Interpreting Survival Differences and Trends

1997 ◽  
Vol 83 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Franco Berrino ◽  
Andrea Micheli ◽  
Milena Sant ◽  
Riccardo Capocaccia
Keyword(s):  
Early Diagnosis ◽  
Survival Data ◽  
Survival Rates ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Disease Stage ◽  
Definition Of ◽  
Survival Differences ◽  
Over Time

Since 1990 a concerted action between European population-based cancer registries (the EUROCARE project) has been carried out with the aims of establishing whether there are differences in cancer patient survival in Europe, and the reasons for such differences. Survival differences actually exist for cancer sites for which the stage of disease at diagnosis is the major prognostic factor (such as breast, stomach and colon cancer). However, for most cancer sites, survival increases over time and the survival rates of different countries tend to converge towards higher values. Interpreting survival differences and trends is not an easy task. Longer survival may be achieved by postponing death through better treatment or by anticipating diagnosis. However, an earlier diagnosis may or may not make a treatment more effective in postponing death. The computation of stage-specific or stage-adjusted survival is not sufficient for interpretation of survival differences, because staging procedures change over time and may vary in different hospitals and countries. In addition to an early diagnosis and more effective treatment, a number of factors may bias survival estimates. They may be classified into factors that can be controlled in the analysis (at least partially), such as mortality from other causes, demographic factors, epoch of diagnosis, different statistical methodology, and factors depending on the validity of cancer registry data, such as definition of the illness, exhaustiveness and quality of registration, completeness of follow-up, definition of the date of diagnosis, and definition of disease stage including the diagnostic procedure used to establish stage. To help disentangle the effects of early diagnosis and better treatment, several statistical approaches are being developed: multivariate analysis on relative survival data, new modeling analysis to separately estimate the proportion of cured patients and the length of survival for those patients destined to die, and the standardized collection of information on stage at diagnosis and staging procedures.

scholarly journals Trends in Overall Survival and Treatment Patterns in Two Large Population-Based Cohorts of Patients with Breast and Colorectal Cancer

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1239 ◽  
Author(s):  
Abbema ◽  
Vissers ◽  
Vos-Geelen ◽  
Lemmens ◽  
Janssen-Heijnen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Survival Rates ◽  
Relative Survival ◽  
Population Based ◽  
Treatment Patterns ◽  
Entire Study ◽  
Younger Patients ◽  
Risk Of Death ◽  
Over Time

Previous studies showed substantial improvement of survival rates in patients with cancer in the last two decades. However, lower survival rates have been reported for older patients compared to younger patients. In this population-based study, we analyzed treatment patterns and the survival of patients with breast cancer (BC) and colorectal cancer (CRC). Patients with stages I–III BC and CRC and diagnosed between 2003 and 2012 were selected from the Netherlands Cancer Registry (NCR). Trends in treatment modalities were evaluated with the Cochran-Armitage trend test. Trends in five-year overall survival were calculated with the Cox hazard regression model. The Ederer II method was used to calculate the five-year relative survival. The relative excess risk of death (RER) was estimated using a multivariate generalized linear model. During the study period, 98% of BC patients aged <75 years underwent surgery, whereas for patients ≥75 years, rates were 79.3% in 2003 and 66.7% in 2012 (p < 0.001). Most CRC patients underwent surgery irrespective of age or time period, although patients with rectal cancer aged ≥75 years received less surgery or radiotherapy over the entire study period than younger patients. The administration of adjuvant chemotherapy increased over time for CRC and BC patients, except for BC patients aged ≥75 years. The five-year relative survival improved only in younger BC patients (adjusted RER 0.95–0.96 per year), and was lower for older BC patients (adjusted RER 1.00, 95% Confidence Interval (CI) 0.98–1.02, and RER 1.00; 95% CI 0.98–1.01 per year for 65–74 years and ≥75 years, respectively). For CRC patients, the five-year relative survival improved over time for all ages (adjusted RER on average was 0.95 per year). In conclusion, the observed survival trends in BC and CRC patients suggest advances in cancer treatment, but with striking differences in survival between older and younger patients, particularly for BC patients.

