scholarly journals Conditional crude probabilities of death for English cancer patients

2019 ◽  
Vol 121 (10) ◽  
pp. 883-889 ◽  
Author(s):  
Kwok F. Wong ◽  
Paul C. Lambert ◽  
Sarwar I. Mozumder ◽  
John Broggio ◽  
Mark J. Rutherford
Keyword(s):  
Cancer Patients ◽  
Causes Of Death ◽  
Cancer Survival ◽  
Relative Survival ◽  
Cancer Registration ◽  
Malignant Tumours ◽  
Younger Patients ◽  
Single Cancer ◽  
Probability Of Death ◽  
The Impact

Abstract Background Cancer survival statistics are typically reported by using measures discounting the impact of other-cause mortality, such as net survival. This is a hypothetical measure and is interpreted as excluding the possibility of cancer patients dying from other causes. Crude probability of death partitions the all-cause probability of death into deaths from cancer and other causes. Methods The National Cancer Registration and Analysis Service is the single cancer registry for England. In 2006–2015, 1,590,477 malignant tumours were diagnosed for breast, colorectal, lung, melanoma and prostate cancer in adults. We used a relative survival framework, with a period approach, providing estimates for up to 10-year survival. Mortality was partitioned into deaths due to cancer or other causes. Unconditional and conditional (on surviving 1-years and 5-years) crude probability of death were estimated for the five cancers. Results Elderly patients who survived for a longer period before dying were more likely to die from other causes of death (except for lung cancer). For younger patients, deaths were almost entirely due to the cancer. Conclusion There are different measures of survival, each with their own strengths and limitations. Careful choices of survival measures are needed for specific scenarios to maximise the understanding of the data.

scholarly journals Impact of Different Modules of 21-Gene Assay in Early Breast Cancer Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Mengdi Chen ◽  
Deyue Liu ◽  
Weilin Chen ◽  
Weiguo Chen ◽  
Kunwei Shen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Low Risk ◽  
Breast Cancer Patients ◽  
Younger Patients ◽  
Gene Assay ◽  
Risk Patients ◽  
Gene Modules ◽  
The Impact

BackgroundThe 21-gene assay recurrence score (RS) provides additional information on recurrence risk of breast cancer patients and prediction of chemotherapy benefit. Previous studies that examined the contribution of the individual genes and gene modules of RS were conducted mostly in postmenopausal patients. We aimed to evaluate the gene modules of RS in patients of different ages.MethodsA total of 1,078 estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients diagnosed between January 2009 and March 2017 from Shanghai Jiao Tong University Breast Cancer Data Base were included. All patients were divided into three subgroups: Group A, ≤40 years and premenopausal (n = 97); Group B, >40 years and premenopausal (n = 284); Group C, postmenopausal (n = 697). The estrogen, proliferation, invasion, and HER2 module scores from RS were used to characterize the respective molecular features. Spearman correlation and analysis of the variance tests were conducted for RS and its constituent modules.ResultsIn patients >40 years, RS had a strong negative correlation with its estrogen module (ρ = −0.76 and −0.79 in Groups B and C) and a weak positive correlation with its invasion module (ρ = 0.29 and 0.25 in Groups B and C). The proliferation module mostly contributed to the variance in young patients (37.3%) while the ER module contributed most in old patients (54.1% and 53.4% in Groups B and C). In the genetic high-risk (RS >25) group, the proliferation module was the leading driver in all patients (ρ = 0.38, 0.53, and 0.52 in Groups A, B, and C) while the estrogen module had a weaker correlation with RS. The impact of ER module on RS was stronger in clinical low-risk patients while the effect of the proliferation module was stronger in clinical high-risk patients. The association between the RS and estrogen module was weaker among younger patients, especially in genetic low-risk patients.ConclusionsRS was primarily driven by the estrogen module regardless of age, but the proliferation module had a stronger impact on RS in younger patients. The impact of modules varied in patients with different genetic and clinical risks.

