What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable?
What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable?
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DOI：
10.1038/sj.bjc.6605401
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发表时间：
2009-12-03
影响因子：
8.8
通讯作者：
中科院分区：
文献类型：
--
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如果欧洲1985-1989年、1990-1994年和1995-1999年诊断出的癌症患者达到平均（或最高）生存率，估计在英国诊断出的癌症患者在诊断后5年内可以避免的死亡人数。在EUROCARE-2， -3和-4研究中，英国癌症患者的五年相对存活率与其他国家相比。计算如果英国癌症患者的相对存活率与欧洲相同，则可以避免的超额死亡（超出一般人群死亡率预期的死亡）。大不列颠（英格兰、威尔士、苏格兰）和其他13个欧洲国家。在1985-1989年（随访至1994年）、1990-1994年（随访至1999年）和1995-1999年（随访至2003年）期间，英国有280万成年人被诊断患有39种癌症中的一种。确诊后5年内每年可避免的死亡人数。癌症患者中可避免的过量（癌症相关）死亡的百分比。与欧洲平均5年相对生存率相比，1985-1989年期间诊断的可避免的死亡人数最多的是乳腺癌（约占该癌症超额死亡率的18%，即7541例死亡）、前列腺癌（14%，即4285例死亡）、结肠癌（9%，即4090例死亡）、胃癌（8%，即3483例死亡）和肺癌（2%，即3548例死亡）。1990-1994年，可避免的死亡人数最多的是前列腺癌（20%，7335人）、乳腺癌（15%，6165人）、结肠癌（9%，4376人）、胃癌（9%，3672人）、肺癌（2%，3735人）和肾癌（22%，2644人）。1995-1999年，大多数可避免的死亡是前列腺癌（17%，5758人）、乳腺癌（15%，5475人）、肺癌（3%，4923人）、结肠癌（10%，4295人）、胃癌（9%，3137人）和肾癌（21%，2686人）。总的来说，如果达到欧洲的平均存活率，1985年至1999年间，英国每年诊断出的癌症患者中约有6600至7500人可以避免过早死亡。这占癌症相关死亡率的6-7%。与欧洲最高的存活率相比，同期癌症患者可避免的过早死亡率从每年约12 800例死亡（占癌症相关死亡率的12.2%）下降到每年约11 400例死亡（10.6%）。可避免死亡率的很大一部分是前列腺癌：将这种癌症从与欧洲平均存活率的比较中排除，可避免的死亡人数每年减少1000-1500人，超额死亡率的百分比最多减少1%。与最高生存率相比，每年可避免的死亡人数将减少1500-2000人，占超额死亡率的百分比将降低1-2%，但癌症患者可避免的过早死亡率的总体趋势将相似，从11.4%（1985-1989年）下降到10.3%（1990-1994年），1995-1999年期间确诊的死亡率为9.7%。对于一些癌症，英国的存活率略高于欧洲的平均存活率；这意味着在1985-2003年期间，每年可避免110-180例过早死亡。1985年至1999年期间，英国诊断出的癌症患者中可避免的过早死亡占癌症相关死亡率的6-7%，与欧洲的平均存活率相比。与欧洲最高的生存水平相比，癌症相关死亡率从12.2%降至10.6%反映了1985-2003年期间微小但稳定的进展。
To estimate the number of deaths among cancer patients diagnosed in Great Britain that would be avoidable within 5 years of diagnosis if the mean (or highest) survival in Europe for patients diagnosed during 1985–1989, 1990–1994 and 1995–1999 were achieved. Five-year relative survival for cancers in Great Britain compared with that from other countries in the EUROCARE-2, -3 and -4 studies. Calculation of excess deaths (those more than expected from mortality in the general population) that would be avoidable among cancer patients in Britain if relative survival were the same as in Europe. Great Britain (England, Wales, Scotland) and 13 other European countries. 2.8 million adults diagnosed in Britain with 1 of 39 cancers during 1985–1989 (followed up to 1994), 1990–1994 (followed up to 1999) and 1995–1999 (followed up to 2003). Annual number of avoidable deaths within 5 years of diagnosis. Percentage of the excess (cancer-related) deaths among cancer patients that would be avoidable. Compared with the mean European 5-year relative survival, the largest numbers of avoidable deaths for patients diagnosed during 1985–1989 were for cancers of the breast (about 18% of the excess mortality from this cancer, 7541 deaths), prostate (14%, 4285), colon (9%, 4090), stomach (8%, 3483) and lung (2%, 3548). For 1990–1994, the largest numbers of avoidable deaths were for cancers of the prostate (20%, 7335), breast (15%, 6165), colon (9%, 4376), stomach (9%, 3672), lung (2%, 3735) and kidney (22%, 2644). For 1995–1999, most of the avoidable deaths were for cancers of the prostate (17%, 5758), breast (15%, 5475), lung (3%, 4923), colon (10%, 4295), stomach (9%, 3137) and kidney (21%, 2686). Overall, some 6600–7500 premature deaths would have been avoided each year among cancer patients diagnosed in Britain during 1985–1999 if the mean survival in Europe had been achieved. This represents 6–7% of cancer-related mortality. Compared with the highest European survival, avoidable premature mortality among cancer patients fell from about 12 800 deaths a year (12.2% of cancer-related mortality) to about 11 400 deaths a year (10.6%) over the same period. A large component of the avoidable mortality is due to prostate cancer: excluding this cancer from comparison with the European mean survival reduces the annual number of avoidable deaths by 1000–1500, and the percentage of excess mortality by up to 1%. Compared with the highest survival, the annual number of avoidable deaths would be 1500–2000 fewer, and 1–2% lower as a percentage of excess mortality, but the overall trend in avoidable premature mortality among cancer patients would be similar, falling from 11.4% (1985–1989) to 10.3% (1990–1994) and 9.7% for those diagnosed during 1995–1999. For several cancers, survival in Britain was slightly higher than the mean survival in Europe; this represented some 110–180 premature deaths avoided each year during the period 1985–2003. Avoidable premature mortality among cancer patients diagnosed in Britain during 1985–1999 has represented 6–7% of cancer-related mortality compared with the mean survival in Europe. Compared with the highest levels of survival in Europe, the reduction from 12.2% to 10.6% of cancer-related mortality reflects small but steady progress over the period 1985–2003.
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影响因子：
2
作者：
ESTEVE, J;BENHAMOU, E;RAYMOND, L
通讯作者：
RAYMOND, L
影响因子：
1.9
作者：
Berrino, F;Micheli, A;Capocaccia, R
通讯作者：
Capocaccia, R
影响因子：
--
作者：
Richards, MA;Stockton, D;Coleman, MP
通讯作者：
Coleman, MP
影响因子：
8.4
作者：
Francisci, Silvia;Capocaccia, Riccardo;Janssen-Heijnen, Maryska
通讯作者：
Janssen-Heijnen, Maryska
影响因子：
50.5
作者：
Capocaccia, R.;Gatta, G.;Tavilla, A.
通讯作者：
Tavilla, A.