Substantial nation-wide improvement in lung cancer relative survival in Norway from 2000 to 2016
Substantial nation-wide improvement in lung cancer relative survival in Norway from 2000 to 2016
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DOI：
10.1016/j.lungcan.2018.06.003
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发表时间：
2018-08-01
期刊：
影响因子：
5.3
通讯作者：
Solberg, Steinar Kristian
中科院分区：
文献类型：
--
作者：
Brustugun, Odd Terje;Gronberg, Bjorn Henning;Solberg, Steinar Kristian
导言：自本世纪初以来，肺癌的诊断程序和治疗方法都发生了重大变化。研究对象是2000年至2016年的全国癌症发病率和存活率数据。发病率和存活率的变化通过绝对数字、百分比和相对存活率的计算(周期分析)来描述。结果：在研究期间，挪威共有44,825人被诊断为肺癌。从2000年到2016年，发病人数增加了49%，而患病率增加了136%。女性的年龄标化率显著上升，而男性的年龄标化率持平。2016年，腺癌约占所有肺癌的50%，女性略多于男性。在此期间，男女合计的“非小细胞肺癌”实体从24%下降到13%，转移性疾病患者的比例从54%下降到46%。女性和男性的总体中位生存时间翻了一番，分别达到14.3个月和11.4个月。转移性疾病患者的中位生存期略有增加，但仍低于6个月。总的5年相对存活率从女性的16%增加到26%，男性从16%增加到22%。在非手术治疗的局部疾病患者中，女性从25%上升到40%以上，男性从10%上升到近40%。结论：在过去的17年里，肺癌的发病率模式发生了显著的变化，生存率有了显著的改善，尤其是在诊断时没有远处转移的患者。希望当实施免疫治疗时，存活率会有更大的提高。
Introduction: There have been significant changes in both diagnostic procedures and therapy for lung cancer since the beginning of the millennium. National incidence and survival data from 2000 through 2016 are studied.Methods: National data on cancer incidence and vital status are virtually complete. Changes in incidence and survival are described by absolute numbers, percentages, and calculation of relative survival (period analysis).Results: A total of 44,825 individuals were diagnosed with lung cancer in Norway in the study period. The number of incident cases increased with 49% whereas the prevalence increased with 136% from 2000 to 2016. Age-standardised rates rose markedly for women and levelled off for men. In 2016, adenocarcinoma accounted for about 50% of all lung cancers, slightly more for women than for men. The entity "NSCLC not otherwise specified" declined from 24% to 13%, and the fraction of patients with metastatic disease decreased from 54% to 46% during the period, for both sexes combined. The overall median survival time doubled for women and men, reaching 14.3 months and 11.4 months, respectively. For patients with metastatic disease, median survival time showed a small increase but remained less than 6 months. The overall 5-year relative survival increased from 16% to 26% in women and from 16% to 22% in men. The corresponding improvements for the subgroup of non-surgically treated cases with localised disease, were up from 25% to more than 40% in females, and from 10% to almost 40% in males.Conclusion: There have been notable changes in incidence patterns and a remarkable improvement in survival for lung cancer over the last 17 years, most markedly for patients without distant metastases at the time of diagnosis. Hopefully, survival will improve even more when immunotherapy is implemented.