Abstract
Original language | English |
---|---|
Pages (from-to) | 127-137 |
Number of pages | 11 |
Journal | European journal of cancer |
Volume | 93 |
DOIs | |
Publication status | Published - 2018 |
Fingerprint
Keywords
- Cancer
- Europe
- Population-based study
- Stage at diagnosis
- Survival
- aged
- Article
- Austria
- breast cancer
- Bulgaria
- cancer diagnosis
- cancer mortality
- cancer registry
- cancer risk
- cancer staging
- cancer survival
- colon cancer
- controlled study
- Croatia
- Eastern Europe
- Estonia
- female
- France
- Germany
- human
- Italy
- Lithuania
- lung cancer
- major clinical study
- male
- malignant neoplasm
- melanoma
- Netherlands
- observational study
- Poland
- priority journal
- rectum cancer
- retrospective study
- Slovenia
- Southern Europe
- Spain
- stomach cancer
- Switzerland
- thyroid cancer
- adolescent
- adult
- age
- delayed diagnosis
- follow up
- middle aged
- mortality
- neoplasm
- pathology
- register
- statistics and numerical data
- survival rate
- very elderly
- young adult
- Adolescent
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Delayed Diagnosis
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Neoplasm Staging
- Neoplasms
- Registries
- Retrospective Studies
- Survival Rate
- Young Adult
Cite this
Is low survival for cancer in Eastern Europe due principally to late stage at diagnosis? / Minicozzi, P.; Walsh, P.M.; Sánchez, M.-J.; Trama, A.; Innos, K.; Marcos-Gragera, R.; Dimitrova, N.; Botta, L.; Johannesen, T.B.; Rossi, S.; Sant, M.; Group, EUROCARE-5 Working; De Angelis, Roberta; Caldora, Massimiliano; Carrani, Eugenio; Francisci, Silvia; Mallone, Sandra; Pierannunzio, Daniela; Roazzi, Paolo; Rossi, Silvia; Santaquilani, Mariano; tavilla, andrea.
In: European journal of cancer, Vol. 93, 2018, p. 127-137.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Is low survival for cancer in Eastern Europe due principally to late stage at diagnosis?
AU - Minicozzi, P.
AU - Walsh, P.M.
AU - Sánchez, M.-J.
AU - Trama, A.
AU - Innos, K.
AU - Marcos-Gragera, R.
AU - Dimitrova, N.
AU - Botta, L.
AU - Johannesen, T.B.
AU - Rossi, S.
AU - Sant, M.
AU - Group, EUROCARE-5 Working
AU - De Angelis, Roberta
AU - Caldora, Massimiliano
AU - Carrani, Eugenio
AU - Francisci, Silvia
AU - Mallone, Sandra
AU - Pierannunzio, Daniela
AU - Roazzi, Paolo
AU - Rossi, Silvia
AU - Santaquilani, Mariano
AU - tavilla, andrea
N1 - Cited By :2 Export Date: 11 April 2019 CODEN: EJCAE Correspondence Address: Minicozzi, P.; Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Italy; email: pamela.minicozzi@istitutotumori.mi.it Funding details: Compagnia di San Paolo Funding details: European Commission, 20102202 Funding details: Fondazione Cariplo Funding details: 1529710, RF-2009 Funding text 1: This work was supported by the Compagnia di San Paolo , the Cariplo Foundation , the European Commission [grant number 20102202 , European Action Against Cancer, EPAAC Joint Action], and the Italian Ministry of Health [grant number 1529710 , Ricerca Finalizzata 2009, RF-2009]. 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PY - 2018
Y1 - 2018
N2 - Background: Cancer survival has persistently been shown to be worse for Eastern European and UK/Ireland patients than those of other European regions. This is often attributed to later stage at diagnosis. However, few stage-specific survival comparisons are available, so it is unclear whether poorer quality treatment or other factors also contribute. For the first time, European cancer registries have provided stage-at-diagnosis data to EUROCARE, enabling population-based stage-specific survival estimates across Europe. Data and methods: In this retrospective observational study, stage at diagnosis (as TNM, condensed TNM, or Extent of Disease) was analysed for patients (≥15 years) from 15 countries grouped into 4 regions (Northern Europe: Norway; Central Europe: Austria, France, Germany, Switzerland, The Netherlands; Southern Europe: Croatia, Italy, Slovenia, and Spain; and Eastern Europe: Bulgaria, Estonia, Lithuania, Poland, and Slovakia), diagnosed with 7 malignant cancers in 2000–2007, and followed to end of 2008. A new variable (reconstructed stage) was created which used all available stage information. Age-standardised 5-year relative survival (RS) by reconstructed stage was estimated and compared between regions. Excess risks of cancer death in the 5 years after diagnosis were also estimated, taking age, sex and stage into account. Results: Low proportions of Eastern European patients