National Estimates of Cancer Patients Survival in Italy: A Model-Based Method

2005 ◽  
Vol 91 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Riccardo Inghelmann ◽  
Enrico Grande ◽  
Silvia Francisco ◽  
Roberta De Angelis ◽  
Andrea Micheli ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Patient Survival ◽  
Relative Survival ◽  
The Elderly ◽  
Cancer Registries ◽  
Pronounced Increase ◽  
Men And Women ◽  
Model Based ◽  
National Survival ◽  
Incident Cases

Aims and background To provide model-based estimates of all cancers patient survival in Italy and in Italian large geographical areas (North-West, North-East, Center, South), where only partial coverage of cancer registries data is available, and to describe them in terms of time trends. Moreover, to measure the degree of representativeness of cancer patient survival obtained from Italian cancer registries data. Methods Relative survival in the four main Italian geographical areas was estimated by a parametric mixture model belonging to the class of “cure” survival models. Data used are from Italian cancer registries, stratified by sex, period of diagnosis and age. The Italian national survival was obtained as a weighted average of these area-specific estimates, with weights proportional to the number of estimated incident cases in every area. The model takes into account also differences in survival temporal trends between the areas. Results Relative survival for all cancers combined in Italian patients diagnosed in 1990-1994 was estimated to be higher in women (53%) than in men (38%) at 5 years from the diagnosis. The survival trend is increasing by period and decreasing creasing by age, both for men and women. The greatest gain in terms of survival was obtained by the elderly, with annual mean growth rates in the period 1978-1994 equal to 3.5% and 3.2% for men and women, respectively. More than 50% of the youngest cancer patients were “cured”, whereas for the elderly this proportion dropped to 15% and 25% for men and women, respectively. The South of Italy had the lowest survival and the North the most pronounced increase. Conclusions The obtained national survival estimates are similar, but not identical, to previously published estimates, in which Italian registries’ data were pooled without any adjustment for geographical representativeness. The four Italian areas have different survival levels and trends, showing variability within the country. The differences in survival between men and women may be explained by the different proportion of lethal cancers. Among males, most cases had a poor prognosis (lung and stomach cancers), whereas among females the largest proportion was made up of curable and less lethal cancers (breast cancer).

Survival in Adult Italian Cancer Patients, 1978–1989

1997 ◽  
Vol 83 (1) ◽  
pp. 39-425 ◽  
Author(s):  
Arduino Verdecchia ◽  
Arduino Verdecchia ◽  
Riccardo Capocaccia ◽  
Roberta De Angelis ◽  
Fulvia Valente ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Cancer Patients ◽  
Patient Survival ◽  
National Level ◽  
International Comparisons ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Cancer Site ◽  
Malignant Neoplasms

Aims To present a systematic analysis of population-based cancer patient survival in Italy. Methods Population-based survival data have been made available from 10 Italian cancer registries within the ITACARE project. Data, collected and validated using a common protocol, included over 100,000 patients with cancer diagnosed between 1978 and 1989. Multivariate weighted analysis was used to provide relative survival estimates attributable to Italy at national level. Results Results are presented, according to a systematic frame, as the main object of the ITACARE study, involving crude and relative survival figures for adult Italian cancer patients, by age, sex, period of diagnosis and registry area. An estimate with reference to Italy as a whole is also presented by cancer site and for all malignant neoplasms combined. Age-standardized relative survival figures are presented to allow comparisons between Italian registries and also to give a basis for international comparisons with countries involved in the EUROCARE study. Conclusions For the fist time, population-based survival of cancer patients is made available in Italy on a large scale analysis of data from all the Italian cancer registries in a combined action. Estimates of cancer patient survival at a national level in Italy allow proper international comparisons with European countries and give elements of evaluation and discussion on the performance of the Italian health care system.

Variations in the Survival of Adult Cancer Patients in Italy

1997 ◽  
Vol 83 (1) ◽  
pp. 497-504 ◽  
Author(s):  
Gemma Gatta ◽  
Eva Buiatti ◽  
Ettore Conti ◽  
Vincenzo De Lisi ◽  
Fabio Falcini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Geographical Area ◽  
Central Italy ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Italian Population ◽  
Age Class ◽  
General Survival ◽  
General Improvement