Studying Survival of Cancer Patients in Different Populations: Its Potential and Role

1997 ◽  
Vol 83 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Andrea Micheli ◽  
Gemma Gatta ◽  
Arduino Verdecchia
Keyword(s):  
Cancer Patients ◽  
Health Expenditure ◽  
Cancer Survival ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Malignant Neoplasms ◽  
Regional Health ◽  
Italian Regions ◽  
Different Populations

Rationale Survival figures from a population-based study incorporate the overall practice in diagnosis, cure and clinical follow-up for a specific disease within a given health care system. Being the outcome of a number of individual, social and economical aspects, population-based survival may be thought as index for measuring the level of a country's development. Data The EUROCARE project, a European Cancer Registries (CR) concerted action, provided reliable information on survival for more than 800,000 cancer patients from 11 European countries. A great deal of epidemiologic information has derived from EUROCARE. Women had a longer survival than men for all studied tumour sites, except for the colon. European survival variability was fairly high for several cancers, but it was lower for cancers with a relatively good prognosis and those sensitive to treatment. The ranking of populations of cancer survival tended to be fairly stable for many cancers: CR of Switzerland and Finland ranked high and Polish CR low. Denmark, Italian and France CR did not substantially differ from the European survival average. For most cancers, prognosis improved during the studied period (years of diagnosis: 1978–1985). Survival figures for colon (r = 0.74, males; r = 0.73, women) and female breast cancer (r = 0.57) well correlated with the national health expenditure of different participating countries. The ITACARE study, a new Italian Cancer Registries collaborative project involving more than 100,000 cancer patients, was set up to study survival differences within the country. Survival of cancer patients was not homogeneous in 7 studied Italian regions (the estimated 5-year relative survival for all malignant neoplasms combined ranked from 37.8% in CR of Sicily to 42.1% in those of Emilia-Romagna). The lowest levels of regional health expenditures were accompanied by the lowest levels of prognosis for overall cancers. However, a relatively low correlation among patient cancer survival and the regional health expenditure (r = 0.21) was found, suggesting that other factors such as different efficiency in managing cancer may play a role in explaining the intracountry differences. Conclusions Population-based survival figures may be used to study epidemiologic aspects, comparing different health systems, and may be interpreted as indexes for discussing inequalities in health in different populations.

Cancer survival outcomes in Ontario, Canada: Significant unexplained variation.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 36-36
Author(s):  
Michael Donald Brundage ◽  
Patti Groome ◽  
Timothy Hanna ◽  
Christopher M. Booth ◽  
Weidong Kong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Care Providers ◽  
Cancer Survival ◽  
Relative Survival ◽  
Survival Outcomes ◽  
Local Health ◽  
Care Providers ◽  
Cancer Specific Survival ◽  
Incident Cases ◽  
The Impact

36 Background: Cancer-specific outcomes are critical for assessing quality of care, and are key quality indicators for cancer control programs. Previous analyses of Ontario (Canada) data show that regional survival differences at the Local Health Integrated Network (LHIN) level exist for relative survival, overall survival, cancer-specific survival (CSS), and mortality rates.We sought to describe: 5-year cancer-specific survival (5Y-CSS) rates among Ontario LHINs; the impact of adjusting for known patient factors; and 5Y-CSS rates among patients diagnosed at Ontario's 50 largest cancer diagnosing hospitals. Methods: Newly diagnosed cases (colorectal, lung, breast, or prostate cancer) were identified in the Ontario Cancer Registry. Records were linked to data from CIHI and Statistics Canada, to identify date of diagnosis, cause-specific vital status, diagnosing hospital, and other reported variables. Cox regression models were used, and all models were adjusted for age and sex. Results: N = 498,382 incident cases (2007-2013) were included. 5Y-CSS varied across LHINs for all patients combined (range 62%-72%; p < 0.0001). Considering colorectal cancer cases as illustrative (N = 57,927), 5Y-CSS varied among LHINs from 58.4%-66.4% (p < 0.0001). Further adjusting for socioeconomic and urban-rural status minimally reduced that variation. Limiting the analysis cohort to patients diagnosed in one of Ontario's 50 largest hospitals (N = 43,245), 5Y-CSS ranged from 52% to 72% (p < 0.0001) among hospitals, and from 55% to 63% (p < 0.0001) among the hospitals affiliated with regional cancer centres. Comparable findings were seen for patients diagnosed with lung, breast, or prostate cancer. Collaborative staging data were available for a subset of patients; 5Y-CSS within all stage III patients (N = 5,360) ranged from 72% to 87%. Conclusions: Important, highly significant differences in cancer survival outcomes exist across Ontario. These are of great interest to patients, health-care providers, system administrators, and policy makers, and are not explained by adjusting for the variables included in these analyses.

