Showing papers on "Relative survival published in 1995"

Brain, other central nervous system, and eye cancer

Abstract: Background. The Surveillance, Epidemiology, and End Results (SEER) Program provides population-based data for the descriptive epidemiology of cancer incidence and survival rates by age, sex, race, and time period according to site and various histologic categories. Methods. Relative frequencies, incidence rates, median age at diagnosis, and 5-year relative survival rates were analyzed by histologic type for microscopically confirmed primary malignant tumors of the brain, central nervous system (CNS) (except lymphomas), and eye, as well as olfactory neuroblastomas. Results. Age-specific incidence rates for astrocytoma and glioblastoma, along with those for malignant meningioma, rose with increasing age up to 70-74 years, whereas rates for ependymoma and medulloblastoma (but not oligodendroglioma) showed a peak at age 0-4 years. Age-adjusted incidence rates for astrocytomas and glioblastomas were lower for blacks compared with whites, but there was little difference for rare types of brain/CNS cancers. Age-adjusted incidence rates increased slightly from 1973-1977 to 1983-1987 for astrocytoma, with little change for other histologic types. For cases diagnosed in 1983-1987, 5-year relative survival rates varied by histologic type and were low for astrocytoma, not otherwise specified (32%), and especially low for glioblastoma (4%); there was no evidence for improvement in survival rates for these two types from 1973-1977 to 1983-1987. Age-specific rates for eye melanoma rose with increasing age (especially for males), and age-adjusted rates were higher for whites than for blacks and declined from 1973-1977 to 1983-1987 in whites. Among cases diagnosed in 1983-1987, 5-year relative survival rates were high for melanoma of the eye (79%) and retinoblastoma (96%); only for retinoblastoma was there evidence of improvement in survival rates between 1973-1977 and 1983-1987. Conclusions. The SEER data are useful in examining the descriptive epidemiologic features, including time trends in incidence and survival rates, for primary cancers of the brain, CNS and eye. The lack of improvement in the low survival rates for some of these cancers emphasizes the remaining therapeutic challenges.

Leukemias, myeloma, and other lymphoreticular neoplasms.

Abstract: Background. The purpose of this study was to assess, the occurrence of various morphologic types of leukemia ) and myeloma within patient demographic groups and to correlate findings with data-reporting periods and other variables, such as 5-year relative survival. Methods. Data from 31,850 cases of multiple subgroups of acute and chronic leukemia, 12,237 cases of myeloma, and 321 cases of “other” lymphoreticular neoplasms were collected by the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. The data were examined by age, sex, race, age-specific and age-adjusted incidence rate, and patient 5-year relative survival during three reporting periods: 1973-1977, 1978-1982, and 1983-1987. Results. The age-adjusted incidence rate for all categories of leukemia combined has been constant, but there has been an increase in the relative frequency (percentage) of acute lymphoid leukemia (ALL) in the general population and a rising incidence rate of myeloid leukemia in the black population. The increase of ALL is offset by a decline of acute myeloid leukemias (AMLs) and acute leukemia, not otherwise specified. The age-adjusted rate of ALL in whites, 1.5 per 100,000 per year, is twice that of blacks, 0.8. The rates for each of the major categories of leukemia are considerably higher in males than in females. Five-year survival rates changed very little for leukemias over the 15 years of the study except for ALL, in which there was a marked improvement between the first (1973-1977) (39.1%) and second (1978-1982) (51.3%) reporting period. The SEER data confirm that multiple myeloma is predominantly a disease of late adulthood and occurs more frequently in blacks and males. The incidence rate of multiple myeloma has not changed during the 15 years surveyed. The 5-year relative survival rate has remained nearly constant for multiple myeloma. There is a marked difference in 5-year relative survival rates for patients with plasmacytoma of bone marrow (45.7%), multiple myeloma (25.9%), and plasma cell leukemia (13.0%). Conclusions. Shifts in the relative frequencies of leukemia types may have been affected by changes in classification criteria, changes in the use of histologic terms over time, and the expanded use of immunophenotyping and other technology to characterize acute leukemias. Incidence rates and 5-year relative survival rates for myeloma have remained stable.

Conditional survival of 56,268 patients with breast cancer

Abstract: Background. Survival rates calculated from the date of diagnosis may not be predictive of future outcome for patients who have already survived several years after diagnosis. Conditional survival rates are more informative clinically because they take into account survival after diagnosis. Methods. Conditional relative survival rates were calculated by the life-table method using data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. Results. Survival rates up to 8 years for patients having survived 1, 2, 3, 4 or 5 years after diagnosis are presented by stage of disease for 56,268 women who were diagnosed as having invasive breast cancer from 1983 to 1987. Conclusions. Women with Stage IV breast cancer had a better survival as they moved further in time from their diagnosis. Survival rates did not improve for those with Stage I and II disease regardless of the number of years they survived after diagnosis. Cancer 1995; 76:237–42.

Socioeconomic variation in cancer survival in the Southeastern Netherlands, 1980-1989

Abstract: Background. The survival rates of patients with cancer by socioeconomic status (SES) has never been investigated in the Netherlands, a country characterized by good general access to health care services. The association between socioeconomic status and survival from cancer of the lung (n = 4591), breast (n = 3928), colorectum (n = 3558), prostate (n = 1484), and stomach (n = 1455) was studied, and the impact of some prognostic factors (stage at diagnosis, histologic type, and treatment) on this association was assessed. Methods. Subjects were patients who were diagnosed from 1980 to 1989 and included in the population-based Eindhoven Cancer Registry in the Southeastern Netherlands. The patients were classified by socioeconomic status based on their postal code of residence at the time of diagnosis (3 or 5 categories). The follow-up ended July 1, 1991, at which time relative survival rates and hazard ratios were calculated. Results. A more favorable relative survival for patients living in high SES areas was found for those with cancer of the lung, breast, colorectum, and prostate, whereas for those with stomach cancer, lower survival was found for patients living in high SES areas. For cancer of the lung, colorectum, and prostate, the socioeconomic variation in survival could not be explained by the distribution of the prognostic factors stage, histologic type, and treatment. For patients with breast and stomach cancer, the socioeconomic variation in survival could be ascribed mainly to differences in the percentage of patients diagnosed with a metastasis. Conclusions. Socioeconomic variation in survival from a number of common cancer sites exists in the Netherlands, despite the fairly equal access to health care services for different socioeconomic groups. Most of the variation could not be explained by the differential distribution of stage, histologic type, and treatment across SES categories. Cancer 1995;75:2946–53.

Comparisons of colon–cancer survival among european countries: The eurocare study

Abstract: Under the aegis of EUROCARE, a European Union project to assemble survival data from population-based cancer registries and analyze them according to standardized procedures, we have investigated and compared colon-cancer survival in 10 European countries. We analyzed 68,283 colon-cancer cases diagnosed between 1978 and 1985 and followed for at least 6 years. After calculating relative survival, putative factors prognostic for survival were investigated by univariate and multiple-regression analyses. Important intercountry colon-cancer survival differences exist within Europe, which are not explained by methodological differences, nor by demographic confounders. In patients aged 60 to 69, the mean European 5-year cumulative relative survival was 40%. Switzerland, Finland and The Netherlands had significantly higher 5-year relative survival, while one area in the UK and Cracow in Poland had significantly lower survival than this European estimate. Prognosis improved over time : from 1978 to 1985, the risk of death was reduced by about 4% per year in all countries studied. Age at diagnosis is inversely related to prognosis. Differences in health provision and hence in quality of care and stage at presentation seem largely responsible for the differences in colon-cancer survival found in the EUROCARE countries.

Survival in breast cancer: A population‐based study in Bangalore, India

Abstract: Survival from cancer reflects the aggressiveness of the disease, the effectiveness of treatment and host factors such as age. While hospital-based survival rates are typically used to evaluate the care provided in a particular hospital, population-based survival reflects the effectiveness of the overall cancer control strategy in the region. Here, we report the survival experience of 1514 breast cancer patients registered by the Bangalore population-based registry during 1982-1989. There have been very few reports on survival from cancer in India, mainly because of poor patient follow-up and inadequate system of registration of death. This has been largely overcome in this study by means of active follow-up through visits of homes of patients. Scrutiny of medical records and matching with death certificates, was also carried out in a small proportion (12%) of cases. Thus, information on vital status (whether dead or alive) as on January 1, 1993 was available for 1334 (88%) subjects and partial follow up data were available for a further 34 (2%). The observed 5 year survival was 42.3% and the corresponding relative survival was 46.8%. The observed survival was 57.4% for localized disease, 45.8% for direct extension, 37% for those with regional node involvement, 14.2% for distant metastasis and 38.3% for those with unstaged disease. The clinical extent of disease and the educational status were independent predictors of survival.

Incidence, mortality and survival in cancer of the cervix in Bangalore, India.

Abstract: Cancer of the cervix is the most common cancer among women in India, constituting between one-sixth to one-half of all female cancers with an age-adjusted incidence rate ranging from 19.4 to 43.5 per 100,000 in the registries under the National Cancer Registry Programme (NCRP) (Annual Reports, NCRP, ICMR). It has been estimated that 100,000 new cases of cancer of the cervix occur in India every year, and 70% or more of these are Stage III or higher at diagnosis. However, the incidence of cancer of the cervix as suggested in this report appears to be on the decline in Bangalore. Besides incidence and clinical stage at presentation knowledge of survival is essential to complete the picture of establishing baseline indicators to monitor and evaluate cancer control programmes. Survival analysis was carried out in 2121 patients diagnosed during 1982-89 in the population of Bangalore, India. The observed 5 year survival was 34.4% and the relative survival 38.3%. Clinical stage at presentation was the single most important variable in predicting survival. The 5 year observed survival for stage I disease was 63.3%, for stage II 44.0%, for stage III 30.3% and for stage IV 5.7%.

The National Cancer Data Base report on gastric cancer.

Abstract: Background. Previous Commission on Cancer studies from the National Cancer Data Base (NCDB) have examined time trends in stage of disease, treatment patterns, and survival for selected cancers. The most current (1991) data for gastric cancer are described here. Methods. Three Calls for Data have yielded a total of 16,992 case reports of gastric cancer for 1985, 1986, and 1991, from hospital cancer registries across the U.S. Results. Gastric cancer was the 15th most frequent cancer reported to the NCDB. The proportion of all reported cancers that were gastric in the two time intervals studied were essentially the same. In 1991, 20.8% of the cases were reported in minorities. Only 46% of gastric cancer cases were staged by the American Joint Committee on Cancer (AJCC) system in 1985 to 86, compared with 77% in 1991. More advanced stages were reported for younger patients, but less advanced stages were noted in the Asian population. Of all patients reported, 41.4% had no reported cancer-directed surgery, 41.1% had partial or hemigastrectomy, and 6.7% had total gastrectomy. More extensive surgery was associated with patients with Stage III disease than with Stages I and II, as might be expected. Survival after treatment remained poor (5-year relative survival; 43% for Stage I, 37% for Stage II, 18% for Stage III, and 20% for Stage IV). Conclusion. Improvements in treatment will emerge allowing survival to serve as a better guide for the quality of care in the future. In the interim, the frequency of American Joint Committee on Cancer staging in patient charts and the fraction of patients with Stages I and II as opposed to Stages III and IV disease (as a measure of prompt diagnosis) may serve as measure of how quickly these cancers are being diagnosed. Cancer 1995;75:1734-44.

