Abstract
Cancer survival analyses based on cancer registry data do not provide direct information
on the main aim of cancer treatment, the cure of the patient. In fact, classic survival
indicators do not distinguish between patients who are cured, and patients who will
die of their disease and in whom prolongation of survival is the main objective of
treatment.
In this study, we applied parametric cure models to the cancer incidence and follow-up
data provided by 49 EUROCARE-4 (European Cancer Registry-based study, fourth edition)
cancer registries, with the aims of providing additional insights into the survival
of European cancer patients diagnosed from 1988 to 1999, and of investigating between-population
differences.
Between-country estimates the proportion of cured patients varied from about 4–13%
for lung cancer, from 9% to 30% for stomach cancer, from 25% to 49% for colon and
rectum cancer, and from 55% to 73% for breast cancer. For all cancers combined, estimates
varied between 21% and 47% in men, and 38% and 59% in women and were influenced by
the distribution of cases by cancer site. Countries with high proportions of cured
and long fatal case survival times for all cancers combined were characterised by
generally favourable case mix. For the European pool of cases both the proportion
of cured and the survival time of fatal cases were associated with age, and increased
from the early to the latest diagnosis period. The increases over time in the proportions
of Europeans estimated cured of lung, stomach and colon and rectum cancers are noteworthy
and suggest genuine progress in cancer control. The proportion of cured of all cancers
combined is a useful general indicator of cancer control as it reflects progress in
diagnosis and treatment, as well as success in the prevention of rapidly fatal cancers.
Keywords
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References
- The cure of colon cancer: results from the Eurocare study.Int J Cancer. 1998; 77: 322-329
- Survival of cancer patients in Europe.The EUROCARE Study. IARC scientific publications no. 132. IARC, Lyon1995
- Survival of cancer patients in Europe. The EUROCARE-2 study. IARC scientific publications no. 151. IARC, Lyon1999 (p. 1–572)
- Survival of cancer patients in Europe: the EUROCARE-3 study.Ann Oncol. 2003; 14: v1-v155
- Mixture models for cancer survival analysis: application to population-based data with covariates.Stat Med. 1999; 18: 441-454
- The use of mixture models for the analysis of survival data with long term survivors.Biometrics. 1982; 38: 1041-1046
- Parametric survival analysis of therapy for stage II breast cancer.Cancer. 1994; 74: 2483-2490
- The EUROCARE-4 database on cancer survival in Europe: Data standardisation, quality control and methods of statistical analysis.Eur J Cancer. 2009; 45: 909-930
SEER∗Stat release 6.3.6. <http://seer.cancer.gov/seerstat/>; 2003 [accessed 25.11.2007].
- The relative survival rate: a statistical methodology.J Natl Cancer Inst Monogr. 1961; 6: 101-121
- The relative survival rate.Cancer. 1995; 76: 1687-1688
- Cancer survival corrected for heterogeneity in patient withdrawal.Biometrics. 1982; 39: 933-942
- Long-term survival expectations of cancer patients in Europe in 2000-2002.Eur J Cancer. 2009; 45: 1028-1041
- Survival of eight major cancers and all cancers combined for European adults diagnosed in 1995–1999: results of the EUROCARE-4 study.Lancet Oncol. 2007; 8: 773-783
- Recent cancer survival in Europe: a 2000–2002 period analysis of EUROCARE-4 data.Lancet Oncol. 2007; 8: 784-796
- Estimate of overdiagnosis of breast cancer due to mammography after adjustment for lead time. A service screening study in Italy.Breast Cancer Res. 2006; 8: R68
- Overdiagnosis and over-treatment of breast cancer: overdiagnosis in randomised controlled trials of breast cancer screening.Breast Cancer Res. 2005; 7: 230-234
- Overdiagnosis due to prostate-specific antigen screening: lessons from US prostate cancer incidence trends.J Natl Cancer Inst. 2002; 94: 981-990
- Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study re-evaluating the data of the Finnish cancer registry.Gut. 2005; 54: 385-387
- EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century.Ann Oncol. 2003; 14: 128-149
- Errors in survival rates caused by routinely used deterministic record linkage methods.Methods Inf Med. 2007; 46: 420-424
- The national death index: a largely expected advance in the access to mortality data.Gac Sanit. 2006; 20: 421-423
- Time trends of breast cancer survival in Europe in relation to incidence and mortality.Int J Cancer. 2006; 119: 2417-2422
- Breast cancer mortality patterns and time trends in 10 new EU member states: mortality declining in young women, but still increasing in the elderly.Int J Cancer. 2004; 112: 1056-1062
- Trends in breast cancer incidence, survival and mortality.Lancet. 2000; 356: 590-592
- EUROCARE-4. Survival of cancer patients diagnosed in 1995–1999. Results and commentary.Eur J Cancer. 2009; 95: 931-991
- Do young breast cancer patients have worse outcomes?.J Surg Res. 2003; 113: 109-113
- Prostate-specific antigen in the early detection of prostate cancer.CMAJ. 2007; 176: 1853-1858
- Practice of opportunistic prostate-specific antigen screening in Italy: data from the Health Search database.Eur J Cancer Prev. 2004; 13: 383-386
- Evidence of prostate cancer screening in a UK region.BJU Int. 2004; 93: 730-734
- Recent trends in prostate cancer mortality show a continuous decrease in several countries.Int J Cancer. 2008; 123: 421-429
- Under-diagnosis and over-diagnosis of prostate cancer in a screening population with serum PSA 2 to 10 ng/ml.J Urol. 2007; 178: 93-97
- Computed tomography screening and lung cancer outcomes.JAMA. 2007; 298: 518
- Stage at diagnosis is a key explanation of differences in breast cancer survival across Europe.Int J Cancer. 2003; 106: 416-422
- IARC handbooks of cancer prevention: breast cancer screening. vol. 7. IARC Press, Lyon2002 (p. 1–229)
Article info
Publication history
Published online: January 09, 2009
Accepted:
November 10,
2008
Received in revised form:
October 24,
2008
Received:
June 23,
2008
Identification
Copyright
© 2008 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
