Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004–2007
Background The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004–2007. Methods Routinely collected population-based data were obtained on all adults (15–99 years) diagnosed with lung cancer in 2004–2...
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| Vydané v: | Thorax Ročník 68; číslo 6; s. 551 - 564 |
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| Hlavní autori: | , , , , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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England
BMJ Publishing Group Ltd and British Thoracic Society
01.06.2013
BMJ Publishing Group LTD |
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| ISSN: | 0040-6376, 1468-3296, 1468-3296 |
| On-line prístup: | Získať plný text |
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| Abstract | Background The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004–2007. Methods Routinely collected population-based data were obtained on all adults (15–99 years) diagnosed with lung cancer in 2004–2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis. Results Age-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer. Conclusions There are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved. |
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| AbstractList | The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007.BACKGROUNDThe authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007.Routinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis.METHODSRoutinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis.Age-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer.RESULTSAge-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer.There are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved.CONCLUSIONSThere are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved. Background The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007. Methods Routinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis. Results Age-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer. Conclusions There are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved. The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007. Routinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis. Age-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer. There are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved. |
| Author | Turner, Donna Engholm, Gerda Butler, John Hatcher, Juanita Steward, John Tracey, Elizabeth Kölbeck, Karl Richards, Michael A Hanna, Louise Johannesen, Tom Børge Maringe, Camille Gjerstorff, Marianne L Peake, Michael D Bergström, Stefan Coleman, Michel P Sundstrøm, Stein Linklater, Karen M Young, Nicholas Gavin, Anna Jakobsen, Erik Rachet, Bernard Walters, Sarah McGahan, Colleen E |
| Author_xml | – sequence: 1 givenname: Sarah surname: Walters fullname: Walters, Sarah email: sarah.walters@lshtm.ac.uk organization: Cancer Research UK Cancer Survival Group, Department of Non Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK – sequence: 2 givenname: Camille surname: Maringe fullname: Maringe, Camille email: sarah.walters@lshtm.ac.uk organization: Cancer Research UK Cancer Survival Group, Department of Non Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK – sequence: 3 givenname: Michel P surname: Coleman fullname: Coleman, Michel P email: sarah.walters@lshtm.ac.uk organization: Cancer Research UK Cancer Survival Group, Department of Non Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK – sequence: 4 givenname: Michael D surname: Peake fullname: Peake, Michael D email: sarah.walters@lshtm.ac.uk organization: Department of Respiratory Medicine, Glenfield Hospital, University Hospitals of Leicester, Leicester, UK – sequence: 5 givenname: John surname: Butler fullname: Butler, John email: sarah.walters@lshtm.ac.uk organization: Royal Marsden Hospital, London, UK – sequence: 6 givenname: Nicholas surname: Young fullname: Young, Nicholas email: sarah.walters@lshtm.ac.uk organization: School of Social and Community Medicine, University of Bristol, Bristol, UK – sequence: 7 givenname: Stefan surname: Bergström fullname: Bergström, Stefan email: sarah.walters@lshtm.ac.uk organization: Department of Oncology, Gävle Hospital, Gävle, Sweden – sequence: 8 givenname: Louise surname: Hanna fullname: Hanna, Louise email: sarah.walters@lshtm.ac.uk organization: Velindre NHS Trust, Cardiff, UK – sequence: 9 givenname: Erik surname: Jakobsen fullname: Jakobsen, Erik email: sarah.walters@lshtm.ac.uk organization: Department of Thoracic Surgery, Odense University Hospital, Odense, Denmark – sequence: 10 givenname: Karl surname: Kölbeck fullname: Kölbeck, Karl email: sarah.walters@lshtm.ac.uk organization: Department of Respiratory Medicine and Allergology, Karolinska University Hospital Stockholm Sweden – sequence: 11 givenname: Stein surname: Sundstrøm fullname: Sundstrøm, Stein email: sarah.walters@lshtm.ac.uk organization: Department of Oncology, St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway – sequence: 12 givenname: Gerda surname: Engholm fullname: Engholm, Gerda email: sarah.walters@lshtm.ac.uk organization: Department of Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark – sequence: 13 givenname: Anna surname: Gavin fullname: Gavin, Anna email: sarah.walters@lshtm.ac.uk organization: Northern Ireland Cancer Registry, Belfast, UK – sequence: 14 givenname: Marianne L surname: Gjerstorff fullname: Gjerstorff, Marianne L email: sarah.walters@lshtm.ac.uk organization: Danish Cancer Registry, Statens Serum Institut—National Institute for Health Data and Disease Control, Copenhagen, Denmark – sequence: 15 givenname: Juanita surname: Hatcher fullname: Hatcher, Juanita email: sarah.walters@lshtm.ac.uk organization: Alberta Health Services, Edmonton, Alberta, Canada – sequence: 16 givenname: Tom Børge surname: Johannesen fullname: Johannesen, Tom Børge email: sarah.walters@lshtm.ac.uk organization: Norwegian Cancer Registry, Oslo, Norway – sequence: 17 givenname: Karen M surname: Linklater fullname: Linklater, Karen M email: sarah.walters@lshtm.ac.uk organization: Thames Cancer Registry, London, UK – sequence: 18 givenname: Colleen E surname: McGahan fullname: McGahan, Colleen E email: sarah.walters@lshtm.ac.uk organization: Cancer Surveillance and Outcomes, British Columbia Cancer Agency, Vancouver, British Columbia, Canada – sequence: 19 givenname: John surname: Steward fullname: Steward, John email: sarah.walters@lshtm.ac.uk organization: Cancer Intelligence and Surveillance Unit, Cardiff, UK – sequence: 20 givenname: Elizabeth surname: Tracey fullname: Tracey, Elizabeth email: sarah.walters@lshtm.ac.uk organization: Cancer Institute New South Wales, Sydney, New South Wales, Australia – sequence: 21 givenname: Donna surname: Turner fullname: Turner, Donna email: sarah.walters@lshtm.ac.uk organization: Cancer Care Manitoba, Winnipeg, Manitoba, Canada – sequence: 22 givenname: Michael A surname: Richards fullname: Richards, Michael A email: sarah.walters@lshtm.ac.uk organization: Department of Health, National Cancer Action Team, London, UK – sequence: 23 givenname: Bernard surname: Rachet fullname: Rachet, Bernard email: sarah.walters@lshtm.ac.uk organization: Cancer Research UK Cancer Survival Group, Department of Non Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23399908$$D View this record in MEDLINE/PubMed http://kipublications.ki.se/Default.aspx?queryparsed=id:126736352$$DView record from Swedish Publication Index (Karolinska Institutet) |
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| Copyright | Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions Copyright: 2013 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions |
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| SubjectTerms | Adolescent Adult Age Age Distribution Aged Aged, 80 and over Australia - epidemiology Canada - epidemiology Clinical Epidemiology Denmark - epidemiology Estimates Female Humans Lung cancer Lung Neoplasms - mortality Lung Neoplasms - pathology Male Middle Aged Mortality Neoplasm Staging Non-Small Cell Lung Cancer Norway - epidemiology Population Surveillance Population-based studies Retrospective Studies Small Cell Lung Cancer Survival analysis Survival Rate - trends Sweden - epidemiology Tumors Young Adult |
| Title | Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004–2007 |
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