International trends in oesophageal cancer survival by histological subtype between 1995 and 2014
International trends in oesophageal cancer survival by histological subtype between 1995 and 2014
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DOI：
10.1136/gutjnl-2020-321089
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发表时间：
2021-02-01
期刊：
影响因子：
24.5
通讯作者：
Arnold, Melina
中科院分区：
文献类型：
--
作者：
Morgan, Eileen;Soerjomataram, Isabelle;Arnold, Melina
即使在高收入国家，食管癌的生存率仍然很低。该疾病流行病学的持续变化突出了通过其两种主要组织学亚型（腺癌（AC）和鳞状细胞癌（SCC））进行生存评估的必要性。方法国际癌症生存比较平台ICBP SURVMARK-2项目收集了1995年至2014年诊断的食管癌病例，随访至2015年12月31日，这些病例来自七个参与国家（澳大利亚、加拿大、丹麦、爱尔兰、新西兰、挪威和英国）的癌症登记处，这些国家的医疗保健可及性相似。按国家、亚型、性别、年龄组和诊断期计算1年和3年年龄标准化净生存率和发病率。结果共纳入AC 111 894例，SCC 73 408例。在每个国家的20年期间观察到生存的显著改善，特别是对于AC，年轻年龄组和诊断后1年。在澳大利亚和爱尔兰，这两种亚型的生存率一直较高，其次是挪威、丹麦、新西兰、英国和加拿大。2010 - 2014年，AC的生存率高于SCC， AC的1年生存率从46.9%（加拿大）到54.4%（爱尔兰），SCC的1年生存率从39.6%（丹麦）到53.1%（澳大利亚）。结论食管AC和SCC的生存均有显著改善，表明治疗取得了进展。在诊断后3年，年龄较大的人群和鳞状细胞癌患者的改善不太明显，这突出了在初级预防的基础上，需要在食管癌的早期发现和治疗方面取得进一步进展，以减轻该疾病的总体负担。
Introduction Survival from oesophageal cancer remains poor, even across high-income countries. Ongoing changes in the epidemiology of the disease highlight the need for survival assessments by its two main histological subtypes, adenocarcinoma (AC) and squamous cell carcinoma (SCC).Methods The ICBP SURVMARK-2 project, a platform for international comparisons of cancer survival, collected cases of oesophageal cancer diagnosed 1995 to 2014, followed until 31st December 2015, from cancer registries covering seven participating countries with similar access to healthcare (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK). 1-year and 3-year age-standardised net survival alongside incidence rates were calculated by country, subtype, sex, age group and period of diagnosis.Results 111 894 cases of AC and 73 408 cases of SCC were included in the analysis. Marked improvements in survival were observed over the 20-year period in each country, particularly for AC, younger age groups and 1 year after diagnosis. Survival was consistently higher for both subtypes in Australia and Ireland followed by Norway, Denmark, New Zealand, the UK and Canada. During 2010 to 2014, survival was higher for AC compared with SCC, with 1-year survival ranging from 46.9% (Canada) to 54.4% (Ireland) for AC and 39.6% (Denmark) to 53.1% (Australia) for SCC.Conclusion Marked improvements in both oesophageal AC and SCC survival suggest advances in treatment. Less marked improvements 3 years after diagnosis, among older age groups and patients with SCC, highlight the need for further advances in early detection and treatment of oesophageal cancer alongside primary prevention to reduce the overall burden from the disease.