: Journal article published
    PubMed ID: 19240723
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  • 2
    Keywords: CANCER ; SURVIVAL ; Germany ; THERAPY ; SUPPORT ; EPIDEMIOLOGY ; LONG-TERM ; PATIENT ; prognosis ; MALIGNANCIES ; AGE ; leukemia ; LONG-TERM SURVIVAL ; UNITED-STATES ; TRENDS ; MALIGNANCY ; THERAPIES ; PERIOD ANALYSIS ; RELATIVE SURVIVAL ; development ; leukaemia ; CML ; cancer research ; DIVISION ; United States ; STATE ; chronic myelocytic leukemia
    Abstract: Within the past 10-15 years, major advances in therapy have strongly improved prognosis of patients with chronic myelocytic leukaemia (CML). We estimated trends in 5- and 10-year relative survival of patients developing CML after a previous malignancy in the United States from 1990-1994 to 2000-2004. Period analysis was employed to disclose recent developments with minimum delay. Overall, 5- and 10-year relative survival increased from 17.6% to 37.7% (p〈0.0001) and from 7.6% to 23.8% (p〈0.0001), respectively. Improvements were particularly strong in younger age groups. Prognosis of CML patients with previous malignancy no longer lags behind prognosis of patients with primary CML.
    Type of Publication: Journal article published
    PubMed ID: 19272642
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  • 3
    Keywords: ACUTE-LYMPHOBLASTIC-LEUKEMIA, ADOLESCENCE, Adolescent, ADOLESCENTS, ADULT, ADULTS, CANCER, cancer re
    Abstract: BACKGROUND:: There are few population-based studies of long-term survival of adolescents and young adults with hematologic malignancies; most pertain to patients diagnosed in the 1990s or earlier. Period analysis was used to obtain up-to-date information on survival expectations of adolescents and young adults diagnosed with hematologic malignancies through the early 21st century. METHODS:: Period analysis was used to calculate 5- and 10-year relative survival for adolescents and young adults diagnosed with Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia (AML), and chronic myelocytic leukemia (CML) for 5 5-year periods from 1981-1985 to 2001-2005, using data from the Surveillance, Epidemiology, and End Results database. RESULTS:: Survival strongly improved for each of the 5 hematologic malignancies. Increases in 10-year relative survival between 1981-1985 and 2001-2005 were as follows: HL, from 80.4% to 93.4%; NHL, from 55.6% to 76.2%; ALL, from 30.5% to 52.1%; AML, from 15.2% to 45.1%; CML, from 0 to 74.5% (P 〈 .001 in all cases). However, although survival improved steadily throughout the period examined for the lymphomas and CML, survival was stable during the late 1990s and early 21st century for the acute leukemias. CONCLUSIONS:: Survival expectations for adolescents and young adults with hematologic malignancies have strongly improved since the 1980s. However, with the exception of HL, survival rates have not reached the levels observed for children diagnosed with these malignancies, and survival expectations for patients with acute leukemia have stabilized at relatively low levels. Cancer 2009. (c) 2009 American Cancer Society.
    Type of Publication: Journal article published
    PubMed ID: 19705347
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  • 4
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  • 5
    Keywords: POPULATION ; ACUTE LYMPHOBLASTIC-LEUKEMIA ; LONG-TERM SURVIVAL ; UNITED-STATES ; PERIOD ANALYSIS ; ACUTE MYELOID-LEUKEMIA ; ACUTE MYELOBLASTIC-LEUKEMIA ; UP-TO-DATE ; ethnicity ; CANCER REGISTRY DATA
    Abstract: The survival of younger patients with acute leukemia has improved in the early 21st century, but it is unknown whether people of all ethnic and racial backgrounds have benefited equally. Using cancer registry data from the Surveillance, Epidemiology and End Results Program, we assessed trends in 5-year relative survival for patients aged 15 years or more with acute lymphoblastic leukemia and acute myeloblastic leukemia divided by racial and ethnic group, including non-Hispanic whites, African-Americans, Hispanics, and Asian-Pacific Islanders in the 1990s and the early 21st century. Modeled period analysis was used to obtain the most up-to-date estimates of survival. Overall, the 5-year survival increased from 31.6% in 1997-2002 to 39.0% in 2003-2008 for patients with acute lymphoblastic leukemia and from 15.5% in 1991-1996 to 22.5% in 2003-2008 for those with acute myeloblastic leukemia. Nevertheless, among patients with acute lymphoblastic leukemia, age-adjusted 5-year relative survival rates remained lower for African-Americans and Hispanics than for non-Hispanic whites. Among patients with acute myeloblastic leukemia, the increase in survival was greatest (from 32.6% in 1991-1996 to 47.1% in 2003-2008) for younger patients (15-54 years), and was more pronounced for non-Hispanic whites (+16.4% units) than for other patients (+10.8% units). Increases in survival are observed in all ethnic or racial groups. Nevertheless, among patients with acute leukemias, disparities in survival persist between non-Hispanic white people and people of other ethnic or racial groups. Disparities are increasing in younger patients with acute myeloblastic leukemia. Improvements in access to treatment, especially for minority patients, may improve outcomes.