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.

scholarly journals Widened difference of incidence and survival between different races in epithelial ovarian cancer: a period analysis.

2020 ◽  
Author(s):  
Li Li ◽  
Lili Han ◽  
Sulaiya Husaiyin ◽  
Miherinisha Maimaiti ◽  
Mayinuer Niyazi
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Median Survival ◽  
Survival Data ◽  
Relative Survival ◽  
Population Based ◽  
Limited Information ◽  
Term Survival ◽  
The Past ◽  
Survival Differences

Abstract Introduction To describe the incidence and relative survival in women with epithelial ovarian cancer (EOC) in a population-based cohort in the four decades after diagnosis. EOC is the major pathological type of all ovarian cancers, however, there is limited information on changes of long-term survival in EOC in the four decades. Methods We extracted the incidence and relative survival data from Surveillance, Epidemiology, and End Results (SEER) registries to assess epidemiological changes of patients with EOC from 1974 to 2013. The survival disparities of patients with EOC among four decades, age, race, and socioeconomic status (SES) were performed by Kaplan-Meier curves. Results The overall incidence of EOC gradually declined from 11.4 to 9.0 per 100,000 in the past four decades. The median survival increased from 27 months in the first decades to 48 months in the fourth decade, with 5-year relative survival rate (RSR) improving from 32.3% to 44.3% in the same period. However, the median survival differences increased from 11 months to 18 months between Whites and Blacks and increased from 7 months to 12 months between low-poverty group and high-poverty group respectively over the past four decades. Discussion This study indicated that the incidence and RSR of EOC patients had improved in the past four decades. But the survival gap between different races and SES gradually widened. More importantly, this study will promote the improvement of health care system and clinical management to erase the survival differences in SES groups and races identified in this study, thereby optimize the clinical outcome.

scholarly journals Improvement of Relative Survival in Elderly Patients with Acute Myeloid Leukemia Emerging from Population-Based Cancer Registries in Switzerland from 2001-2013

Blood ◽  
2017 ◽  
Vol 130 (Suppl_1) ◽  
pp. 863-863
Author(s):  
Annatina Schnegg-Kaufmann ◽  
Anita Feller ◽  
Helen Boldomero ◽  
Alicia Rovó ◽  
Markus G Manz ◽  
...  
Keyword(s):  
Health Care ◽  
Elderly Patients ◽  
Financial Support ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Elderly Aml ◽  
Time Periods ◽  
Over Time ◽  
Acute Myeloid