scholarly journals Exploring the impact of cancer registry completeness on international cancer survival differences: a simulation study

2020 ◽  
Author(s):  
Therese M.-L. Andersson ◽  
Mark J. Rutherford ◽  
Tor Åge Myklebust ◽  
Bjørn Møller ◽  
Isabelle Soerjomataram ◽  
...  
Keyword(s):  
Cancer Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Cancer Registration ◽  
Death Certificates ◽  
International Partnership ◽  
Impact On Survival ◽  
Survival Differences ◽  
The Impact

Abstract Background Data from population-based cancer registries are often used to compare cancer survival between countries or regions. The ICBP SURVMARK-2 study is an international partnership aiming to quantify and explore the reasons behind survival differences across high-income countries. However, the magnitude and relevance of differences in cancer survival between countries have been questioned, as it is argued that observed survival variations may be explained, at least in part, by differences in cancer registration practice, completeness and the availability and quality of the respective data sources. Methods As part of the ICBP SURVMARK-2 study, we used a simulation approach to better understand how differences in completeness, the characteristics of those missed and inclusion of cases found from death certificates can impact on cancer survival estimates. Results Bias in 1- and 5-year net survival estimates for 216 simulated scenarios is presented. Out of the investigated factors, the proportion of cases not registered through sources other than death certificates, had the largest impact on survival estimates. Conclusion Our results show that the differences in registration practice between participating countries could in our most extreme scenarios explain only a part of the largest observed differences in cancer survival.

scholarly journals Lung cancer survival in Norway, 1997–2011: from nihilism to optimism

2015 ◽  
Vol 47 (1) ◽  
pp. 275-287 ◽  
Author(s):  
Yngvar Nilssen ◽  
Trond Eirik Strand ◽  
Lars Fjellbirkeland ◽  
Kristian Bartnes ◽  
Bjørn Møller
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Cancer Survival ◽  
Treatment Options ◽  
Diagnostic Testing ◽  
Relative Survival ◽  
Population Based ◽  
Related Factors ◽  
Lung Cancer Patients ◽  
Lung Cancer Survival

We examine changes in survival and patient-, tumour- and treatment-related factors among resected and nonresected lung cancer patients, and identify subgroups with the largest and smallest survival improvements.National population-based data from the Cancer Registry of Norway, Statistics Norway and the Norwegian Patient Register were linked for lung cancer patients diagnosed during 1997–2011. The 1- and 5-year relative survival were estimated, and Cox proportional hazard regression, adjusted for selected patient characteristics, was used to assess prognostic factors for survival in lung cancer patients overall and stratified by resection status.We identified 34 157 patients with lung cancer. The proportion of histological diagnoses accompanied by molecular genetics testing increased from 0% to 26%, while those accompanied by immunohistochemistry increased from 8% to 26%. The 1-year relative survival among nonresected and resected patients increased from 21.7% to 34.2% and 75.4% to 91.5%, respectively. The improved survival remained significant after adjustment for age, sex, stage and histology. The largest improvements in survival occurred among resected and adenocarcinoma patients, while patients ≥80 years experienced the smallest increase.Lung cancer survival has increased considerably in Norway. The explanation is probably multifactorial, including improved attitude towards diagnostic work-up and treatment, and more accurate diagnostic testing that allows for improved selection for resection and improved treatment options.