Aims As part of the ITACARE project, the present study analyzed and compared population-based data on the survival of adult cancer patients in Italy, according to sex, age, period of diagnosis and geographical area. Methods Nine Italian population-based cancer registries provided data on all their cancer patients (total 90,431 cases) followed for at least 5 years and diagnosed during the period 1978–1989. About 10% of the Italian population is covered by these registries. The data was analyzed by means of a multivariate model. Results The major findings were that there was a general improvement in 5-year relative survival over the study period (from 33% to 39%) and that there were significant differences in survival between different areas of the country, particularly for cancer sites which respond well to treatment. In general, the area covered by the Ragusa (Sicily) registry was characterized by significantly worse survival than other registry populations. Other important findings were that for all malignant cancer sites 5-year relative survival decreased with age from 50% for the youngest age class (15–44 years) to 27% for the oldest age class (75+ years) and that women have a better prognosis for most cancer sites (overall 5-year relative survival in women 48% vs 32% in men). Conclusions The significant regional differences in survival may reflect unequal provision of care, particularly between northern-central Italy and the south. The reasons for the general survival improvement with time are not completely understood, whereas the marked overall sex difference is related to the fact that the commonest cancer in women (breast cancer) is eminently more treatable than the commonest malignancy in men (lung cancer). The unfavorable trend with increasing age may be due to increasing difficulty in applying complete therapy protocols as general health declines, sometimes in relation to an advanced cancer stage at diagnosis.

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.

scholarly journals Cancer cure for 32 cancer types: results from the EUROCARE-5 study

2020 ◽  
Vol 49 (5) ◽  
pp. 1517-1525
Author(s):  
Luigino Dal Maso ◽  
Chiara Panato ◽  
Andrea Tavilla ◽  
Stefano Guzzinati ◽  
Diego Serraino ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Lung Cancers ◽  
Pancreatic Cancers ◽  
Corpus Uteri ◽  
Cure Fraction ◽  
Prostate Cancers

Abstract Background Few studies have estimated the probability of being cured for cancer patients. This study aims to estimate population-based indicators of cancer cure in Europe by type, sex, age and period. Methods 7.2 million cancer patients (42 population-based cancer registries in 17 European countries) diagnosed at ages 15–74 years in 1990–2007 with follow-up to 2008 were selected from the EUROCARE-5 dataset. Mixture-cure models were used to estimate: (i) life expectancy of fatal cases (LEF); (ii) cure fraction (CF) as proportion of patients with same death rates as the general population; (iii) time to cure (TTC) as time to reach 5-year conditional relative survival (CRS) >95%. Results LEF ranged from 10 years for chronic lymphocytic leukaemia patients to <6 months for those with liver, pancreas, brain, gallbladder and lung cancers. It was 7.7 years for patients with prostate cancer at age 65–74 years and >5 years for women with breast cancer. The CF was 94% for testis, 87% for thyroid cancer in women and 70% in men, 86% for skin melanoma in women and 76% in men, 66% for breast, 63% for prostate and <10% for liver, lung and pancreatic cancers. TTC was <5 years for testis and thyroid cancer patients diagnosed below age 55 years, and <10 years for stomach, colorectal, corpus uteri and melanoma patients of all ages. For breast and prostate cancers, a small excess (CRS < 95%) remained for at least 15 years. Conclusions Estimates from this analysis should help to reduce unneeded medicalization and costs. They represent an opportunity to improve patients’ quality of life.

Regional Estimates of Prostate Cancer Burden in Italy

2007 ◽  
Vol 93 (4) ◽  
pp. 380-386 ◽  
Author(s):  
Riccardo Inghelmann ◽  
Enrico Grande ◽  
Silvia Francisci ◽  
Arduino Verdecchia ◽  
Andrea Micheli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Survival Data ◽  
Relative Survival ◽  
Developed Countries ◽  
Opportunistic Screening ◽  
The South ◽  
Pronounced Increase ◽  
Italian Regions ◽  
Central Regions ◽  
Incident Cases

Aims and background Prostate cancer is one of the most common cancers in developed countries and the most common among men in industrialized countries. The introduction of new diagnostic procedures caused an increase in new diagnoses in Italy starting from the early 1990s, while the prognosis of prostate cancer improved due to the use of hormonal treatments. The aim of this paper is to present estimates of prostate cancer mortality, incidence and prevalence over the period 1970-2005 for the Italian regions and for Italy as a whole, and to assess the changes that opportunistic screening and the diffusion of more effective treatments introduced. Methods Estimated figures for incidence, prevalence and mortality were obtained with the MIAMOD method. Starting from the knowledge of mortality in the period 1970-1999 and of the relative survival in the period of diagnosis 1978-1994, we derived incidence and prevalence estimates up to the year 2005 by means of a statistical back-calculation approach. Survival at regional and national levels was modelled on the basis of published survival data from the Italian cancer registries. Results The incidence trend showed a steep increase all over the country during the entire estimation period 1970-2005 with a more pronounced increase in the Center-North then in the South of Italy. Incidence of northern and central regions was about twice as high as that of southern regions. Mortality trends were however constant or declining in the majority of northern-central regions, while they still increased in the South. A total of around 43,000 incident cases, 174,000 prevalent cases and 9,000 deaths were estimated for Italy in 2005. Discussion The effects of opportunistic screening are reflected in an earlier diagnosis for many patients. The existing North-South gradient in incidence seems to be associated with the different spread of the PSA test in different parts of the country. Prostate cancer remains a great health problem in terms of both incidence and prevalence.