Abstract Introduction: Acute Myeloid Leukaemia (AML) is a rare disease with increasing frequency in the elderly and an emerging impact on health care resources. Trends of classification, incidence, mortality, and survival of AML patients have not yet been reported for Switzerland. Given the demographic ageing, we were mainly interested to investigate whether elderly patients have benefited on a population-based level from the recent changes in AML management. Methods: We performed a population-based, observational analysis of AML cases reported to Cantonal Cancer Registries in Switzerland. Data was aggregated by the National Institute for Epidemiology and Cancer Registration and stratified for the two time-periods 2001-2007/2008-2013. The Swiss Federal Statistics Office provided canton-specific mid-year estimates of the size of the general population and mortality statistics. Data from transplanted patients was provided from the registry of the Swiss Blood Stem Cell Transplant Group . Results: 2'351 new AML cases were registered within the observation time at a median age of 68/67 yrs (range 0-96 yrs). The extrapolated mean annual frequency increased from 275 to 305 AML cases (+10.8%) in the two time periods. In contrast, the age-standardized incidence and mortality rates remained stable (3.0 [95 CI: 2.8-3.2] and 1.9-2.0 [1.8-2.1] per 100'000 person-years, respectively). Incidence was up to 1.4-fold more frequent in males and increased up to 7 fold in patients &gt;75 yrs of age. The fraction of non-classifiable AML cases decreased over time (54.6%/41.8%), but remained high in elderly patients (75-84 yrs: 54.1%, 85+ yrs: 59.1%). As expected, 5-year relative survival (RS) correlated directly with AML risk classes (favorable: 61.7-68.4%, intermediate: 14.9%-27.3%, adverse: 11.4%-20.4%, non-classifiable: 11.4%-14.7%) and inversely with age (&lt;65 yrs: 42.6-42.7%, 65-74 yrs: 5.2%-13.5%, 75-84 yrs: 2-3%; 85+ yrs: 0%). RS improved only modestly in all age classes over time (19.2%/23.3%). Most interestingly, a trend towards improved RS was found in AML patients aged 65-74 yrs (5.2%/13.5%) and with intermediate (20.4%/27.3%) as well as adverse risk (11.4%/ 21.9%). This trend was multifactorial and only partially explained by an increased referral to allogeneic HSCT (1.4%/7%) or inclusion in clinical trials of patients ≥65 yrs. Conclusions: AML incidence remained stable during the observation period, indicating that the 10.8% raise in annual case-frequency is mainly related to population growth and ageing and not to an increase of age-specific risk. AML classification improved over time, but non-classifiable AML cases remained high in elderly patients, suggesting that diagnostics and reporting is less accurate with increasing age. A trend towards improved RS was found in AML patients aged 65-74 yrs and with intermediate as well as adverse risk. These trends were caused by multiple factors and mainly based on the general changes of treatment management of AML patients ≥65 yrs. Survival of elderly AML patients remains dismal. Nevertheless, recent progress in clinical management of elderly AML patients resulted in an emerging improvement of survival on a population-based level in Switzerland. The demographic trend will further increase AML burden and has to be taken into account for structural as well as financial considerations for future health care systems. Disclosures Gregor: AbbVie: Other: Personal Fees; Celgene: Other: Personal Fees, Non-Financial Support; Gilead: Other: Personal Fees; GlaxoSmithKline: Other: Personal Fees; Janssen: Other: Personal Fees, Non-Financial Support; Mundipharma: Other: Personal Fees; Novartis: Other: Personal Fees, Non-Financial Support; Roche: Other: Personal Fees, Non-Financial Support.

scholarly journals Cancer Survival in Saudi Arabia 2005-2009: Analysis of the Population-based Saudi Cancer Registry

2021 ◽  
Author(s):  
Mohamed Aseafan ◽  
Edward Devol ◽  
Mahmoud AlAhwal ◽  
Riad Souissi ◽  
Reham Sindi ◽  
...  
Keyword(s):  
Cancer Registry ◽  
Survival Data ◽  
Hodgkin’S Lymphoma ◽  
Cancer Survival ◽  
Demographic Data ◽  
Survival Rates ◽  
Population Based ◽  
Hodgkin's Lymphoma ◽  
Disease Stage ◽  
Vital Status

Abstract The Saudi Cancer Registry reported in 2007 the 5-year observed survival for the most common cancer sites for the years 1994-2004. In this report we looked at the cancer survival in the period 2005-2009 and evaluated the trend over the 15 years period from 1994-2009. Cases of the top 14 cancer sites reported by the population based Saudi Cancer Registry from 1 January 2005 to December 31, 2009 were submitted for survival analysis. The vital status of those patients was collected. Analysis of survival for the above period was compared with the prior reported 2 periods (1994-1999, 2000-2004). In addition, analysis was done according to age, sex, disease stage and the province. Data of 25,969 patients of the commonest cancer sites were submitted. Of those 14,146 (54%) had complete demographic data available and vital status was reported. The observed 5-year survival for the 14,146 patients analyzed was 66%. Thyroid cancer had the highest 5- year observed survival of 94% (standard Error (SE) 0.0062), followed by Breast (72%, SE 0.0085). In hematological malignancies, Hodgkin’s Lymphoma had the highest 5-year survival of 86% (SE 0.0116). Survival rates has improved in most of the cancers sites for the studied periods except for lung, uterine and Hodgkin’s lymphoma which plateaued. Our study confirms a steady improvement in the 5-year observed survival over time for the majority of cancers. Our survival data were comparable to western countries. This data should be used by policy makers to improve on cancer care in the kingdom.

