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.

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.

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.

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.

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.

State of the Russian Oncology Service: malignant neoplasms of the tongue C01, 02 (mortality rate in patients, median survival of patients, taking into account the stage of the disease and the histological structure of the tumor). Part II

2021 ◽  
Author(s):  
Vakhtang M. Merabishvili ◽  
Elvira N. Merabishvili ◽  
Alexander M. Shcherbakov ◽  
Alexander B. Vasiliev ◽  
Alexey F. Barsukov ◽  
...  
Keyword(s):  
Survival Rate ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Median Survival ◽  
Tongue Cancer ◽  
Survival Rates ◽  
Relative Survival ◽  
Population Based ◽  
Malignant Neoplasms ◽  
Oncology Service

Malignant neoplasms of the tongue occupy 0.55% in the general structure of the cancer incidence in Russian population. No information on other parameters (the number of deaths, mortality of patients, their distribution by stages of the disease and other analytical indicators) is provided in the official reporting. The opportunity appeared only with the development of Population-based Cancer Registries (PCR) system, but this wealth of material is not used for the official reporting. Tongue cancer is a visual localization with a high mortality rate, which requires special attention. The study was conducted to investigate the state of Russian Oncology Service for tongue cancer patients with the calculations of one-year mortality rate, annual mortality rate, median survival, 1,3,5-year observed and relative survival rates, first time in Russia, at the level of the newly created Population-based Cancer Registry of the Federal District. In Russia, there has been little research on the analysis of the cancer survival rate at the population level. We have been conducting developments for all malignant tumors localizations since 2000 based on the St. Petersburg PCR database. The level of 5-year observed and relative survival rates for tongue cancer patients in Russia (St. Petersburg and the NWFD RF) has been found to be significantly lower than the EU average (Eurocare-4). To carry out this study, 5188 observations from the NWFD RF PCR database were selected. It has been established that during 4 periods of observation, the mortality rate for tongue cancer patients during the first year of observation in the NWFD RF has decreased under the C01 rubric (cancer of the base of the tongue) from 58.5 to 45.8%; and under the C02 rubric (malignant neoplasm of other and unspecified parts of tongue) from 54.5 to 42.7%. The five-year survival rate for tongue cancer patients has increased by 23.3%.

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.

scholarly journals When is a cancer patient cured? (Results from the EUROCARE-5 study)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Dal Maso ◽  
C Panato ◽  
A Tavilla ◽  
S Guzzinati ◽  
D Serraino ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Lymphocytic Leukemia ◽  
Cancer Type ◽  
Lung Cancers ◽  
Corpus Uteri ◽  
Cure Fraction

Abstract Background Although heterogenous risks of recurrence or late effects according to cancer type and host factors exist, increasing evidence of cure has emerged for some cancers. This leads, among other important topics, to the so-called “right to be forgotten” law, adopted in France and Belgium to help cancer survivors access loans and insurance. The aim of the study was to estimate population-based indicators of cancer cure in Europe by type, sex, age, and period. Methods Data from 7.2 million cancer patients, aged 15-74 years, from 42 population-based cancer registries in 17 countries were extracted from the EUROCARE-5 dataset. Mixture-cure models were used to estimate: a) median life expectancy of fatal cases (LEF); b) cure fraction (CF) as a proportion of patients with death rates similar to the general population; and c) time to cure (TTC) as the time to reach five-year conditional relative survival (CRS)>95%. Results LEF ranged from 10 years for patients with chronic lymphocytic leukemia to < 6 months for those with liver, pancreas, brain, gallbladder, and lung cancers. The CF was 94% for testis, 87% for thyroid cancer in women (70% in men), 86% for skin melanoma in women (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 remained for at least 15 years. Conclusions In a context of increasing number of people living after a cancer diagnosis, these results may help to reduce unneeded medicalization (e.g., follow-up) and resources needed for their care, and they further document that there is already a cure for some cancers. Fundings This work was supported by the Italian Association of Cancer Research (AIRC) and the European Commission (IPAAC). Key messages Cancer cure indicators are provided for European patients and 32 cancer type. Recognizing cancer patients as cured has relevant clinical and social implications.

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.

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).

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