Abstract
Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5-6%). Net survival in Northern, Western and Southern Europe (81-84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70-99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 1170-1181 |
| Number of pages | 12 |
| Journal | International Journal of Cancer |
| Volume | 132 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Mar 1 2013 |
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Keywords
- cancer registries
- CONCORD
- excess hazard
- net survival
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Breast cancer survival in the US and Europe : A CONCORD high-resolution study. / Allemani, Claudia; Sant, Milena; Weir, Hannah K.; Richardson, Lisa C.; Baili, Paolo; Storm, Hans; Siesling, Sabine; Torrella-Ramos, Ana; Voogd, Adri C.; Aareleid, Tiiu; Ardanaz, Eva; Berrino, Franco; Bielska-Lasota, Magdalena; Bolick, Susan; Cirilli, Claudia; Colonna, Marc; Contiero, Paolo; Cress, Rosemary; Crocetti, Emanuele; Fulton, John P.; Grosclaude, Pascale; Hakulinen, Timo; Izarzugaza, M. Isabel; Malmström, Per; Peignaux, Karin; Primic-Žakelj, Maja; Rachtan, Jadwiga; Safaei Diba, Chakameh; Sánchez, Maria José; Schymura, Maria J.; Shen, Tiefu; Traina, Adele; Tryggvadottir, Laufey; Tumino, Rosario; Velten, Michel; Vercelli, Marina; Wolf, Holly J.; Woronoff, Anne Sophie; Wu, Xiaocheng; Coleman, Michel P.
In: International Journal of Cancer, Vol. 132, No. 5, 01.03.2013, p. 1170-1181.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Breast cancer survival in the US and Europe
T2 - A CONCORD high-resolution study
AU - Allemani, Claudia
AU - Sant, Milena
AU - Weir, Hannah K.
AU - Richardson, Lisa C.
AU - Baili, Paolo
AU - Storm, Hans
AU - Siesling, Sabine
AU - Torrella-Ramos, Ana
AU - Voogd, Adri C.
AU - Aareleid, Tiiu
AU - Ardanaz, Eva
AU - Berrino, Franco
AU - Bielska-Lasota, Magdalena
AU - Bolick, Susan
AU - Cirilli, Claudia
AU - Colonna, Marc
AU - Contiero, Paolo
AU - Cress, Rosemary
AU - Crocetti, Emanuele
AU - Fulton, John P.
AU - Grosclaude, Pascale
AU - Hakulinen, Timo
AU - Izarzugaza, M. Isabel
AU - Malmström, Per
AU - Peignaux, Karin
AU - Primic-Žakelj, Maja
AU - Rachtan, Jadwiga
AU - Safaei Diba, Chakameh
AU - Sánchez, Maria José
AU - Schymura, Maria J.
AU - Shen, Tiefu
AU - Traina, Adele
AU - Tryggvadottir, Laufey
AU - Tumino, Rosario
AU - Velten, Michel
AU - Vercelli, Marina
AU - Wolf, Holly J.
AU - Woronoff, Anne Sophie
AU - Wu, Xiaocheng
AU - Coleman, Michel P.
PY - 2013/3/1
Y1 - 2013/3/1
N2 - Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5-6%). Net survival in Northern, Western and Southern Europe (81-84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70-99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment.
AB - Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5-6%). Net survival in Northern, Western and Southern Europe (81-84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70-99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment.
KW - cancer registries
KW - CONCORD
KW - excess hazard
KW - net survival
UR - http://www.scopus.com/inward/record.url?scp=84872849005&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84872849005&partnerID=8YFLogxK
U2 - 10.1002/ijc.27725
DO - 10.1002/ijc.27725
M3 - Article
C2 - 22815141
AN - SCOPUS:84872849005
VL - 132
SP - 1170
EP - 1181
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
IS - 5
ER -