Fast track — ArticlesRecent cancer survival in Europe: a 2000–02 period analysis of EUROCARE-4 data
Introduction
The crude annual incidence of cancer in Europe has been estimated at 338 per 100 000 population for eastern Europe and 447 per 100 000 population in western Europe.1 To measure the overall effect of the management of cancer, data on population-based survival are important. According to the EUROCARE studies,2, 3, 4, 5, 6, 7 survival varies greatly across Europe for common and rare malignancies. These variations can be explained by a number of factors, including differences in the quality of cancer-treatment facilities, in screening programmes, in evidence-based best-practice guidelines, in facilities for radiotherapy, and in access to new anticancer drugs. The results of the EUROCARE studies have encouraged governments in European Union (EU) member states to improve cancer services by increasing their organisation and investments, developing screening programmes, and providing more rapid access to state-of-the-art diagnostic facilities and treatment.8, 9
One of the limitations of long-term survival estimates derived from conventional survival analyses is that they refer to cohorts of individuals diagnosed many years before and not to patients diagnosed more recently; therefore, time trends in survival cannot be detected early (eg, the effects that earlier diagnosis or treatment might have on survival patterns). To address this limitation, period survival analysis has been used.10 Unlike traditional cohort analyses of survival, period analysis provides long-term survival estimates that also take into consideration survival of more recently diagnosed patients.
In the current study, we applied the period-analysis method to data, collected by the European cancer registries, of patients diagnosed from 1978 to 2002 to estimate recent survival by country and cancer site, and to assess survival changes in Europe. Survival 5 years after diagnosis was used as the indicator of outcome. We also compared our findings with data on cancer survival in the USA from the US SEER (Surveillance, Epidemiology, and End Results) programme.
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Data sources and procedures
The data source for this analysis was the EUROCARE-4 study database, which includes data on the incidence of cancer and follow-up information on patients with cancer who were diagnosed from Jan 1, 1978, to Dec 31, 2002, collected by 83 cancer registries throughout Europe. This included the 47 cancer registries that had collected data in a more recent period (1996–2002) and followed patients until Dec 31, 2003 (table 1). These registries consisted of 12 national registries that had 100% national
Results
Since 2002, about 6·7 million patients from 21 countries with incident cancer, who were grouped into five geographical areas, were included in the European pool (table 1). The first year that the registries began to record incidence of cancer varied between 1978 and 1997. The percentage of invalid records was 0·1% overall and ranged from 0% to 0·9 % for individual registries. When data from the periods 1996–99 and 2000–02 were compared, the total percentage of microscopically confirmed patients
Discussion
Overall survival has improved for all cancers and for the major cancer sites. Survival for patients treated in 2000–02 was highest generally for countries in northern Europe and lowest in countries in eastern Europe—although the eastern European countries had the largest improvements.
The use of period analysis allowed us to estimate survival within a few years of diagnosis and to acquire recent estimates (ie, for 2000–02) for Europe. Consequently, survival and time trends can be interpreted in
References (41)
- et al.
EUROCARE-3 summary: cancer survival at the end of 20th century
Annal Oncol
(2003) The Calman-Hine Report: a personal retrospective on the UK's first comprehensive policy on cancer services
Lancet Oncol
(2006)Long-term survival rates of cancer patients achieved by the end of the 20th century: a periodic analysis
Lancet
(2002)- et al.
Up-to-date long-term survival of cancer patients: an evaluation of period analysis on Swedish Cancer Registry data
Eur J Cancer
(2004) An empirical evaluation of period survival analysis using data from the Canadian Cancer Registry
Ann Epidemiol
(2006)- et al.
A computer program package for relative survival analysis
Comp Programs Biomed
(1985) - et al.
Standard cancer population for estimating age standardising survival ratios
Eur J Cancer
(2004) - et al.
Electronic availability of EUROCARE-3 data: a tool for further analysis
Ann Oncol
(2003) - et al.
Interpretating international comparisons of cancer survival: The effect of incomplete registration and the presence of death certificate only cases on survival estimates
Eur J Cancer
(2007) - et al.
EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century
Ann Oncol
(2003)
Prostate cancer screening between low-income African-American and Caucasian men
Urol Oncol
Cancer survival increases in Europe, but international differences remain wide
Eur J Cancer
Towards evidence-based guidelines for radiotherapy infrastructure and staffing needs in Europe: the ESTRO QUARTS project
Radiother Oncol
The GLOBOCAN 2002 software and database, version 2.0, September, 2004
Survival of adult cancer patients in Europe diagnosed from 1978–1989: the EUROCARE II study
Eur J Cancer
Childhood cancer survival in Europe 1978–1992: the EUROCARE study
Eur J Cancer
Survival of cancer patients in Europe. The EUROCARE-3 study
Annal Oncol
The NHS cancer plan: a plan for investment a plan for reform, 2000
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