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Lancet Oncol. 2019 Sep 11. pii: S1470-2045(19)30456-5. doi: 10.1016/S1470-2045(19)30456-5. [Epub ahead of print]

Progress in cancer survival, mortality, and incidence in seven high-income countries 1995-2014 (ICBP SURVMARK-2): a population-based study.

Author information

1
Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France. Electronic address: arnoldm@iarc.fr.
2
Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France; Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK.
3
Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France.
4
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
5
Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway; Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway.
6
Cancer Institute NSW, Alexandria, NSW, Australia.
7
Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia.
8
WA Cancer and Palliative Care Network Policy Unit, Health Networks Branch, Department of Health, Perth, WA, Australia.
9
Cancer Control Alberta, Alberta Health Services, Calgary, AB, Canada.
10
BC Cancer, Vancouver, BC, Canada.
11
Population Oncology, CancerCare Manitoba, Winnipeg, MB, Canada.
12
New Brunswick Cancer Network, Department of Health, Fredericton, NB, Canada.
13
Newfoundland Cancer Registry, Cancer Care Program - Eastern Health, Dr H Bliss Murphy Cancer Centre, St John's, Newfoundland, NL, Canada.
14
Nova Scotia Health Authority Cancer Care Program, Registry & Analytics, Halifax, NS, Canada.
15
Surveillance and Cancer Registry, Cancer Care Ontario, Toronto, ON, Canada.
16
Prince Edward Island Cancer Registry, Charlottetown, PE, Canada.
17
Research Institute, McGill University Health Center, Montreal, QC, Canada.
18
Saskatchewan Cancer Agency, Regina, SK, Canada.
19
Danish Cancer Society, Copenhagen, Denmark.
20
National Cancer Registry Ireland, Cork, Ireland.
21
Cancer Society of New Zealand, Wellington, New Zealand.
22
National Cancer Registration and Analysis Service, Public Health England, Cambridge, UK.
23
Northern Ireland Cancer Registry, Queen's University Belfast, UK.
24
Scottish Cancer Registry, Information Services Division, National Health Services Scotland, Edinburgh, UK.
25
Welsh Cancer Intelligence and Surveillance Unit, Public Health Wales, Cardiff, UK.
26
Canadian Partnership Against Cancer, Toronto, ON, Canada.
27
Royal Marsden Hospital, London, UK.
28
Cancer Research UK, London, UK.
29
Nuffield Department of Population Health, University of Oxford, Oxford, UK.
30
King's College London, Clinical Trials Unit, London, UK.
31
Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
32
Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway.

Abstract

BACKGROUND:

Population-based cancer survival estimates provide valuable insights into the effectiveness of cancer services and can reflect the prospects of cure. As part of the second phase of the International Cancer Benchmarking Partnership (ICBP), the Cancer Survival in High-Income Countries (SURVMARK-2) project aims to provide a comprehensive overview of cancer survival across seven high-income countries and a comparative assessment of corresponding incidence and mortality trends.

METHODS:

In this longitudinal, population-based study, we collected patient-level data on 3·9 million patients with cancer from population-based cancer registries in 21 jurisdictions in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway, and the UK) for seven sites of cancer (oesophagus, stomach, colon, rectum, pancreas, lung, and ovary) diagnosed between 1995 and 2014, and followed up until Dec 31, 2015. We calculated age-standardised net survival at 1 year and 5 years after diagnosis by site, age group, and period of diagnosis. We mapped changes in incidence and mortality to changes in survival to assess progress in cancer control.

FINDINGS:

In 19 eligible jurisdictions, 3 764 543 cases of cancer were eligible for inclusion in the study. In the 19 included jurisdictions, over 1995-2014, 1-year and 5-year net survival increased in each country across almost all cancer types, with, for example, 5-year rectal cancer survival increasing more than 13 percentage points in Denmark, Ireland, and the UK. For 2010-14, survival was generally higher in Australia, Canada, and Norway than in New Zealand, Denmark, Ireland, and the UK. Over the study period, larger survival improvements were observed for patients younger than 75 years at diagnosis than those aged 75 years and older, and notably for cancers with a poor prognosis (ie, oesophagus, stomach, pancreas, and lung). Progress in cancer control (ie, increased survival, decreased mortality and incidence) over the study period was evident for stomach, colon, lung (in males), and ovarian cancer.

INTERPRETATION:

The joint evaluation of trends in incidence, mortality, and survival indicated progress in four of the seven studied cancers. Cancer survival continues to increase across high-income countries; however, international disparities persist. While truly valid comparisons require differences in registration practice, classification, and coding to be minimal, stage of disease at diagnosis, timely access to effective treatment, and the extent of comorbidity are likely the main determinants of patient outcomes. Future studies are needed to assess the impact of these factors to further our understanding of international disparities in cancer survival.

FUNDING:

Canadian Partnership Against Cancer; Cancer Council Victoria; Cancer Institute New South Wales; Cancer Research UK; Danish Cancer Society; National Cancer Registry Ireland; The Cancer Society of New Zealand; National Health Service England; Norwegian Cancer Society; Public Health Agency Northern Ireland, on behalf of the Northern Ireland Cancer Registry; The Scottish Government; Western Australia Department of Health; and Wales Cancer Network.

PMID:
31521509
DOI:
10.1016/S1470-2045(19)30456-5
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