Cancer survival in five continents: a worldwide population-based study (CONCORD)

Michel P. Coleman, Manuela Quaresma, Franco Berrino, Jean Michel Lutz, Roberta De Angelis, Riccardo Capocaccia, Paolo Baili, Bernard Rachet, Gemma Gatta, Timo Hakulinen, Andrea Micheli, Milena Sant, Hannah K. Weir, J. Mark Elwood, Hideaki Tsukuma, Sergio Koifman, Gulnar Azevedo e Silva, Silvia Francisci, Mariano Santaquilani, Arduino VerdecchiaHans H. Storm, John L. Young

Research output: Contribution to journalArticle

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Abstract

Background: Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15-99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990-94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. Methods: To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Findings: Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2-4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Interpretation: Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. Funding: Centers for Disease Control and Prevention (Atlanta, GA, USA), Department of Health (London, UK), Cancer Research UK (London, UK).

Original languageEnglish
Pages (from-to)730-756
Number of pages27
JournalThe Lancet Oncology
Volume9
Issue number8
DOIs
Publication statusPublished - Aug 2008

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Survival
Population
Neoplasms
Life Tables
SEER Program
Registries
Breast Neoplasms
Mortality
Prostatic Neoplasms
Algeria
Eastern Europe
Censuses
Centers for Disease Control and Prevention (U.S.)
Survival Analysis
North America
Rectum
Quality Control
Brazil
Prostate
Colorectal Neoplasms

ASJC Scopus subject areas

  • Oncology

Cite this

Coleman, M. P., Quaresma, M., Berrino, F., Lutz, J. M., De Angelis, R., Capocaccia, R., ... Young, J. L. (2008). Cancer survival in five continents: a worldwide population-based study (CONCORD). The Lancet Oncology, 9(8), 730-756. https://doi.org/10.1016/S1470-2045(08)70179-7

Cancer survival in five continents : a worldwide population-based study (CONCORD). / Coleman, Michel P.; Quaresma, Manuela; Berrino, Franco; Lutz, Jean Michel; De Angelis, Roberta; Capocaccia, Riccardo; Baili, Paolo; Rachet, Bernard; Gatta, Gemma; Hakulinen, Timo; Micheli, Andrea; Sant, Milena; Weir, Hannah K.; Elwood, J. Mark; Tsukuma, Hideaki; Koifman, Sergio; e Silva, Gulnar Azevedo; Francisci, Silvia; Santaquilani, Mariano; Verdecchia, Arduino; Storm, Hans H.; Young, John L.

In: The Lancet Oncology, Vol. 9, No. 8, 08.2008, p. 730-756.

Research output: Contribution to journalArticle

Coleman, MP, Quaresma, M, Berrino, F, Lutz, JM, De Angelis, R, Capocaccia, R, Baili, P, Rachet, B, Gatta, G, Hakulinen, T, Micheli, A, Sant, M, Weir, HK, Elwood, JM, Tsukuma, H, Koifman, S, e Silva, GA, Francisci, S, Santaquilani, M, Verdecchia, A, Storm, HH & Young, JL 2008, 'Cancer survival in five continents: a worldwide population-based study (CONCORD)', The Lancet Oncology, vol. 9, no. 8, pp. 730-756. https://doi.org/10.1016/S1470-2045(08)70179-7
Coleman MP, Quaresma M, Berrino F, Lutz JM, De Angelis R, Capocaccia R et al. Cancer survival in five continents: a worldwide population-based study (CONCORD). The Lancet Oncology. 2008 Aug;9(8):730-756. https://doi.org/10.1016/S1470-2045(08)70179-7
Coleman, Michel P. ; Quaresma, Manuela ; Berrino, Franco ; Lutz, Jean Michel ; De Angelis, Roberta ; Capocaccia, Riccardo ; Baili, Paolo ; Rachet, Bernard ; Gatta, Gemma ; Hakulinen, Timo ; Micheli, Andrea ; Sant, Milena ; Weir, Hannah K. ; Elwood, J. Mark ; Tsukuma, Hideaki ; Koifman, Sergio ; e Silva, Gulnar Azevedo ; Francisci, Silvia ; Santaquilani, Mariano ; Verdecchia, Arduino ; Storm, Hans H. ; Young, John L. / Cancer survival in five continents : a worldwide population-based study (CONCORD). In: The Lancet Oncology. 2008 ; Vol. 9, No. 8. pp. 730-756.
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abstract = "Background: Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15-99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990-94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. Methods: To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Findings: Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42{\%} of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2-4{\%} lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2{\%} lower for breast cancer and up to 5{\%} lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Interpretation: Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. Funding: Centers for Disease Control and Prevention (Atlanta, GA, USA), Department of Health (London, UK), Cancer Research UK (London, UK).",
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T1 - Cancer survival in five continents

T2 - a worldwide population-based study (CONCORD)

AU - Coleman, Michel P.

AU - Quaresma, Manuela

AU - Berrino, Franco

AU - Lutz, Jean Michel

AU - De Angelis, Roberta

AU - Capocaccia, Riccardo

AU - Baili, Paolo

AU - Rachet, Bernard

AU - Gatta, Gemma

AU - Hakulinen, Timo

AU - Micheli, Andrea

AU - Sant, Milena

AU - Weir, Hannah K.

AU - Elwood, J. Mark

AU - Tsukuma, Hideaki

AU - Koifman, Sergio

AU - e Silva, Gulnar Azevedo

AU - Francisci, Silvia

AU - Santaquilani, Mariano

AU - Verdecchia, Arduino

AU - Storm, Hans H.

AU - Young, John L.

PY - 2008/8

Y1 - 2008/8

N2 - Background: Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15-99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990-94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. Methods: To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Findings: Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2-4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Interpretation: Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. Funding: Centers for Disease Control and Prevention (Atlanta, GA, USA), Department of Health (London, UK), Cancer Research UK (London, UK).

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