Estimating Relative Survival of Italian Cancer Patients from Sparse Cancer Registries Data

1997 ◽  
Vol 83 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Roberta De Angelis ◽  
Riccardo Capocaccia ◽  
Arduino Verdecchia
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Survival Data ◽  
Cancer Survival ◽  
National Level ◽  
Survival Rates ◽  
Relative Survival ◽  
Cancer Registries ◽  
Breast Cancer Patients ◽  
National Estimates

Purpose A method is presented for estimating relative survival of cancer patients at the national level from survival data provided by cancer registries covering only a subset of the general population and referring to different, and not necessarily overlapping, incidence periods. Methods Relative survival rates are estimated as a function of the covariates sex, age, epoch of diagnosis, and registry area by means of a multiple regression model. National estimates are then computed by appropriate weighting of the sex-, age-, time- and registry-specific expected relative survival values. Results The method is illustrated by a sample application to survival data of female breast cancer patients in Italy. The national estimates of breast cancer survival pattern show a mild decrease of survival with age and a marked increase with period of diagnosis.

scholarly journals Relative survival after diagnosis with a primary brain or other central nervous system tumor in the National Program of Cancer Registries, 2004 to 2014

2019 ◽  
Vol 7 (3) ◽  
pp. 306-312 ◽  
Author(s):  
Quinn T Ostrom ◽  
Gabrielle Truitt ◽  
Haley Gittleman ◽  
Daniel J Brat ◽  
Carol Kruchko ◽  
...  
Keyword(s):  
United States ◽  
Survival Data ◽  
Survival Rates ◽  
Relative Survival ◽  
Cancer Registries ◽  
The United States ◽  
Central Nervous System Tumor ◽  
National Program ◽  
The Us ◽  
Survival Patterns

Abstract Background The majority of reported cancer survival statistics in the United States are generated using the National Cancer Institute’s publicly available Surveillance, Epidemiology, and End Results (SEER) data, which prior to 2019 represented 28% of the US population (now 37%). In the case of rare cancers or special subpopulations, data sets based on a larger portion of the US population may contribute new insights into these low-incidence cancers. The purpose of this study is to characterize the histology-specific survival patterns for all primary malignant and nonmalignant primary brain tumors in the United States using the Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR). Methods Survival data were obtained from the NPCR (includes data from 39 state cancer registries, representing 81% of the US population). Relative survival rates (RS) with 95% CI were generated using SEER*Stat 8.3.5 from 2004 to 2014 by behavior, histology, sex, race/ethnicity, and age at diagnosis. Results Overall, there were 488 314 cases from 2004 to 2014. Overall 5-year RS was 69.8% (95% CI = 69.6%-69.9%). Five-year RS was 35.9% (95% CI = 35.6%-36.1%) for malignant and 90.2% (95% CI = 90.1%-90.4%) for nonmalignant tumors. Pilocytic astrocytoma had the longest 5-year RS (94.2%, 95% CI = 93.6%-94.6%) of all glioma subtypes, whereas glioblastoma had the shortest 5-year RS (6.1%, 95% CI = 6.0%-6.3%). Nonmalignant nerve sheath tumors had the longest 5-year RS (99.3%, 95% CI = 99.1%-99.4%). Younger age and female sex were associated with increased survival for many histologies. Conclusions Survival after diagnosis with primary brain tumor varies by behavior, histology, and age. Using such a database that includes more than 80% of the US population may represent national survival patterns.

scholarly journals Population-based survival for cancer patients in Saudi Arabia for the years 2005–2009

