Trends in cancer survival in the Nordic countries 1990-2016: the NORDCAN survival studies
Trends in cancer survival in the Nordic countries 1990-2016: the NORDCAN survival studies
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DOI：
10.1080/0284186x.2020.1822544
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发表时间：
2020-09-30
期刊：
影响因子：
3.1
通讯作者：
Lambert, Paul C.
中科院分区：
文献类型：
--
作者：
Lundberg, Frida E.;Andersson, Therese M. -L.;Lambert, Paul C.
背景 北欧国家之间癌症生存率的差异此前已有报道。本研究的目的是根据五个国家癌症登记处的最新信息，检查这些结果差异是否仍然存在。材料和方法 用于分析的数据来自 NORDCAN 数据库，重点关注 1990 年至 2016 年在丹麦、芬兰、冰岛、挪威和瑞典诊断出的九种常见癌症，并在 2017 年进行最大程度的随访。使用灵活的参数 RS 模型估计 1 年和 5 年的相对生存率 (RS)，并计算最早和最近可用年份之间的百分点差异。结果 所有国家的大多数研究地点的 1 年和 5 年 RS 均出现持续改善。此前观察到的各国之间的差异已经减弱。这些改善在丹麦尤其明显，目前丹麦的癌症生存率与其他北欧国家相似。结论 观察到的癌症生存率改善的原因可能是多因素的，包括早期诊断、改进的治疗方案、国家癌症计划的实施、统一的国家癌症护理指南和标准化的患者路径。对于大多数地点来说，以前丹麦的生存劣势已不再存在。持续监测癌症生存对于评估政策变化的影响和医疗保健系统的有效性非常重要。
Background Differences in cancer survival between the Nordic countries have previously been reported. The aim of this study was to examine whether these differences in outcome remain, based on updated information from five national cancer registers. Materials and methods The data used for the analysis was from the NORDCAN database focusing on nine common cancers diagnosed 1990-2016 in Denmark, Finland, Iceland, Norway and Sweden with maximum follow-up through 2017. Relative survival (RS) was estimated at 1 and 5 years using flexible parametric RS models, and percentage point differences between the earliest and latest years available were calculated. Results A consistent improvement in both 1- and 5-year RS was found for most studied sites across all countries. Previously observed differences between the countries have been attenuated. The improvements were particularly pronounced in Denmark that now has cancer survival similar to the other Nordic countries. Conclusion The reasons for the observed improvements in cancer survival are likely multifactorial, including earlier diagnosis, improved treatment options, implementation of national cancer plans, uniform national cancer care guidelines and standardized patient pathways. The previous survival disadvantage in Denmark is no longer present for most sites. Continuous monitoring of cancer survival is of importance to assess the impact of changes in policies and the effectiveness of health care systems.