    Type of Publication: Journal article published
    PubMed ID: 22929974
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  • 6
    Keywords: POPULATION ; LONG-TERM SURVIVAL ; UNITED-STATES ; PERIOD ANALYSIS ; RELATIVE SURVIVAL ; CELL TRANSPLANTATION ; cancer survival ; UP-TO-DATE ; HEALTH-INSURANCE ; RACE
    Abstract: Survival for patients with multiple myeloma has increased during the first decade of the 21st century. However, it is unknown whether the improvements in survival have extended equally in all ethnic groups. Using data from the United States Surveillance, Epidemiology and End Results Program, we assessed trends in survival and disease-related mortality for patients with myeloma by ethnic group, including non-Hispanic whites (nHw), AfricanAmericans (AA), Hispanics and people of Asian and Pacific Islander descent (API) from 1998-2001 to 2006-2009. Overall, age adjusted 5-year relative survival increased, from 35.6% in 1998-2001 to 44% in 2006-2009. The greatest improvements were observed for patients aged 15-49, for whom survival increased by + 16.8% units for nHw and + 14.4% units for AA, whereas improvement was less pronounced and not statistically significant in Hispanics and API. Excess mortality hazard ratios were 1.20 (95% confidence interval [CI]: 1.09-1.33) for AA and 1.25 (95% CI: 1.11-1.41) for Hispanics compared to nHw in 2006-2009. Although survival increased greatly for nHw with myeloma between 1998-2001 and 2006-2009, smaller increases were observed for people of other ethnic groups. Persistent excess mortality was seen for AA and Hispanic patients with myeloma. Ethnic inequalities persisted or even increased from earlier periods to 2006-2009. The results suggest that ethnic minorities may not have benefited from newer treatments to the same extent as nHw patients have.
    Type of Publication: Journal article published
    PubMed ID: 23879201
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  • 7
    Keywords: FOLLOW-UP ; LONG-TERM SURVIVAL ; CHRONIC MYELOGENOUS LEUKEMIA ; CHRONIC MYELOID-LEUKEMIA ; MARROW-TRANSPLANTATION ; PERIOD ANALYSIS ; cancer survival ; UP-TO-DATE ; PATIENTS RECEIVING IMATINIB ; DIAGNOSED CHRONIC-PHASE
    Abstract: Introduction: The advent of tyrosine kinase inhibitors has produced 5-year survival of 90 + % for chronic myelocytic leukemia (CML) patients in clinical trials. However, population level survival has been lower, especially in older patients. Here, we examine survival of patients with CML in Germany and compare it to survival of patients in the United States (US). Methods: Data were extracted from the Surveillance, Epidemiology, and End Results database in the US and 11 cancer registries in Germany. Patients 15-69 years old diagnosed with CML were included in the analysis. Period analysis for 2002-2006 was used to provide the most up-to-date possible estimates of five-year relative survival. Results: Five-year relative survival was 68.7% overall in Germany and 72.7% in the US. Survival was higher in the US for all age groups except for ages 15-39 years, but the difference was only statistically significant for ages 5059 years (at 67.5% vs 77.7% in Germany and the US, respectively). Survival decreased with age, ranging from 83.1% and 81.9%, respectively, in Germany and the US for patients 15-39 years old to 54.2% and 54.5%, respectively, in patients 65-69 years old. Survival increased between 2002 and 2006 by 12.0% points in Germany and 17.1% points in the US. Conclusions: Five-year survival estimates were higher in the US than in Germany overall, but the difference was only significant for ages 50-59 years. Survival did not equal that seen in clinical trials for either country, but strong improvement in survival was seen between 2002 and 2006.
    Type of Publication: Journal article published
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  • 8
    Keywords: MODEL ; DISEASE ; chemotherapy ; LONG-TERM SURVIVAL ; OLDER PATIENTS ; PERIOD ANALYSIS ; EMPIRICAL-EVALUATION ; cancer survival ; UP-TO-DATE ; DISPARITIES
    Abstract: Treatment for Hodgkin lymphoma (HL) is more aggressive in Germany than in the United States (US) and differences in treatment may lead to differences in population level survival. Patients diagnosed with HL in 11 German states in 1997-2006 were included in the analyses and were compared to similar analyses from patients in the Surveillance, Epidemiology, and End Results database in the US. Period analysis was used to calculate 5-year relative survival for the time period of 2002-2006 overall and by gender, age and histology. Overall 5-year relative survival for patients with HL in Germany was 84 center dot 3%, compared to 80 center dot 6% for the US. Survival was highest in patients aged 15-29years at 97 center dot 9% and decreased with age to 57 center dot 5% at age 60+ Survival for men and women, respectively, was 84 center dot 7% and 84 center dot 1% in Germany and 78 center dot 2% and 83 center dot 6% in the US. 5-year relative survival for patients diagnosed with HL in Germany was close to 100% for younger patients. Survival of HL patients in the US was lower than in Germany overall, but was comparable in older patients and in women. Population-based studies with longer follow-up are still needed to examine effects of late toxicity on long term survival.
    Type of Publication: Journal article published
    PubMed ID: 24433418
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  • 9
    Keywords: HELICOBACTER-PYLORI ; B-CELL LYMPHOMA ; NON-HODGKINS-LYMPHOMA ; PERIOD ANALYSIS ; MALT-LYMPHOMA ; UP-TO-DATE ; CLINICAL-PRACTICE GUIDELINES ; EARLY 21ST-CENTURY ; MARGINAL ZONE LYMPHOMA ; RITUXIMAB PLUS CYCLOPHOSPHAMIDE
    Abstract: Background and AimThis study aims to examine survival for gastric lymphomas and its main subtypes, mucosa-associated lymphoid tissue lymphoma (MALT), and diffuse large B-cell lymphoma (DLBCL), in Germany and in the United States. MethodsData for patients diagnosed in 1997-2010 were used from 10 population-based German cancer registries and compared to the data from the US Surveillance, Epidemiology and End Results (SEER) 13 registries database. Patients age 15-74 diagnosed with gastric lymphomas were included in the analysis. Period analysis and modeled period analysis were used to estimate 5-year and 10-year relative survival (RS) in 2002-2010 and survival trends from 2002-2004 to 2008-2010. ResultsOverall, the database included 1534 and 2688 patients diagnosed with gastric lymphoma in 1997-2010 in Germany and in the United States, respectively. Survival was substantially higher for MALT (5-year and 10-year RS: 89.0% and 80.9% in Germany, 93.8% and 86.8% in the United States) than for DLBCL (67.5% and 59.2% in Germany, and 65.3% and 54.7% in the United States) in 2002-2010. Survival was slightly higher among female patients and decreased by age for gastric lymphomas combined and its main subtypes. A slight, nonsignificant, increase in the 5-year RS for gastric lymphomas combined was observed in Germany and the United States, with increases in 5-year RS between 2002-2004 and 2008-2010 from 77.1% to 81.0% and from 77.3% to 82.0%, respectively. Five-year RS of MALT exceeded 90% in 2008-2010 in both countries. ConclusionsFive-year RS of MALT meanwhile exceeds 90% in both Germany and the United States, but DLBCL has remained below 70% in both countries.
    Type of Publication: Journal article published
    PubMed ID: 25967274
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  • 10
    Keywords: LONG-TERM SURVIVAL ; CHRONIC MYELOGENOUS LEUKEMIA ; RECENT TRENDS ; CHRONIC LYMPHOCYTIC-LEUKEMIA ; GUIDELINES ; PERIOD ANALYSIS ; EMPIRICAL-EVALUATION ; cancer survival ; CHRONIC MYELOCYTIC-LEUKEMIA ; POPULATION-LEVEL
    Abstract: BACKGROUND: Chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML) are highly treatable conditions occurring primarily in older patients. Lower survival among older people has been reported in both conditions, but newer treatments may change both the overall survival rate and the relative risk associated with aging. Here, we examine survival for patients with CLL and CML in the United States (US) and England. METHODS: Patients with CLL and CML were identified from the Surveillance, Epidemiology, and End Results (US) and National Cancer Registry (England). Five-year relative survival was calculated by major age group. Excess hazard ratios (EHR) by age were calculated for each condition, and multivariable analysis was performed to adjust for the following potential confounders: gender, race or ethnic group (US only), period of diagnosis, and a measure of socioeconomic deprivation (England only). RESULTS: Five-year relative survival increased for both CLL and CML in both England and the US between 1996-2000 and 2006-2010. However, relative age-related disparities persisted. For CLL, the EHR for death was 9.44 (7.84-11.36) in the US and 6.14 (5.65-6.68) in England for ages 85+ compared to ages 55-64. For CML, the EHR was 3.52 (3.17-3.90) in the US and 4.54 (4.13-4.98) in England for ages 75+ compared to ages 45-64. CONCLUSIONS: Survival improved for patients with chronic leukemias in the early 21st century. However, age-related disparities persist, despite clinical trial evidence that treatment in older adults with chronic leukemia can be safe and effective. Further research to determine the reasons for the lower survival in older patients and greater awareness of this problem may improve survival for older patients with chronic leukemia.
    Type of Publication: Journal article published
    PubMed ID: 25315799
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