were diagnosed with local stage cancers and high proportions with metastatic stage cancers. Stage-specific RS (especially for non-metastatic disease) was generally lower for Eastern European patients. After adjusting for age, sex, and stage, excess risks of death remained higher for Eastern European patients than for European patients in general. Conclusions: Late diagnosis alone does not explain worse cancer survival in Eastern Europe: greater risk of cancer death together with worse stage-specific survival suggest less effective care, probably in part because fewer resources are allocated to health care than in the rest of Europe. We recommend that Eastern European cancer registries and other involved bodies to draw attention to poor cancer survival, so as to stimulate research and inform policies to improve outcomes. © 2018 Elsevier Ltd
AB - Background: Cancer survival has persistently been shown to be worse for Eastern European and UK/Ireland patients than those of other European regions. This is often attributed to later stage at diagnosis. However, few stage-specific survival comparisons are available, so it is unclear whether poorer quality treatment or other factors also contribute. For the first time, European cancer registries have provided stage-at-diagnosis data to EUROCARE, enabling population-based stage-specific survival estimates across Europe. Data and methods: In this retrospective observational study, stage at diagnosis (as TNM, condensed TNM, or Extent of Disease) was analysed for patients (≥15 years) from 15 countries grouped into 4 regions (Northern Europe: Norway; Central Europe: Austria, France, Germany, Switzerland, The Netherlands; Southern Europe: Croatia, Italy, Slovenia, and Spain; and Eastern Europe: Bulgaria, Estonia, Lithuania, Poland, and Slovakia), diagnosed with 7 malignant cancers in 2000–2007, and followed to end of 2008. A new variable (reconstructed stage) was created which used all available stage information. Age-standardised 5-year relative survival (RS) by reconstructed stage was estimated and compared between regions. Excess risks of cancer death in the 5 years after diagnosis were also estimated, taking age, sex and stage into account. Results: Low proportions of Eastern European patients were diagnosed with local stage cancers and high proportions with metastatic stage cancers. Stage-specific RS (especially for non-metastatic disease) was generally lower for Eastern European patients. After adjusting for age, sex, and stage, excess risks of death remained higher for Eastern European patients than for European patients in general. Conclusions: Late diagnosis alone does not explain worse cancer survival in Eastern Europe: greater risk of cancer death together with worse stage-specific survival suggest less effective care, probably in part because fewer resources are allocated to health care than in the rest of Europe. We recommend that Eastern European cancer registries and other involved bodies to draw attention to poor cancer survival, so as to stimulate research and inform policies to improve outcomes. © 2018 Elsevier Ltd
KW - Cancer
KW - Europe
KW - Population-based study
KW - Stage at diagnosis
KW - Survival
KW - aged
KW - Article
KW - Austria
KW - breast cancer
KW - Bulgaria
KW - cancer diagnosis
KW - cancer mortality
KW - cancer registry
KW - cancer risk
KW - cancer staging
KW - cancer survival
KW - colon cancer
KW - controlled study
KW - Croatia
KW - Eastern Europe
KW - Estonia
KW - female
KW - France
KW - Germany
KW - human
KW - Italy
KW - Lithuania
KW - lung cancer
KW - major clinical study
KW - male
KW - malignant neoplasm
KW - melanoma
KW - Netherlands
KW - observational study
KW - Poland
KW - priority journal
KW - rectum cancer
KW - retrospective study
KW - Slovenia
KW - Southern Europe
KW - Spain
KW - stomach cancer
KW - Switzerland
KW - thyroid cancer
KW - adolescent
KW - adult
KW - age
KW - delayed diagnosis
KW - follow up
KW - middle aged
KW - mortality
KW - neoplasm
KW - pathology
KW - register
KW - statistics and numerical data
KW - survival rate
KW - very elderly
KW - young adult
KW - Adolescent
KW - Adult
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Delayed Diagnosis
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoplasm Staging
KW - Neoplasms
KW - Registries
KW - Retrospective Studies
KW - Survival Rate
KW - Young Adult
U2 - 10.1016/j.ejca.2018.01.084
DO - 10.1016/j.ejca.2018.01.084
M3 - Article
VL - 93
SP - 127
EP - 137
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0014-2964
ER -