TY - JOUR
T1 - Differences in the management and survival of metastatic colorectal cancer in Europe. A population-based study
AU - Working Group on Colorectum
AU - Bouvier, Anne Marie
AU - Jooste, V.
AU - Sanchez-Perez, Maria José
AU - Bento, M. J.
AU - Rocha Rodrigues, Jessica
AU - Marcos-Gragera, Rafael
AU - Carmona-Garcia, Maria Carmen
AU - Luque-Fernandez, Miguel Angel
AU - Minicozzi, Pamela
AU - Bouvier, Véronique
AU - Innos, Kaire
AU - Sant, Milena
AU - Van Eycken, L.
AU - Henau, K.
AU - Grozeva, T.
AU - Valerianova, Z.
AU - Innos, K.
AU - Mägi, M.
AU - Bouvier, V.
AU - Launoy, G.
AU - Robaszkiewicz, M.
AU - Bouvier, A. M.
AU - Jooste, V.
AU - Babaev, V.
AU - Katalinic, A.
AU - Ólafsdóttir, E. J.
AU - Tryggvadóttir, L.
AU - Amati, C.
AU - Baili, P.
AU - Bonfarnuzzo, S.
AU - Margutti, C.
AU - Meneghini, E.
AU - Minicozzi, Pamela
AU - Moretti, G.
AU - Sant, Milena
AU - Cirilli, C.
AU - Carrozzi, G.
AU - Spata, E.
AU - Tumino, R.
AU - Rossi, P. Giorgi
AU - Vicentini, M.
AU - Stracci, F.
AU - Bianconi, F.
AU - Contiero, P.
AU - Tagliabue, G.
AU - Kycler, W.
AU - Oko, M.
AU - Macek, P.
AU - Smok-Kalwat, J.
AU - Bielska-Lasota, M.
N1 - Funding Information:
This study was funded in part by ERA-NET within the framework of the call on “Translational research on tertiary prevention in cancer patients” (TRANSCAN) with funding from: the Italian Ministry of Health; the Research Foundation Flanders (FWO), Belgium; the Institut National du Cancer (INCa, JTC2013), France; Estonia; Estonian Research Council (grant number PRG722), the Federal Ministry of Education and Research (BMBF), Germany; Naradowe Centrum Badań i Rozwoju, Poland; the Ministry of Education, Science and Sport (MIZS), Slovenia; and La Caixa Foundation, Spain, the Spanish National Institute of Health, Carlos III (grant number AC14/00036), and the Andalusian Department of Health (grant number PI-0152/2017), Spain.
Funding Information:
The authors thank the participating cancer registries for collecting and preparing the data as part of their essential role in cancer control. This work was carried out as part of HIGHCARE (High resolution project on prognosis and care of cancer patients). The authors thank S. Bonfarnuzzo and C. Amati for technical support and S. Normand (Digestive cancer registry of Burgundy; Dijon) for help in the data management. AMB and MS contributed to the study conception, design, analysis and interpretation of data. Data management was performed by PM. Data collection was performed by AMB, MJSP, MJB, JRR, RMG, MCCG, MALF, VB and KI. Analyses were designed and performed by VJ. The first draft of the manuscript was written by AMB, VJ and MS and all authors contributed to revising the article critically for important intellectual content. All authors read and approved the final manuscript. This study was funded in part by ERA-NET within the framework of the call on ?Translational research on tertiary prevention in cancer patients? (TRANSCAN) with funding from: the Italian Ministry of Health; the Research Foundation Flanders (FWO), Belgium; the Institut National du Cancer (INCa, JTC2013), France; Estonia; Estonian Research Council (grant number PRG722), the Federal Ministry of Education and Research (BMBF), Germany; Naradowe Centrum Bada? i Rozwoju, Poland; the Ministry of Education, Science and Sport (MIZS), Slovenia; and La Caixa Foundation, Spain, the Spanish National Institute of Health, Carlos III (grant number AC14/00036), and the Andalusian Department of Health (grant number PI-0152/2017), Spain. The funding sources had no role in study design, the collection, analysis or interpretation of data, the writing of the report, or the decision to submit the article for publication.
Publisher Copyright:
© 2021
PY - 2021/5
Y1 - 2021/5
N2 - Background: The management regarding metastatic colorectal cancer throughout Europe is not well known. Aims: To draw a European comparison of the management and prognosis of metastatic colorectal cancers. Methods: Factors associated with chemotherapy administration were identified through logistic regressions. Net survival was estimated and crude probabilities of death related to cancer and other causes using a flexible cumulative hazard model. Results: Among the 13 227 patients with colorectal cancer diagnosed between 2010 and 2013 in cancer registries from 10 European countries, 3140 were metastatic. 62% of metastatic patients received chemotherapy. Compared to Spain, the related adjusted odds ratios ranged from 0.7 to 4.0 (P<0.001) according to country. The 3-year net survival by country ranged between 16% and 37%. The survival gap between countries diminished from 21% to 10% when adjusting for chemotherapy, age and sex. Geographical differences in the crude probability of death related to cancer were large for patients <70 or ≥80 years at diagnosis. Conclusion: Heterogeneity in the application of European guidelines partly explain these differences. General health between populations, accessibility to a reference centre, or provision of health care could also be involved. Further population-based studies are warranted to disentangle between these possible explanations.
AB - Background: The management regarding metastatic colorectal cancer throughout Europe is not well known. Aims: To draw a European comparison of the management and prognosis of metastatic colorectal cancers. Methods: Factors associated with chemotherapy administration were identified through logistic regressions. Net survival was estimated and crude probabilities of death related to cancer and other causes using a flexible cumulative hazard model. Results: Among the 13 227 patients with colorectal cancer diagnosed between 2010 and 2013 in cancer registries from 10 European countries, 3140 were metastatic. 62% of metastatic patients received chemotherapy. Compared to Spain, the related adjusted odds ratios ranged from 0.7 to 4.0 (P<0.001) according to country. The 3-year net survival by country ranged between 16% and 37%. The survival gap between countries diminished from 21% to 10% when adjusting for chemotherapy, age and sex. Geographical differences in the crude probability of death related to cancer were large for patients <70 or ≥80 years at diagnosis. Conclusion: Heterogeneity in the application of European guidelines partly explain these differences. General health between populations, accessibility to a reference centre, or provision of health care could also be involved. Further population-based studies are warranted to disentangle between these possible explanations.
KW - Colorectal cancer
KW - Disease Management
KW - Europe
KW - Metastasis
KW - Registries
KW - Survival
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U2 - 10.1016/j.dld.2021.01.021
DO - 10.1016/j.dld.2021.01.021
M3 - Article
C2 - 33637435
AN - SCOPUS:85101391259
VL - 53
SP - 639
EP - 645
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 5
ER -