The Itacare Study

1997 ◽  
Vol 83 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Milena Sant ◽  
Gemma Gatta ◽  
Fulvia Valente ◽  
Alessandro Barchielli ◽  
Valerio Ramazzotti ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Survival Data ◽  
Collaborative Study ◽  
Transitional Cell ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Italian Population ◽  
Breast Cancer Patients

ITACARE is a collaborative study on the survival of Italian cancer patients diagnosed in the period 1978–1989. The study involves 11 Italian population-based cancer registries (CRs) (Firenze, Forlì-Ravenna, Genova, Latina, Modena, Parma, Ragusa, Torino, Varese, the childhood CR of Piedmont and the colorectal CR of Modena), and its principal aim is to identify and analyze possible differences between the areas covered by the CRs. This article describes the ITACARE database. Ten percent of the Italian population is covered by the participating CRs, most of which are located in the northern part of the country. All malignant cancer sites (classified by ICD-9) except skin cancers were included. For bladder cancers, papillomas and transitional cell tumours grade 1 and 2 were also included. Survival data on over 100,000 cases were collected. The principal information variables were sex, date of birth, diagnosis and end of follow-up, life status, ICD-9 code for tumour site, diagnosis modality (clinical, cytologic confirmation, histologic confirmation), ICD-0 morphology code, and tumour stage (grouped into broad categories). Follow-up is active in all registries. All cases were checked systematically for errors and inconsistencies, following which about 0.2% of cases were excluded from the analyses. The percentage of cases microscopically verified, which is an indicator of diagnostic accuracy and data reliability, was higher among patients under 65 years of age (90%), breast cancer patients (92%) and cases covered by the Varese, Torino and Forlì-Ravenna CRs (more than 82%). The percentage of cases known by death certificate only (an indicator of the completeness and quality of registration) was about 3% of total cases and was higher among older patients (4%). Province-specific mortality, used to compute relative survival from cancer (i.e., survival adjusted for competing causes of death), varied according to period of diagnosis, sex and area: the highest mortality was among women of the Ragusa CR (Sicily) and men in northern CRs. Overall mortality decreased during the period, more markedly in the north and among women.

DYNAMICS OF OBSERVED AND RELATIVE SURVIVAL OF COLON CANCER PATIENTS IN ST. PETERSBURG AND THE REPUBLIC OF BELARUS (ACCORDING TO POPULATION-BASED CANCER REGISTRIES)

2017 ◽  
Vol 63 (3) ◽  
pp. 394-405
Author(s):  
Vakhtang Merabishvili ◽  
Aleksey Okeanov ◽  
Alesya Yevmenenko
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Survival Rates ◽  
Cancer Control ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Problem Analysis ◽  
The Republic ◽  
Analysis Of Dynamics

Actuality of problem. Analysis of observed and relative survival is related to important criteria for evaluation of cancer control at the population-based level covering all patients on the administrative territory as well as the group of treated patients. Comparison of the effectiveness of treatment of patients in different countries allows revealing more adequate methods of complex anti-cancer activities. In this paper such study was carried out with respect to colon cancer according to population-based cancer registries of the Republic of Belarus and St. Petersburg. Purpose of study is to compare dynamics of observed and relative survival rates in colon cancer patients in the Republic of Belarus and St. Petersburg. Materials and methods. In the basis of the study there were taken databases of population-based cancer registries of the Republic of Belarus and St. Petersburg and also there was used standard methodology by constructing expectancy tables and estimating the significance of differences in rates. Analysis of obtained data. There was performed in-depth comparative analysis of dynamics of survival rates by sex, age and histological tumor types. Conclusion. Conducted comparative study of survival colon cancer patients in the Republic of Belarus and St. Petersburg showed significant growth of rates however relative survival in Europe was much higher than in the Republic of Belarus and western regions of Russia.

