Quantifying differences in breast cancer survival between England and Norway
Quantifying differences in breast cancer survival between England and Norway
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DOI：
10.1016/j.canep.2011.04.003
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发表时间：
2011-12-01
影响因子：
2.6
通讯作者：
Moller, Henrik
中科院分区：
文献类型：
--
作者：
Lambert, Paul C.;Holmberg, Lars;Moller, Henrik
背景：英国乳腺癌的生存率低于其他一些欧洲国家。我们比较了英格兰和挪威患者的年龄和确诊时间。研究方法：我们纳入了1996-2004年诊断的303，648例英国和24，919例挪威乳腺癌病例，使用灵活的参数相对生存模型，能够改善生存差异的量化。估计粗概率，将所有原因导致的死亡概率划分为癌症和其他原因导致的死亡概率，并估计“可避免的”死亡人数。结果：英国各年龄组的相对生存率均较低，且随年龄增长而增加。这种差异主要是由于英国在确诊后的头几个月内死亡率较高。老年患者因其他原因死亡的比例较高。在诊断后5年，英格兰85岁的妇女死于癌症的概率为0.35，死于其他原因的概率为0.32，而在挪威，这两个概率分别为0.26和0.35。到了八年，英格兰“可避免的”全因死亡人数为1020人，“可避免的”乳腺癌相关死亡人数为1488人。结论：英国乳腺癌生存率较低主要是由于诊断后第一年的死亡率较高。粗略概率有助于我们了解疾病对个体患者的影响，并帮助评估不同的治疗方案。皇冠版权所有（C）2011由爱思唯尔有限公司出版。保留所有权利。
Background: Survival from breast cancer is lower in the UK than in some other European countries. We compared survival in England and Norway by age and time from diagnosis. Methods: We included 303,648 English and 24,919 Norwegian cases of breast cancer diagnosed 1996-2004 using flexible parametric relative survival models, enabling improved quantification of differences in survival. Crude probabilities were estimated to partition the probability of death due to all causes into that due to cancer and other causes and to estimate the number of "avoidable'' deaths. Results: England had lower relative survival for all ages with the difference increasing with age. Much of the difference was due to higher excess mortality in England in the first few months after diagnosis. Older patients had a higher proportion of deaths due to other causes. At 5 years post diagnosis, a woman aged 85 in England had probabilities of 0.35 of dying of cancer and 0.32 of dying of other causes, whilst in Norway they were 0.26 and 0.35. By eight years the number of "avoidable'' all-cause deaths in England was 1020 with the number of "avoidable'' breast cancer related deaths 1488. Conclusion: Lower breast cancer survival in England is mainly due to higher mortality in the first year after diagnosis. Crude probabilities aid our understanding of the impact of disease on individual patients and help assess different treatment options. Crown Copyright (C) 2011 Published by Elsevier Ltd. All rights reserved.