scholarly journals Cause of death for patients with breast cancer: discordance between death certificates and medical files, and impact on survival estimates

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Hava Izci ◽  
Tim Tambuyzer ◽  
Jessica Vandeven ◽  
Jérôme Xicluna ◽  
Hans Wildiers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cause Of Death ◽  
Cancer Survival ◽  
False Negative ◽  
Relative Survival ◽  
Death Certificates ◽  
Breast Cancer Patients ◽  
University Hospitals ◽  
Kappa Value

Abstract Background Registration and coding of cause of death is prone to error since determining the exact underlying condition leading directly to death is challenging. In this study, causes of death from the death certificates were compared to patients’ medical files interpreted by experts at University Hospitals Leuven (UHL), to assess concordance between sources and its impact on cancer survival assessment. Methods Breast cancer patients treated at UHL (2009–2014) (follow-up until December 31st 2016) were included in this study. Cause of death was obtained from death certificates and expert-reviewed medical files at UHL. Agreement was calculated using Cohen’s kappa coefficient. Cause-specific survival (CSS) was calculated using the Kaplan-Meier method and the relative survival probability (RS) using the Ederer II and Pohar Perme method. Results A total of 2862 patients, of whom 354 died, were included. We found an agreement of 84.7% (kappa-value of 0.69 (95% C.I.: 0.62–0.77)) between death certificates and medical files. Death certificates had 10.7% false positive and 4.5% false negative rates. However, five-year CSS and RS measures were comparable for both sources. Conclusion For breast cancer patients included in our study, fair agreement of cause of death was seen between death certificates and medical files with similar CSS and RS estimations.

scholarly journals 633Poorly controlled diabetes is a predictor of colorectal cancer survival

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Ming Li ◽  
David Roder
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Cancer Survival ◽  
Epidemiological Studies ◽  
Colorectal Cancer Survival ◽  
Increased Risk ◽  
History Of ◽  
Colorectal Cancer Patients ◽  
The Impact

Abstract Background Epidemiological studies have shown diabetes associated with increased risk of colorectal cancer. This study investigates the impact of a pre-cancer diabetes-related hospitalization record on colorectal cancer survival. Methods A retrospective cohort of 13190 colorectal cancer patients recorded on the South Australian Cancer Registry in 2003-2013 were examined. Diabetes-related hospitalization histories were obtained using linked inpatient data. Colorectal cancer deaths were available for 2003-2013. The association of survival from colorectal cancer with diabetes-related hospitalization history was assessed using competing risk analysis, adjusting for sociodemographic factors and cancer stage at diagnosis. Results 2765 patients with colorectal cancer (26.5%) had a history of hospital admission for diabetic complications, the most common being multiple complications (32%), followed by kidney and eye complications. The 5- and 10-year cancer survival probabilities were 63% and 56% in those with a diabetes complication history, significantly lower than 66% and 60% for patients without these complications (adjusted sub hazard ratio 1.11, 95% CI 1.02-1.20). Risk of colorectal cancer death was lower when theses diabetes-related hospitalizations were earlier than the year of cancer diagnosis - i.e., adjusted SHR 0.80, 95% CI 0.66-0.97 for 3-5 and 0.76, 95% CI 0.59-0.98 for 6+ years before the cancer diagnosis compared with same-year hospitalizations. Conclusions Colorectal cancer patients with a history of diabetes-related hospitalization have poorer survival, particularly if these hospitalizations were in the same year as the cancer diagnosis. Key messages Poorly controlled diabetes histories predict increased risk of colorectal cancer mortality.

scholarly journals Cancer Patients’ Survival: Standard Calculation Methods And Some Considerations Regarding Their Interpretation