Regional Estimates of Stomach Cancer Burden in Italy

2007 ◽  
Vol 93 (4) ◽  
pp. 367-373 ◽  
Author(s):  
Riccardo Inghelmann ◽  
Enrico Grande ◽  
Silvia Francisci ◽  
Arduino Verdecchia ◽  
Andrea Micheli ◽  
...  
Keyword(s):  
Stomach Cancer ◽  
Survival Data ◽  
Relative Survival ◽  
Cancer Registries ◽  
Mortality Trends ◽  
Female Ratio ◽  
The North ◽  
Italian Regions ◽  
Incidence And Mortality ◽  
Incident Cases

Aims and background Stomach cancer still remains one of the most frequent tumors in Italy and Europe. The aim of this paper is to present estimates for stomach cancer mortality, incidence and prevalence over the period 1970-2010 for the Italian regions and for Italy as a whole. Methods Estimated figures for incidence, prevalence and mortality were obtained by using the MIAMOD method. Starting from the knowledge of mortality in the period 1970-1999 and of relative survival in the period of diagnosis 1978-1994, we derived incidence and prevalence estimates and projections up to the year 2010 by means of a statistical back-calculation approach. Survival at the regional and national levels was modelled on the basis of published survival data from the Italian cancer registries. Results Incidence and mortality trends for both sexes decrease by about 60% during the estimation period 1970-2010. Both indicators show a 2-fold male/female ratio all over the country, and a similar gender time trend. The incidence and mortality in the North and Center of the country are estimated to be higher and to decrease more steeply than those in the South, both for men and women. A total of around 13,000 incident cases, 57,000 prevalent cases, and 8,000 deaths are estimated to have occurred in Italy in 2005. Conclusions The incidence and mortality trends are estimated to decline during the entire period 1970-2010, with different slopes between northern-central and southern regions. The incidence and mortality are quite similar among Italian regions, showing that the risk of developing the disease diminishes and is becoming more homogeneous than in the past decades all over the country.

Recent Major Progress in Long-Term Cancer Patient Survival Disclosed by Modeled Period Analysis

2007 ◽  
Vol 25 (22) ◽  
pp. 3274-3280 ◽  
Author(s):  
Hermann Brenner ◽  
Adam Gondos ◽  
Volker Arndt
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patient ◽  
Cancer Patients ◽  
Patient Survival ◽  
Relative Survival ◽  
The United States ◽  
Substantial Improvement ◽  
Tumor Spread ◽  
Period Analysis

Purpose To disclose most recent trends in long-term cancer patient survival. Methods We estimated trends in 5- and 10-year relative survival of cancer patients in the United States in 1998 to 2003 from the 1973 to 2003 database of the Surveillance, Epidemiology, and End Results Program using recently introduced period-analysis modeling techniques that provide the most up-to-date and precise survival estimates. Results Statistically significant and partly very substantial improvement in 5- and 10-year relative survival in the 1998 to 2003 period was seen for 14 of 24 of the assessed common forms of cancer, including breast and colorectal cancer. For example, by 2003, 5-year relative survival exceeded 90% for patients with breast cancer and reached levels of about two thirds for patients with colorectal cancer and kidney cancer and patients with non-Hodgkin's lymphoma. Unfortunately, 5-year relative survival remained essentially unchanged at approximately 16% for lung cancer patients, and, despite statistically significant improvement, as low as 7% for pancreatic cancer patients. Overall, improvement was most pronounced for patients with regional tumor spread and somewhat less so for patients with localized tumors, whereas hardly any improvement was achieved for patients with distant tumor spread. Conclusion Our analysis discloses further major improvement in prognosis for most, but not all forms of cancer in recent years. The largest contribution to this improvement comes from improved prognosis of patients with regional tumor spread.

Excess risk of dying of other causes of cured cancer patients

2019 ◽  
Vol 105 (3) ◽  
pp. 199-204 ◽  
Author(s):  
Laura Botta ◽  
Gemma Gatta ◽  
Annalisa Trama ◽  
Riccardo Capocaccia
Keyword(s):  
General Population ◽  
Cancer Patients ◽  
Survival Data ◽  
Relative Survival ◽  
The Elderly ◽  
Additional Parameter ◽  
Lung Cancers ◽  
Death Risk ◽  
Lung Cancer Patients ◽  
Risk Of Death

Background: The proportion of patients cured of cancer is usually estimated with cure models assuming they have the same death risk as the general population. These patients, even when cured, often maintain an extra death risk compared to the overall population. Our aims were to estimate this extra risk, and to take it into account in estimating cure proportions and relative survival (RS). Methods: We used RS mixture model with an additional parameter expressing the extra noncancer death risk of patients, assumed constant with age. We applied the model to the SEER registries survival data (1990–1994 diagnosed patients) with colorectal, breast, and lung cancers, and followed up to 2013. Results: The estimated relative risk of death for cured patients versus the general population was 1.11 for colorectal, 1.16 for breast, and 2.17 and 2.12, respectively, for female and male lung cancers. Taking this extra risk into account leads, for all cancers, to a higher estimated proportion of cured and a lower RS of uncured patients. In addition, it leads to a higher estimated RS for all patients aged >70 years, and for lung cancer patients aged >50 years, at diagnosis. Conclusions: Mortality of survivors not directly due to the diagnosed cancer was significantly higher than in the general population. It affected the estimates of cure proportions for all age classes and RS in the elderly.

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