Abstract
Background
Since 25 years the EUROCARE study monitors the survival of cancer patients in Europe through
centralised collection, quality check and statistical analysis of population-based
cancer registries (CRs) data. The European population covered by the study increased
remarkably in the latest round. The study design and statistical methods were also
changed to improve timeliness and comparability of survival estimates.
To interpret the EUROCARE-5 results on adult cancer patients better here we assess
the impact of these changes on data quality and on survival comparisons.
Methods
In EUROCARE-5 the survival differences by area were studied applying the complete
cohort approach to data on nearly nine million cancer patients diagnosed in 2000–2007
and followed up to 2008. Survival time trends were analysed applying the period approach
to data on about 10 million cancer cases diagnosed from 1995 to 2007 and followed
up to 2008. Differently from EUROCARE-4, multiple primary cancers were included and
relative survival was estimated with the Ederer II method.
Results
EUROCARE-5 covered a population of 232 million resident persons, corresponding to
50% of the 29 participating countries. The population coverage increased particularly
in Eastern Europe.
Cases identified from death certificate only (DCO) were on average 2.9%, range 0–12%.
Microscopically confirmed cases amounted to over 85% in most CRs. Compared to previous
methods, including multiple cancers and using the Ederer II estimator reduced survival
estimates by 0.4 and 0.3 absolute percentage points, on average.
Conclusions
The increased population size and registration coverage of the EUROCARE-5 study ensures
more robust and comparable estimates across European countries. This enlargement did
not impact on data quality, which was generally satisfactory. Estimates may be slightly
inflated in countries with high or null DCO proportions, especially for poor prognosis
cancers. The updated methods improved the comparability of survival estimates between
recently and long-term established registries and reduced biases due to informative
censoring.
Keywords
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Article info
Publication history
Accepted:
August 5,
2015
Received in revised form:
August 3,
2015
Received:
March 31,
2015
Footnotes
Sources of support (grants): The Compagnia di San Paolo, Fondazione Cariplo, Italy, Italian Ministry of Health (Ricerca Finalizzata 2009, RF-2009-1529710) and the European Commission (European Action Against Cancer, EPAAC, Joint Action No. 20102202).
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