2016 ◽  
Vol 55 (2) ◽  
pp. 144-151
Author(s):  
Vesna Zadnik ◽  
Tina Žagar ◽  
Maja Primic Žakelj
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Cancer Survival ◽  
Relative Survival ◽  
Population Based ◽  
Breast Cancer Patients ◽  
Data Set ◽  
Online Systems ◽  
The Difference ◽  
Standard Calculation

Abstract Background Cancer patients’ survival is an extremely important but complex indicator for assessing regional or global inequalities in diagnosis practices and clinical management of cancer patients. The population-based cancer survival comparisons are available through international projects (i.e. CONCORD, EUROCARE, OECD Health Reports) and online systems (SEER, NORDCAN, SLORA). In our research we aimed to show that noticeable differences in cancer patients’ survival may not always reflect the real inequalities in cancer care, but can also appear due to variations in the applied methodology for relative survival calculation. Methods Four different approaches for relative survival calculation (cohort, complete, period and hybrid) have been implemented on the data set of Slovenian breast cancer patients diagnosed between 2000 and 2009, and the differences in survival estimates have been quantified. The major cancer survival comparison studies have been reviewed according to the selected relative survival calculation approach. Results The gap between four survival curves widens with time; after ten years of follow up the difference increases to more than 10 percent points between the highest (hybrid) and the lowest (cohort) estimates. In population-based comparison studies, the choice of the calculation approach is not uniformed; we noticed a tendency of simply using the approach which yields numerically better survival estimates. Conclusion The population-based cancer relative survival, which is continually reported by recognised research groups, could not be compared directly as the methodology is different, and, consequently, final country scores differ. A uniform survival measure would be of great benefit in the cancer care surveillance.

scholarly journals The Impact of Primary Tumor Location in Synchronous Metastatic Colorectal Cancer: Differences in Metastatic Sites and Survival

2019 ◽  
Vol 27 (5) ◽  
pp. 1580-1588 ◽  
Author(s):  
Nelleke P. M. Brouwer ◽  
Dave E. W. van der Kruijssen ◽  
Niek Hugen ◽  
Ignace H. J. T. de Hingh ◽  
Iris D. Nagtegaal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Relative Survival ◽  
Tumor Location ◽  
Primary Tumor Location ◽  
Metastatic Sites ◽  
The Impact

Abstract Purpose We explored differences in survival between primary tumor locations, hereby focusing on the role of metastatic sites in synchronous metastatic colorectal cancer (mCRC). Methods Data for patients diagnosed with synchronous mCRC between 1989 and 2014 were retrieved from the Netherlands Cancer registry. Relative survival and relative excess risks (RER) were analyzed by primary tumor location (right colon (RCC), left colon (LCC), and rectum). Metastatic sites were reported per primary tumor location. Survival was analyzed for metastatic sites combined and for single metastatic sites. Results In total, 36,297 patients were included in this study. Metastatic sites differed significantly between primary tumor locations, with liver-only metastases in 43%, 54%, and 52% of RCC, LCC, and rectal cancer patients respectively (p < 0.001). Peritoneal metastases were most prevalent in RCC patients (33%), and lung metastases were most prevalent in rectal cancer patients (28%). Regardless of the location of metastases, patients with RCC had a worse survival compared with LCC (RER 0.81, 95% CI 0.78–0.83) and rectal cancer (RER 0.73, 95% CI 0.71–0.76). The survival disadvantage for RCC remained present, even in cases with metastasectomy for liver-only disease (LCC: RER 0.66, 95% CI 0.57–0.76; rectal cancer: RER 0.84, 95% CI 0.66–1.06). Conclusions This study showed significant differences in relative survival between primary tumor locations in synchronous mCRC, which can only be partially explained by distinct metastatic sites. Our findings support the concept that RCC, LCC and rectal cancer should be considered distinct entities in synchronous mCRC.

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