EUROCARE Working group. Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995–99: results of the EUROCARE-4 study

Maria Sklodowska Curie Memorial Cancer Centre, Gleiwitz, Silesian Voivodeship, Poland
The Lancet Oncology (Impact Factor: 24.69). 10/2007; 8(9):773-83. DOI: 10.1016/S1470-2045(07)70245-0
Source: PubMed


EUROCARE is the largest population-based cooperative study on survival of patients with cancer. The EUROCARE project aims to regularly monitor, analyse, and explain survival trends and between-country differences in survival. This report (EUROCARE-4) presents survival data for eight selected cancer sites and for all cancers combined, diagnosed in adult (aged >/=15 years) Europeans in 1995-99 and followed up until the end of 2003.
We analysed data from 83 cancer registries in 23 European countries on 2 699 086 adult cancer cases that were diagnosed in 1995-99 and followed up to December, 2003. We calculated country-specific and mean-weighted age-adjusted 5-year relative survival for eight major cancers. Additionally, case-mix-adjusted 5-year survival for all cancers combined was calculated by countries ranked by total national expenditure on health (TNEH). Changes to survival were analysed relative to cases diagnosed in 1990-94.
Mean age-adjusted 5-year relative survival for colorectal (53.8% [95% CI 53.3-54.1]), lung (12.3% [12.1-12.5]), breast (78.9% [78.6-79.2]), prostate (75.7% [75.2-76.2]), and ovarian (36.3% [35.7-37.0]) cancer was highest in Nordic countries (except Denmark) and central Europe, intermediate in southern Europe, lower in the UK and Ireland, and worst in eastern Europe. Survival for melanoma (81.6% [81.0-82.3]), cancer of the testis (94.2% [93.4-95.0]), and Hodgkin's disease (80.0% [79.0-81.0]) varied little with geography. All-cancer survival correlated with TNEH for most countries. Denmark and UK had lower all-cancer survival than countries with similar TNEH; Finland had high all-cancer survival, but moderate TNEH. Survival increased and intercountry survival differences narrowed between the data for 1990-94 and 1995-99 for, notably, Hodgkin's disease (range 66.1-82.9 [IQR 72.2-78.6] vs 74.0-83.9 [78.6-81.9]), colorectal (29.4-56.7 [45.8-54.1] vs 38.8-59.7 [50.7-57.5]), and breast (61.7-82.7 [72.3-78.3] vs 69.3-87.6 [76.6-82.7]) sites.
Increases in survival and decreases in geographic differences over time, which are mainly due to improvements in health-care services in countries with poor survival, might indicate better cancer care. Wealthy countries with high TNEH generally had good cancer outcomes, but those with conspicuously worse outcomes than those with similar TNEH might not be allocating health resources efficiently.

Download full-text


Available from: Stefano Rosso, Mar 21, 2014
  • Source
    • "In addition, Denmark has a less favourable stage distribution than other countries [4]. Later diagnosis is thus believed to be a potential explanation for the poorer prognosis among cancer patients in Denmark compared with other countries [2] [5]. This may occur as a result of longer patient intervals sometimes referred to as patient delay (i.e. the time from the first symptom is experienced until healthcare is sought) [6]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim was to assess the association between cognitive and emotional symptom representations prior to diagnosis and the length of the patient interval (i.e. the time from the first symptom is experienced until healthcare is sought) for colorectal cancer patients.
    Full-text · Article · Nov 2015 · Patient Education and Counseling
  • Source
    • "In Europe today the number of people surviving cancer is increasing with 46.2% of all those diagnosed living 10 or more years beyond initial treatment and for some cancers, such as breast and prostate cancer, this is substantially higher (Berrino et al., 2007; Brenner, 2002). By 2030 it is projected that there will be more than 4 million cancer survivors within the UK population (Maddams et al., 2009) and 13.7 million in the USA with 59% of survivors 65 years or older (Siegel et al., 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Cancer survival is increasing as patients live longer with a cancer diagnosis. This success has implications for health service provision in that increasing numbers of adults who have received cancer therapy are requiring monitoring and long-term health care by a wide range of practitioners. Given these recent trends there is a need to explore staff perceptions and confidence in managing the consequences of cancer diagnosis and treatment in cancer survivors to enhance an integrated cancer service delivery.
    Preview · Article · Sep 2015 · International journal of nursing studies
  • Source
    • "PubMed have not significantly changed the course of several solid tumours including brain, liver and pancreatic cancers (Berrino et al. 2007; De Angelis et al. 2014; Hanahan 2014). Bibliometric indexes are not therapeutic indexes, and current paradigms used in cancer research could be productive in terms of publications and patents while leading to therapeutic impasses. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite important human and financial resources and considerable accumulation of scientific publications, patents, and clinical trials, cancer research has been slow in achieving a therapeutic revolution similar to the one that occurred in the last century for infectious diseases. It has been proposed that science proceeds not only by accumulating data but also through paradigm shifts. Here, we propose to use the concept of 'paradigm shift' as a method of investigation when dominant paradigms fail to achieve their promises. The first step in using the 'paradigm shift' method in cancer research requires identifying its founding paradigms. In this review, two of these founding paradigms will be discussed: (i) the reification of cancer as a tumour mass and (ii) the translation of the concepts issued from infectious disease in cancer research. We show how these founding paradigms can generate biases that lead to over-diagnosis and over-treatment and also hamper the development of curative cancer therapies. We apply the 'paradigm shift' method to produce perspective reversals consistent with current experimental evidence. The 'paradigm shift' method enlightens the existence of a tumour physiologic-prophylactic-pathologic continuum. It integrates the target/antitarget concept and that cancer is also an extracellular disease. The 'paradigm shift' method has immediate implications for cancer prevention and therapy. It could be a general method of investigation for other diseases awaiting therapy.
    Full-text · Article · Sep 2015 · Journal of Biosciences
Show more

We use cookies to give you the best possible experience on ResearchGate. Read our cookies policy to learn more.