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  • LONG-TERM SURVIVAL  (22)
  • 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: 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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  • 4
    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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  • 5
    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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  • 6
    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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  • 7
    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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  • 8
    Keywords: CANCER ; SURVIVAL ; Germany ; DIAGNOSIS ; EPIDEMIOLOGY ; TIME ; PATIENT ; LYMPHOMA ; MALIGNANCIES ; AGE ; RATES ; leukemia ; ACUTE LYMPHOBLASTIC-LEUKEMIA ; DATABASE ; LONG-TERM SURVIVAL ; SURVEILLANCE ; US ; UNITED-STATES ; REVEALS ; CHILDREN ; TRENDS ; HODGKINS-DISEASE ; HEMATOLOGIC MALIGNANCIES ; STATES ; MALIGNANCY ; ONCOLOGY ; CHILDHOOD ; RE ; aging ; INCREASE ; PERIOD ANALYSIS ; ACUTE MYELOID-LEUKEMIA ; non-Hodgkin lymphoma ; analysis ; methods ; USA ; population-based ; IMPROVEMENT ; INCREASES ; UP-TO-DATE ; modeling ; ADOLESCENTS 1978-1997 ; INFORMATION-SYSTEM PROJECT ; non Hodgkin lymphoma ; non-Hodgkin ; TO-DATE ; STATE ; COLLABORATIVE BRITISH COHORT ; CANCER-PATIENT SURVIVAL
    Abstract: Background Advances in the treatment of childhood hematologic malignancies have led to improvements in survival for several of these conditions during the past few decades, but most population-based survival data available to date refer only to patients diagnosed up to the mid-1990s. Methods We used period analysis to assess trends in 5- and 10-year survival in US patients younger than 15 years of age at diagnosis with four hematologic malignancies-acute lymphoblastic leukemia, acute non-lymphoblastic leukemia, Hodgkin lymphoma, and non-Hodgkin lymphoma-over three recent 5-year intervals, 1990-1994, 1995-1999, and 2000-2004, using data on a total of 6957 patients from the Surveillance, Epidemiology, and End Results database. Expected survival for 2005-2009 was estimated by modeling from trends in the preceding intervals. Results Major improvements in 5- and 10-year relative survival between 1990-1994 and 2000-2004 were seen for acute lymphoblastic leukemia (from 80.2% to 87.5% and from 73.4% to 83.8%, respectively), acute non-lymphoblastic leukemia (from 41.9% to 59.9% and from 38.7% to 59.1%, respectively), and non-Hodgkin lymphoma (from 76.6% to 87.7% and from 73.0% to 86.9%, respectively). For those diagnosed with Hodgkin lymphoma, 5- and 10-year survival rates for the 1990-1994 period were 96.1% and 94.4%, respectively, and these rates did not change substantially in the later time periods. Projected 10-year survival rates for children diagnosed in the 2005-2009 period were 88.0% for acute lymphoblastic leukemia, 63.9% for acute non-lymphoblastic leukemia, 90.6% for non-Hodgkin lymphoma, and 94.3% for Hodgkin lymphoma. Conclusions Application of period analysis to a population-based study of childhood hematologic malignancies reveals ongoing increases in survival for three of the four common childhood hematologic malignancies
    Type of Publication: Journal article published
    PubMed ID: 18780868
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  • 9
    Keywords: SURVIVAL ; Germany ; COHORT ; EPIDEMIOLOGY ; PATIENT ; PERFORMANCE ; PATTERNS ; DATABASE ; LONG-TERM SURVIVAL ; UNITED-STATES ; TRENDS ; EUROPE ; MULTIPLE-MYELOMA ; multiple myeloma ; cancer registries ; PERIOD ANALYSIS ; thalidomide ; EMPIRICAL-EVALUATION ; cancer survival ; UP-TO-DATE ; OLDER
    Abstract: New therapeutic options have led to substantial increases in survival expectations of younger patients with multiple myeloma in recent years. In the past, the impact of these innovations on long-term survival has been disclosed only with substantial delay. We aimed to derive up-to-date estimates of long-term survival expectations of concurrently diagnosed multiple myeloma patients. Using data from the 1973-2005 database of the Surveillance, Epidemiology, and End Results (SEER) Program, we employed a novel model-based projection method to project 5-and 10-year relative survival expectations of multiple myeloma patients in the United States diagnosed in 2006-2010. Preliminary empirical evaluation of the method using historical data indicated good performance. Projected 5-year relative survival for patients diagnosed in 2006-2010 below 45 years of age is 68.0%, which exceeds the most up-to-date estimates obtained from traditional cohort and period analysis by 15.5 and 7.0 percent units respectively. Ten-year relative survival projection for patients in this age group is 55.3%, exceeding the most up-to-date estimates from traditional cohort and period analysis by 19.7 and 7.4 percent units respectively. By contrast, survival projections remain much lower and hardly exceed estimates from traditional survival analysis for older patients. Patients diagnosed with multiple myeloma in 2006-2010, especially those diagnosed at younger ages, are expected to have much higher long-term survival perspectives than suggested by previously available survival statistics
    Type of Publication: Journal article published
    PubMed ID: 19144659
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  • 10
    Keywords: CANCER ; SURVIVAL ; evaluation ; Germany ; THERAPY ; COHORT ; DISEASE ; EPIDEMIOLOGY ; LONG-TERM ; POPULATION ; PATIENT ; prognosis ; PERFORMANCE ; LYMPHOMA ; AGE ; statistics ; chemotherapy ; DATABASE ; LONG-TERM SURVIVAL ; EUROPE ; Hodgkin's lymphoma ; REGISTRY ; THERAPIES ; cancer registries ; PERIOD ANALYSIS ; RELATIVE SURVIVAL ; LEVEL ; USA ; population-based ; EMPIRICAL-EVALUATION ; PROGRESS ; cancer survival ; ERROR ; SPREAD ; ABVD
    Abstract: Available long-term survival figures for patients with Hodgkin's lymphoma (HL) from population-based cancer registries mostly refer to patients diagnosed in the 1980s and 1990s, and do not reflect recent progress in and spread of effective therapy at the population level. Using data from the Surveillance, Epidemiology, and End Results program, we employed a novel model-based projection method to estimate 5- and 10-year relative survival expectations of HL patients in the U. S. diagnosed in 2006-2010. Preliminary empirical evaluation of the method using historical data indicates excellent performance. Projections of 10-year relative survival percentages and their standard errors by age groups are as follows: 15-24 y: 94.7 (1.1), 25-34 years, 89.4 (1.5); 35-44 years, 90.1 (1.6); 45-54 years, 83.6 (2.7); 55-64 years, 70.5 (4.7); 65-74 years, 48.5 (5.9); and 75+ years, 24.0 (5.7). These estimates are 2.5-11.1 percentage points higher than those obtained by standard cohort analysis from the same database ( pertaining to patients diagnosed in 1991-1995). Patients diagnosed with HL in 2006-2010 have higher long-term survival expectations than suggested by conventional survival statistics from population-based cancer registries. The 10-year survival expectations are now close to or exceed 90% in all age groups up to age 45, and exceed 80% and 70% in the 45-54 and 55-64 age groups, respectively. The Oncologist 2009; 14: 806-813
    Type of Publication: Journal article published
    PubMed ID: 19648314
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