Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004-2007
Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004-2007
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DOI：
10.1136/thoraxjnl-2012-202297
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发表时间：
2013-06-01
期刊：
影响因子：
10
通讯作者：
Rachet, Bernard
中科院分区：
文献类型：
--
作者：
Walters, Sarah;Maringe, Camille;Rachet, Bernard
研究背景作者考虑了诊断时分期的差异是否可以解释2004- 2007年六个发达国家之间肺癌生存率的差异。（15-99岁），2004-2007年诊断为肺癌，并在澳大利亚、加拿大、丹麦、挪威、瑞典和英国。57352例患者的分期数据来自不同的分类系统。灵活的参数风险模型的对数累积规模被用来估计净生存率在1年和多余的风险高达18个月后diagnosis.Results标准化的1年净生存率从非小细胞肺癌范围从30%（英国）到46%（瑞典）。英国和丹麦患者的生存率低于其他地区，部分原因是分期分布更不利。然而，在阶段特异性生存方面也存在广泛的国际差异。英国TNM I期非小细胞肺癌的净生存率比瑞典低16%，TNM IV期疾病生存率低10%。小细胞肺癌也发现了类似的模式。结论使用基于人群的数据时存在可比性问题，但即使有这些限制，本研究表明，虽然在诊断阶段的差异解释了一些国际变化的总体肺癌生存，阶段特异性生存存在很大的差异，这表明其他因素也很重要，如治疗差异。国际癌症生存研究应纳入分期，并应提高基于人群数据的可比性。
Background The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007.Methods Routinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis.Results Age-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer.Conclusions There are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved.