Stage at diagnosis and early mortality from cancer in England.
Stage at diagnosis and early mortality from cancer in England.
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DOI：
10.1038/bjc.2015.49
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发表时间：
2015-03-31
影响因子：
8.8
通讯作者：
Rous, B.
中科院分区：
文献类型：
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作者：
McPhail, S.;Johnson, S.;Greenberg, D.;Peake, M.;Rous, B.
诊断时的分期是整体癌症结局的关键预测因素。这是第一次，阶段的完整性是足够高的强大的分析，为整个英格兰。我们分析了2012年英国国家癌症登记服务（NCRS）癌症分析系统中诊断为乳腺癌、结直肠癌、肺癌、前列腺癌或卵巢癌的患者的数据。沿着至2013年底的1年相对生存率与1年内死亡率的调整超额率比率一起计算。一年相对生存率随诊断时分期的增加而降低。对于乳腺癌、前列腺癌和结直肠癌，4期癌症的生存率大幅下降，而对于肺癌和卵巢癌，每一阶段的相对生存率都大幅下降。诊断后1年内死亡率的超额比率表明，分期和年龄是最重要的辅助因素，但他们也确定了性别，收入剥夺和居住的地理区域的统计学显着影响。进一步降低死亡率可能是最有效地实现诊断所有癌症之前，他们进展到第4阶段，但对于肺癌和卵巢癌也有必要转移到早期阶段，并努力提高阶段特异性生存在所有阶段。
Stage at diagnosis is a key predictor of overall cancer outcome. For the first time, stage completeness is high enough for robust analysis for the whole of England. We analysed data from the National Cancer Registration Service's (NCRS) Cancer Analysis System on persons diagnosed with breast, colorectal, lung, prostate or ovarian cancers in England in 2012. One-year relative survival (followed-up to the end of 2013) was calculated along with adjusted excess rate ratios, for mortality within 1 year. One-year relative survival decreased with increasing stage at diagnosis. For breast, prostate and colorectal cancers survival showed a major reduction for stage 4 cancers, whereas for lung and ovarian cancers there were substantial decreases in relative survival for each level of increase in stage. Excess rate ratios for mortality within 1 year of diagnosis showed that stage and age were the most important cofactors, but they also identified the statistically significant effects of sex, income deprivation and geographic area of residence. Further reductions in mortality may be most effectively achieved by diagnosing all cancers before they progress to stage 4, but for lung and ovarian cancers there is also a need for a stage shift to earlier stages together with efforts to improve stage-specific survival at all stages.
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