Estimation and projections of stomach cancer trends in Italy

Abstract: Mortality data from official sources, and survival data from population-based cancer registries, are used for the estimation of incidence and prevalence of stomach cancer. Time trends of morbidity, survival, and mortality during the period 1970–90 are presented and analyzed. Incidence rates were decreasing during the considered period, but the rate of decrease was slowing down during the last decade. Almost stable rates, and even slightly increasing for women, were estimated for the youngest cohorts. Relative survival for stomach cancer was higher for women and for young ages; it was associated positively with period of diagnosis, and presented a significant South-North geographic gradient. Prevalence was estimated as decreasing during the period 1970–80, but increasing during the successive decade, due to both better survival and population aging. Projection of stomach cancer morbidity and mortality to the year 2000 showed that the disease should still be considered in Italy as a major public health problem.

Descriptive epidemiology of lymphoid and haemopoietic malignancies in Bangalore, India

Abstract: Lymphoid and haemopoietic malignancies as a group constitute one of the important cancers in India, as elsewhere in the world. While information on incidence and mortality of these cancers, and that on survival, are available from most developed countries, there are very few reports describing this experience in developing ones. Population-based cancer registration commenced in Bangalore, India, in January 1982, under the auspices of the Indian Council of Medical Research. This source provides fairly complete and reliable incidence data, but, in order to obtain mortality and survival information, active follow-up involving visits of homes of patients was undertaken. Between 1982 and 1989, 1397 cases of lymphoid and haemopoietic malignancies were registered in the Bangalore cancer registry, giving an age-adjusted incidence rate of 7.7 and 4.8 per 100,000 in males and females respectively. Active follow-up provided mortality/survival information in 1267 or 90.7% of these cases. The overall observed 5-year survival for these cancers combined (both sexes) was 26%, and relative survival 28.4%. The 5-year survival rate was lower in all the individual lymphomas and leukaemias as compared with similar reports from the developed countries. Survival in Hodgkin's disease was influenced by clinical stage and age at presentation.

A proportional regression model for 20 year survival of colon cancer in Norway

Abstract: Twenty year survival of all Norwegians with colon cancer registered in a period of 10 years is estimated by both relative survival rates, and with a proportional regression model for the excess intensity. Male colon cancer patients have a significant positive excess mortality at least 20 years after diagnosis, while the excess mortality for females is about zero after 10 years. Stratified analyses for men indicate non-proportionality throughout the follow-up period, and when this information is included in the regression model, there are significant effects of age between 60 and 70 years and for pelvic cancer. The use of proportional regression models is also discussed when excess intensities are close to zero or negative.

An analysis of familial prostate cancer

Abstract: Background Clinical and pathological features of familial prostate cancer patients were examined. Methods We compared 7 pairs (14 patients) of familial prostate cancer patients (Group F) with those of 1741 prostate cancer patients diagnosed in around Gunma Prefecture between 1987 and 1993 (Group G). Relative survival rates were compared because the average age was different in two groups. Results In Group F and Group G, age at diagnosis ranged from 54 to 86 and 47 to 97 years old, and the averages were 68.1 +/- 8.5 (S.D.) and 74.2 +/- 8.3, respectively. The average age tended to be younger in Group F. The ratio of early stage cancer tended to be higher and that of poorly differentiated cancer tended to be lower in Group F. The 3- and 5-year relative survival rate was 82.4% and 57.6% in Group F, and 84.3% and 73.9% in Group G, respectively. The 5-year survival rate tended to be lower in Group F, but almost no difference was observed between two groups on the whole. In Group F, of 6 patients whose causes of death were clear, 4 (66.7%) died of prostate cancer, while in Group G, of 398 patients whose causes of death were elaar, 224 (56.3%) died of prostate cancer. Family history of other cancer sites was positive in 3 of 6 families in Group F. Conclusions Familial prostate cancer patients tended to be young, in early stage and low ratio of poorly differentiated cancer.

Childbearing and Survival After Breast Cancer..