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohamed Aseafan ◽  
Edward Devol ◽  
Mahmoud AlAhwal ◽  
Riad Souissi ◽  
Reham Sindi ◽  
...  
Keyword(s):  
Cancer Registry ◽  
Survival Data ◽  
Hodgkin’S Lymphoma ◽  
Cancer Survival ◽  
Demographic Data ◽  
Survival Rates ◽  
Population Based ◽  
Hodgkin's Lymphoma ◽  
Disease Stage ◽  
Vital Status

AbstractThe Saudi Cancer Registry reported in 2007 the 5-year observed survival for the most common cancer sites for the years 1994–2004. In this report we looked at the cancer survival in the period 2005–2009 and evaluated the trend over the 15 years period from 1994 to 2009. Cases of the top 14 cancer sites reported by the population based Saudi Cancer Registry from 1 January 2005 to December 31, 2009, were submitted for survival analysis. The vital status of those patients was collected. Analysis of survival for the above period was compared with the prior reported 2 periods (1994–1999, 2000–2004). In addition, analysis was done according to age, sex, disease stage and the province. Data of 25,969 patients of the commonest cancer sites were submitted. Of those 14,146 patients (54%) had complete demographic data available and vital status was reported. Thyroid cancer had the highest 5- year observed survival of 94% (95% confidence interval (CI) 93–95%)), followed by Breast (72%, 95% CI 71–74%). In hematological malignancies, Hodgkin’s Lymphoma had the highest 5-year survival of 86% (95% CI 84–88%). Survival rates has improved in most of the cancers sites for the studied periods except for lung, uterine and Hodgkin’s lymphoma which plateaued. Our study confirms a steady improvement in the 5-year observed survival over time for the majority of cancers. Our survival data were comparable to western countries. This data should be used by policy makers to improve on cancer care in the kingdom.

scholarly journals German oncology certification system for colorectal cancer – relative survival rates of a single certified centre vs. national and international registry data

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maximilian Richter ◽  
Lena Sonnow ◽  
Amir Mehdizadeh-Shrifi ◽  
Axel Richter ◽  
Rainer Koch ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
International Comparison ◽  
Cancer Registry ◽  
Survival Data ◽  
Survival Rates ◽  
Relative Survival ◽  
Registry Data ◽  
Cancer Registry Data ◽  
Colon And Rectal Cancer

Abstract Objectives To evaluate how the certification of specialised Oncology Centres in Germany affects the relative survival of patients with colorectal cancer (CRC) by means of national and international comparison. Methods Between 2007 and 2013, 675 patients with colorectal cancer, treated at the Hildesheim Hospital, an academic teaching hospital of the Hannover Medical School (MHH), were included. A follow-up of the entire patient group was performed until 2014. To obtain international data, a SEER-database search was done. The relative survival of 148,957 patients was compared to our data after 12, 36 and 60 months. For national survival data, we compared our rates with 41,988 patients of the Munich Cancer Registry (MCR). Results Relative survival at our institution tends to be higher in advanced tumour stages compared to national and international cancer registry data. Nationally we found only little variation in survival rates for low stages CRC (UICC I and II), colon, and rectal cancer. There were notable variations regarding relative survival rates for advanced CRC tumour stages (UICC IV). These variations were even more distinct for rectal cancer after 12, 36 and 60 months (Hildesheim Hospital: 89.9, 40.3, 30.1%; Munich Cancer Registry (MCR): 65.4, 28.7, 16.6%). The international comparison of CRC showed significantly higher relative survival rates for patients with advanced tumour stages after 12 months at our institution (77 vs. 54.9% for UICC IV; raw p<0.001). Conclusions Our findings suggest that patients with advanced tumour stages of CRC and especially rectal cancer benefit most from a multidisciplinary and guidelines-oriented treatment at Certified Oncology Centres. For a better evaluation of cancer treatment and improved national and international comparison, the creation of a centralised national cancer registry is necessary.

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