International differences in lung cancer survival by sex, histological type and stage at diagnosis: an ICBP SURVMARK-2 Study

IntroductionLung cancer has a poor prognosis that varies internationally when assessed by the two major histological subgroups (non-small cell (NSCLC) and small cell (SCLC)).Method236 114 NSCLC and 43 167 SCLC cases diagnosed during 2010–2014 in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK were included in the analyses. One-year and 3-year age-standardised net survival (NS) was estimated by sex, histological type, stage and country.ResultsOne-year and 3-year NS was consistently higher for Canada and Norway, and lower for the UK, New Zealand and Ireland, irrespective of stage at diagnosis. Three-year NS for NSCLC ranged from 19.7% for the UK to 27.1% for Canada for men and was consistently higher for women (25.3% in the UK; 35.0% in Canada) partly because men were diagnosed at more advanced stages. International differences in survival for NSCLC were largest for regional stage and smallest at the advanced stage. For SCLC, 3-year NS also showed a clear female advantage with the highest being for Canada (13.8% for women; 9.1% for men) and Norway (12.8% for women; 9.7% for men).ConclusionDistribution of stage at diagnosis among lung cancer cases differed by sex, histological subtype and country, which may partly explain observed survival differences. Yet, survival differences were also observed within stages, suggesting that quality of treatment, healthcare system factors and prevalence of comorbid conditions may also influence survival. Other possible explanations include differences in data collection practice, as well as differences in histological verification, staging and coding across jurisdictions.

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Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004–2007

Thorax ◽

10.1136/thoraxjnl-2012-202297 ◽

2013 ◽

Vol 68 (6) ◽

pp. 551-564 ◽

Cited By ~ 215

Author(s):

Sarah Walters ◽

Camille Maringe ◽

Michel P Coleman ◽

Michael D Peake ◽

John Butler ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Survival ◽

Population Based ◽

Stage At Diagnosis ◽

Population Based Study ◽

The Uk ◽

Lung Cancer Survival

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ASSOCIATION OF STAGE AT DIAGNOSIS OF NON-SMALL CELL LUNG CANCER WITH OVERALL SURVIVAL AND ONE-YEAR HEALTHCARE EXPENDITURES: AN ANALYSIS OF THE SEER-MEDICARE DATABASE

CHEST Journal ◽

10.1016/j.chest.2021.07.1468 ◽

2021 ◽

Vol 160 (4) ◽

pp. A1608-A1609

Author(s):

Anil Vachani ◽

Barbara Johnson ◽

Stephen Johnston ◽

William Johnson ◽

Urmila Chandran ◽

...

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Stage At Diagnosis ◽

Small Cell Lung ◽

Healthcare Expenditures ◽

One Year ◽

Medicare Database

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Age disparities in lung cancer survival in New Zealand: the role of patient and clinical factors

10.1101/2020.10.05.20206912 ◽

2020 ◽

Author(s):

Sophie Pilleron ◽

Camille Maringe ◽

Hadrien Charvat ◽

June Atkinson ◽

Eva Morris ◽

...

Keyword(s):

Lung Cancer ◽

New Zealand ◽

Cancer Survival ◽

Age Difference ◽

Stage At Diagnosis ◽

Clinical Factors ◽

Emergency Presentation ◽

Age Disparities ◽

Lung Cancer Survival

AbstractBackgroundAge is an important prognostic factor for lung cancer. However, no studies have investigated the age difference in lung cancer survival per se. We, therefore, described the role of patient-related and clinical factors on the age pattern in lung cancer excess mortality hazard by stage at diagnosis in New Zealand.MethodsWe extracted 22 487 new lung cancer cases aged 50-99 (median age = 71, 47.1% females) diagnosed between 1 January 2006 and 31 July 2017 from the New Zealand population-based cancer registry and followed up to December 2019. We modelled the effect of age at diagnosis, sex, ethnicity, deprivation, comorbidity, and emergency presentation on the excess mortality hazard by stage at diagnosis, and we derived corresponding lung cancer net survival.ResultsThe age difference in net survival was particularly marked for localised and regional lung cancers, with a sharp decline in survival from the age of 70. No identified factors influenced age disparities in patients with localised cancer. However, for other stages, females had a greater age difference in survival between middle-aged and older patients with lung cancer than males. Comorbidity and emergency presentation played a minor role. Ethnicity and deprivation did not influence age disparities in lung cancer survival.ConclusionSex and stage at diagnosis were the most important factors of age disparities in lung cancer survival in New Zealand.Key messagesWhat is the key question?How do patient-related and clinical factors influence age pattern in lung cancer survival?What is the bottom line?Age disparities in lung cancer survival were strongest for females and non-advanced disease. Deprivation, ethnicity, comorbidity, and emergency presentation did not influence age disparities.Why read on?Our findings reinforce the call for a better representation of older adults in clinical trials and a wider use of geriatric assessment to identify patients who will benefit treatment.

