Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries.
Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries.
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DOI：
10.1016/s0140-6736(17)33326-3
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发表时间：
2018-03-17
期刊：
影响因子：
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通讯作者：
CONCORD Working Group
中科院分区：
文献类型：
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作者：
Allemani C;Matsuda T;Di Carlo V;Harewood R;Matz M;Nikšić M;Bonaventure A;Valkov M;Johnson CJ;Estève J;Ogunbiyi OJ;Azevedo E Silva G;Chen WQ;Eser S;Engholm G;Stiller CA;Monnereau A;Woods RR;Visser O;Lim GH;Aitken J;Weir HK;Coleman MP;CONCORD Working Group
2015年，CONCORD计划的第二个周期建立了全球癌症生存监测，作为卫生系统有效性的衡量标准，并为全球癌症控制政策提供信息。CONCORD-3更新了至2014年的全球癌症生存监测，其中包括2000-2014年15年间3750万名诊断为癌症的患者的个体数据。数据由71个国家和地区的322个基于人群的癌症登记处提供，其中47个提供了100%人口覆盖率的数据。这项研究包括18种癌症或癌症组：成人的食道、胃、结肠、直肠、肝、胰腺、肺、乳腺（妇女）、子宫颈、卵巢、前列腺和皮肤黑色素瘤，以及成人和儿童的脑瘤、白血病和淋巴瘤。采用了标准化的质量控制程序;有关登记处纠正了错误。我们估计了五年的净生存率。估计值采用国际癌症生存标准权重进行年龄标准化。对于大多数癌症，美国和加拿大、澳大利亚和新西兰以及芬兰、冰岛、挪威和瑞典的五年净生存率仍然是世界上最高的。对于许多癌症，丹麦正在缩小与其他北欧国家的生存差距。生存率总体上呈上升趋势，即使是一些更致命的癌症：在一些国家，肝癌、胰腺癌和肺癌的生存率提高了5%。对于2010-2014年诊断的女性，乳腺癌的预测五年生存率在美国和澳大利亚接近90%，但国际差异仍然非常大，南非的水平低至40%。对于胃肠道癌症，五年生存率最高的是东南亚，韩国的胃癌（69%），结肠癌（72%）和直肠癌（71%），日本的食管癌（36%）和台湾的肝癌（28%）。相比之下，在同一地区，皮肤黑色素瘤（韩国60%，中国台湾52%，中国50%）、淋巴系统恶性肿瘤（韩国53%，中国台湾51%，中国38%）和骨髓系统恶性肿瘤（韩国46%，中国台湾33%，中国25%）的生存率通常低于其他地区。对于2010-2014年诊断的儿童，急性淋巴细胞白血病的五年生存率从泰国的66%到芬兰的95%不等。儿童脑肿瘤的五年生存率高于成人，全球范围非常广泛（从泰国的45%到瑞典和丹麦的80%）。CONCORD计划能够及时比较卫生系统在为18种癌症提供护理方面的总体有效性，这些癌症占每年全球诊断的所有癌症的75%。它为全球癌症控制政策提供了证据基础。从2017年起，经济合作与发展组织将使用CONCORD项目的结果作为癌症存活率的官方基准，作为全球48个国家医疗保健质量的指标之一。政府必须认识到，基于人群的癌症登记是关键的政策工具，可用于评估癌症预防策略的影响和卫生系统对所有诊断为癌症的患者的有效性。
In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival, as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the world-wide surveillance of cancer survival to 2014, with individual data for 37.5 million patients diagnosed with cancer during the 15-year period 2000–2014. Data were provided by 322 population-based cancer registries in 71 countries and territories, of which 47 provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate and melanoma of the skin in adults, and brain tumours, leukaemias and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated five-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights. For most cancers, five-year net survival remains among the highest in the world in the US and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas and lung. For women diagnosed during 2010–2014, the predicted five-year survival for breast cancer is now close to 90% in the US and in Australia, but international differences remain very wide, with levels as low as 40% in South Africa. For gastrointestinal cancers, the highest levels of five-year survival are seen in South-East Asia, in Korea for cancers of the stomach (69%), colon (72%) and rectum (71%), in Japan for oesophageal cancer (36%) and in Taiwan for liver cancer (28%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (60% in Korea, 52% in Taiwan, 50% in China), and for both lymphoid malignancies (53% in Korea, 51% in Taiwan, 38% in China) and myeloid malignancies (46% in Korea, 33% in Taiwan, 25% in China). For children diagnosed during 2010–2014, five-year survival for acute lymphoblastic leukaemia ranged from 66% in Thailand to 95% in Finland. Five-year survival from brain tumours in children is higher than for adults, and the global range is very wide (from 45% in Thailand to 80% in Sweden and Denmark). The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed world-wide every year. It contributes to the evidence base for global policy on cancer control. From 2017, the Organisation for Economic Co-operation and Development will use findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries world-wide. It is crucial for governments to recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer.