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  • EARLY 21ST-CENTURY  (6)
  • 1
    Keywords: MORTALITY ; BREAST-CANCER ; statistics ; UNITED-STATES ; SURVIVAL RATES ; SEER program ; RECORD LINKAGE ERRORS ; INCOMPLETE REGISTRATION ; EARLY 21ST-CENTURY ; TRACE-BACK
    Abstract: Background: The proportion of cases notified by death certificate only (DCO) is a commonly used criterion to judge completeness of cancer registration even though it is affected by additional factors, particularly during initial years of newly established registries. Methods: Based on cancer registry data from the United States, we provide model calculations to demonstrate the magnitude and time course of the impact of the following mechanisms on DCO proportions of "young" registries: registration of cancer deaths from patients diagnosed prior to the registration period and delayed registration by death certificate of patients diagnosed but not reported after initiation of registration. Results: DCO proportions of up to 〉= 30% can be expected from deaths of previously diagnosed patients during the first year of registration. Although this proportion is expected to gradually diminish over subsequent years, DCO proportions may be dominated for several years by this source, which may still be relevant after 10 or more years of cancer registration for cancers with relatively large proportions of late deaths. Otherwise, however, underreporting during patients' lifetime is expected to become the predominant source of DCO proportions in the long run. Conclusions: Our results may guide interpretation of DCO proportions of relatively "young" cancer registries.
    Type of Publication: Journal article published
    PubMed ID: 23084081
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  • 2
    Keywords: HORMONE REPLACEMENT THERAPY ; LONG-TERM SURVIVAL ; COLON-CANCER ; POSTMENOPAUSAL WOMEN ; PERIOD ANALYSIS ; RELATIVE SURVIVAL ; UP-TO-DATE ; EUROCARE HIGH-RESOLUTION ; EARLY 21ST-CENTURY ; GENDER INFLUENCES TREATMENT
    Abstract: Risk of colorectal cancer (CRC) is considerably higher in men compared to women; however, there is inconclusive evidence of sex differences in CRC prognosis. We aimed to assess and explain sex differences in 5-year relative survival using standard and model-based period analysis among 164,996 patients diagnosed with CRC from 1997 to 2006 and reported to 11 German cancer registries covering a population of 33 million inhabitants. Age-adjusted 5-year relative survival was higher in women (64.5% vs. 61.9%, P 〈 0.0001). A substantial survival advantage of women was confirmed in multivariate analysis after adjusting for CRC stage and subsite in subjects under 65 years of age (relative excess risk, RER 0.86, 95% CI 0.82-0.90), but not in older subjects (RER 1.01, 95% CI 0.98-1.04); this pattern was similar in the 1st and in the 2nd to 5th year after diagnosis. The survival advantage of women varied by CRC stage and age and was most pronounced for localized disease (RERs 0.59-0.88 in various age subgroups) and in patients under 45 years of age (RERs 0.59, 0.72 and 0.76 in patients with localized, regional or advanced disease, respectively). On the contrary, sex differences in survival did not vary by location of CRC. In conclusion, our large population-based study confirmed a survival advantage of female compared to male CRC patients, most notably in young and middle aged patients and patients with localized disease. The effect of sex hormones, either endogenous or through hormonal replacement therapy, might be the most plausible explanation for the observed patterns.
    Type of Publication: Journal article published
    PubMed ID: 23861851
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  • 3
    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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  • 4
    Keywords: POPULATION ; AGE ; COLORECTAL-CANCER ; UNITED-STATES ; PATIENT SURVIVAL ; PERIOD ANALYSIS ; UP-TO-DATE ; THYROID-CANCER ; EARLY 21ST-CENTURY ; DEATH CERTIFICATE
    Abstract: Monitoring cancer survival by population-based cancer registries is a prerequisite to evaluate current quality of cancer care. The present study provides 1-, 5- and 10-year relative survival as well as 5-year relative survival conditional on 1-year survival estimates and recent survival trends for Germany using data from 11 population-based cancer registries, covering around one third of the German population. Period analysis was employed to estimate relative survival for 24 common and 11 less common cancer sites for the period 2007-2010. German and United States survival estimates were compared utilizing the Surveillance, Epidemiology and End Results 13 database. Trends in cancer survival in Germany between 2002-2004 and 2008-2010 are described. Five-year relative survival increased in Germany from 2002-2004 to 2008-2010 for most cancer sites. Among the 24 most common cancers, largest improvements were seen for multiple myeloma (+8% units), non-Hodgkin lymphoma (+6.2% units), prostate cancer (+5.2% units) and colorectal cancer (+4.6% units). In 2007-2010, the survival disadvantage in Germany compared to the US was largest for cancers of the mouth/pharynx (-11.0% units), thyroid (-6.8% units), and prostate (-7.5 % units). While survival estimates were much lower for elderly patients in both countries, differences in age patterns were observed for some cancer sites. The reported improvements in cancer survival might reflect advances in quality of cancer care on the population level as well as increased use of screening in Germany. The survival differences across countries and the survival disadvantage in the elderly require further investigation. (c) 2014 Wiley Periodicals, Inc.
    Type of Publication: Journal article published
    PubMed ID: 25380088
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  • 5
    Keywords: CANCER ; ASSOCIATION ; LONG-TERM SURVIVAL ; UNITED-STATES ; B-CELL LYMPHOMA ; OLDER PATIENTS ; ACUTE MYELOID-LEUKEMIA ; SOCIOECONOMIC-STATUS ; PLUS RITUXIMAB ; EARLY 21ST-CENTURY
    Abstract: Background. New treatment options and supportive care measures have greatly improved survival of patients with non-Hodgkin lymphoma (NHL) but may not be affordable for those with no insurance or inadequate insurance. Methods. Using data from the Surveillance, Epidemiology, and End Results database, we estimated overall and cause-specific survival according to insurance status within 3 years after diagnosis of patients diagnosed with NHL in the U.S. in the period 2007-2011. Because NHL is a heterogeneous condition, we also examined survival in diffuse large B-cell lymphoma (DLBCL). Results. Survival was higher for patients with non-Medicaid insurance compared with either uninsured patients or patients with Medicaid. For patients with any NHL, the 3-year survival estimates were 68.0% for uninsured patients, 60.7% for patients with Medicaid, and 84.9% for patients with non-Medicaid insurance. Hazard ratios (HRs) for uninsured and Medicaid-only patients compared with insured patients were 1.92 (95% confidence interval [CI]: 1.76-2.10) and 2.51 (95% CI: 2.36-2.68), respectively. Results were similar for patients with DLBCL, with survival estimates of 68.5% for uninsured patients (HR: 1.78; 95% CI: 1.57-2.02), 58%, for patients with Medicaid (HR: 2.42; 95% CI: 2.22-2.64), and 83.3% for patients with non-Medicaid insurance. Cause-specific analysis showed survival estimates of 80.3% for uninsured patients (HR: 1.83; 95% CI: 1.62-2.05), 77.7% for patients with Medicaid (HR: 2.23; 95% CI: 2.05-2.42), and 90.5% for patients with non-Medicaid insurance. Conclusion. Lack of insurance and Medicaid only were associated with significantly lower survival for patients with NHL. Further evaluation of the reasons for this disparity and implementation of comprehensive coverage for medical care are urgently needed.
    Type of Publication: Journal article published
    PubMed ID: 25876991
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  • 6
    Keywords: THERAPY ; DIAGNOSIS ; TRIAL ; CHILDREN ; TRENDS ; PERIOD ANALYSIS ; EMPIRICAL-EVALUATION ; UP-TO-DATE ; CANCER-PATIENT SURVIVAL ; EARLY 21ST-CENTURY
    Abstract: Background: Adulthood acute lymphoblastic leukemia (ALL) is a rare disease. In contrast to childhood ALL, survival for adults with ALL is poor. Recently, new protocols, including use of pediatric protocols in young adults, have improved survival in clinical trials. Here, we examine population level survival in Germany and the United States (US) to gain insight into the extent to which changes in clinical trials have translated into better survival on the population level. Methods: Data were extracted from the Surveillance, Epidemiology, and End Results database in the US and 11 cancer registries in Germany. Patients age 15-69 diagnosed with ALL were included. Period analysis was used to estimate 5-year relative survival (RS). Results: Overall 5-year RS was estimated at 43.4% for Germany and 35.5% for the US (p = 0.004), with a decrease in survival with increasing age. Survival was higher in Germany than the US for men (43.6% versus 37.7%, p = 0.002) but not for women (42.4% versus 40.3%, p 〉 0.1). Five-year RS estimates increased in Germany and the US between 2002 and 2006 by 11.8 and 7.3 percent units, respectively (p = 0.02 and 0.04, respectively). Conclusions: Survival for adults with ALL continues to be low compared with that for children, but a substantial increase in 5-year survival estimates was seen from 2002 to 2006 in both Germany and the US. The reasons for the survival differences between both countries require clarification.
    Type of Publication: Journal article published
    PubMed ID: 24475044
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