Abstract: : An increase in breast cancer incidence among younger women has been observed, thus many young breast cancer patients are faced with questions concerning their reproductive futures. At present it is unclear whether attempting childbearing may increase these women's risk of death. This project obtained data from a large sample of women to compare relative survival of women with and without births among young women with breast cancer. Data were obtained from three population based registries (the Surveillance, Epidemiology, and End Results, or SEER Registries, in Seattle, Detroit, and Los Angeles). All women less than 45 years of age, diagnosed with breast cancer were identified in each of the three study regions. Their records were linked with birth certificates from each state to identify those (about 3%-4%) with a live birth after their initial diagnosis with breast cancer. Comparison subjects were identified from among young women with breast cancer in each region without subsequent births, matched on age and stage of disease at diagnosis, diagnosis year, race, and presence of multiple primary tumor. Date of last follow up and vital status for all subjects are being updated from several sources, and relative survival will be compared among these two groups.

Prostate cancer: population-based survival rates in central Italy.

Abstract: Aims To evaluate survival in prostate cancer patients in the Province of Florence where the Tuscany Cancer Registry is active. Methods The survival of 777 patients with prostate cancer diagnosed in the period 1985-87 was evaluated. The observed and relative survival rates 1, 3 and 5 years after diagnosis were computed. Also the prognostic effect of age, disease extension, tumor grade, histological verification, place of residence and year of diagnosis were evaluated using univariate and multivariate analysis. Results The observed survival was 73.4% 1 year, 42.5% 3 years and 29.2% 5 years after diagnosis. The relative survival was respectively 78.7%, 53.0% and 43.0%. Significant independent risks were evident when the disease was extended out of the prostate, for patients older than 80 years, for high grade tumors and for patients without histological verification. Conclusion The 5-year relative survival rate in the province of Florence is similar to those from other European Registries and the Latina Registry, but much lower than the one reported by the SEER program in the US. Data on histological verification percentage, availability of information on disease extension, and tumor grade are discussed as indicators of the quality of the diagnostic approach in comparison with other registries.

Comments and Critique Non-specilalist Units, Clinical Trials and Survival from Testicular Cancer

Abstract: THE PAST two decades have seen striking improvements in the prognosis for testicular cancer, and by the mid 198Os, 5-year relative survival rates of around 90% were being observed in populations in Europe and North America [l-3]. Populationbased survival rates by histological type are rarely reported. In Denmark, the rise in S-year relative survival from 76% for patients diagnosed during 19173-77 to 91% for those diagnosed during 1983-87 was largely attributable to an increase from 64 to 89% for non-seminomatous tumours, although survival from seminoma also saw a more modest improvement from 88 to 95% [ 11. The greatly improved prognosis for testicular cancer is one of the major success stories of clinical oncology [4]. The place of general oncology departments in the treatment of testicular cancer has been controversial for some years. The latest contribution to the debate on this topic is the paper by Norum and colleagues in this issue pp. 293-295 [5]. In their series of 98 patients, treated1 over an 8-year period at a small centre in a remote part of Norway, survival was similar to that in major centres, and the authors argue that patients with testicular cancer can be treated according to co-operative group protocols in a small general oncology department without any adverse effects on outcome. Nearly 10 years ago, it w,as reported that survival rates for men with non-seminomatous testicular tumours treated in a general oncology department had been similar to those obtained in the contemporary national multicentre study [6], but at one large centre participating in that study, survival rates were substantially higher [7]. There results were hard to evaluate as they were not population-based, and the numbers of patients were small. The earliest population-based analysis of survival from testicular cancer in relation to patterns of organisation of medical care concerned 246 patients included in the Irish Testicular Tumour Registry during 1980-85 [8]. In this series, 41% of patients had seminomas and 59% had non~seminomatous germ-cell tumours. 4-year survival was significantly higher for patients who were treated by a urologist (76%) than for those who were not (64%). Patients had similar survival rates whether or not an oncologist