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Role of Treatment in International Differences in One-Year Mortality From Early Stage Non-Small Cell Lung Cancer: a Tentative Answer From the International Cancer Benchmarking Partnership Study

Annals of Oncology ◽

10.1093/annonc/mdv048.21 ◽

2015 ◽

Vol 26 ◽

pp. i18

Author(s):

T. Solomon ◽

M.D. Peake ◽

J. Butler ◽

M.P. Coleman ◽

W.K. Evans ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

International Differences ◽

One Year

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International variation in oesophageal and gastric cancer survival 2012–2014: differences by histological subtype and stage at diagnosis (an ICBP SURVMARK-2 population-based study)

Gut ◽

10.1136/gutjnl-2021-325266 ◽

2021 ◽

pp. gutjnl-2021-325266

Author(s):

Melina Arnold ◽

Eileen Morgan ◽

Aude Bardot ◽

Mark J Rutherford ◽

Jacques Ferlay ◽

...

Keyword(s):

Gastric Cancer ◽

New Zealand ◽

Oesophageal Cancer ◽

Cancer Survival ◽

High Income ◽

Stage At Diagnosis ◽

Histological Subtype ◽

Histological Subtypes ◽

The Uk ◽

Localised Disease

ObjectiveTo provide the first international comparison of oesophageal and gastric cancer survival by stage at diagnosis and histological subtype across high-income countries with similar access to healthcare.MethodsAs part of the ICBP SURVMARK-2 project, data from 28 923 patients with oesophageal cancer and 25 946 patients with gastric cancer diagnosed during 2012–2014 from 14 cancer registries in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK) were included. 1-year and 3-year age-standardised net survival were estimated by stage at diagnosis, histological subtype (oesophageal adenocarcinoma (OAC) and oesophageal squamous cell carcinoma (OSCC)) and country.ResultsOesophageal cancer survival was highest in Ireland and lowest in Canada at 1 (50.3% vs 41.3%, respectively) and 3 years (27.0% vs 19.2%) postdiagnosis. Survival from gastric cancer was highest in Australia and lowest in the UK, for both 1-year (55.2% vs 44.8%, respectively) and 3-year survival (33.7% vs 22.3%). Most patients with oesophageal and gastric cancer had regional or distant disease, with proportions ranging between 56% and 90% across countries. Stage-specific analyses showed that variation between countries was greatest for localised disease, where survival ranged between 66.6% in Australia and 83.2% in the UK for oesophageal cancer and between 75.5% in Australia and 94.3% in New Zealand for gastric cancer at 1-year postdiagnosis. While survival for OAC was generally higher than that for OSCC, disparities across countries were similar for both histological subtypes.ConclusionSurvival from oesophageal and gastric cancer varies across high-income countries including within stage groups, particularly for localised disease. Disparities can partly be explained by earlier diagnosis resulting in more favourable stage distributions, and distributions of histological subtypes of oesophageal cancer across countries. Yet, differences in treatment, and also in cancer registration practice and the use of different staging methods and systems, across countries may have impacted the comparisons. While primary prevention remains key, advancements in early detection research are promising and will likely allow for additional risk stratification and survival improvements in the future.

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Understanding Differences in Cancer Survival between Populations: A New Approach and Application to Breast Cancer Survival Differentials between Danish Regions

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16173093 ◽

2019 ◽

Vol 16 (17) ◽

pp. 3093 ◽

Cited By ~ 3

Author(s):

Marie-Pier Bergeron-Boucher ◽

Jim Oeppen ◽

Niels Vilstrup Holm ◽

Hanne Melgaard Nielsen ◽

Rune Lindahl-Jacobsen ◽

...

Keyword(s):

Breast Cancer ◽

Decomposition Method ◽

Cancer Survival ◽

Reference Population ◽

Breast Cancer Survival ◽

Absolute Difference ◽

Stage At Diagnosis ◽

Aggregated Data ◽

One Year ◽

Survival Differences

Large variations in cancer survival have been recorded between populations, e.g., between countries or between regions in a country. To understand the determinants of cancer survival differentials between populations, researchers have often applied regression analysis. We here propose the use of a non-parametric decomposition method to quantify the exact contribution of specific components to the absolute difference in cancer survival between two populations. Survival differences are here decomposed into the contributions of differences in stage at diagnosis, population age structure, and stage-and-age-specific survival. We demonstrate the method with the example of differences in one-year and five-year breast cancer survival between Denmark’s five regions. Differences in stage at diagnosis explained 45% and 27%, respectively, of the one- and five-year survival differences between Zealand and Central Denmark for patients diagnosed between 2008 and 2010. We find that the introduced decomposition method provides a powerful complementary analysis and has several advantages compared with regression models: No structural or distributional assumptions are required; aggregated data can be used; and the use of absolute differences allows quantification of the survival that could be gained by improving, for example, stage at diagnosis relative to a reference population, thus feeding directly into health policy evaluation.

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