How many deaths have been avoided through improvements in cancer survival?
How many deaths have been avoided through improvements in cancer survival?
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DOI：
10.1136/bmj.320.7239.895
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发表时间：
2000-04-01
影响因子：
--
通讯作者：
Coleman, MP
中科院分区：
文献类型：
--
作者：
Richards, MA;Stockton, D;Coleman, MP
目的估计由于最近生存率的提高，英格兰和威尔士避免了许多癌症死亡。国家统计数据的设计分析。设置英格兰和威尔士。受试者150万成年人在1981-5年或1986- 1988年期间被诊断为47种不同癌症之一。90.主要结果测量1986年至2010年期间诊断出癌症的患者中诊断后5年内癌症死亡人数的减少。结果1986-90年诊断出的癌症患者在诊断后五年内避免了17041例死亡。如果生存率与1981- 1985年诊断的癌症患者相同，这代表了预期癌症死亡的3.3%，三分之二的避免死亡来自五种癌症的生存率改善：女性乳腺癌（4822例）、结肠癌（2560例）、直肠癌（1090例）和膀胱癌（1157例）以及皮肤黑色素瘤（1098例）。超额死亡人数减少比例最大的是皮肤黑色素瘤（23%）、睾丸癌（17%）和骨癌（17%）。在避免的死亡中，约有12 000人（70%）是在75岁以下的成年人死亡。肺癌、前列腺癌、胃癌、卵巢癌和脑癌的生存率的提高很小：占所有癌症的33%，但仅避免了11%的死亡。如果近期癌症存活率的改善速度继续下去，到2010年，75岁以下的患者在诊断后5年内将避免约24000例死亡，约占政府减少10万例癌症死亡的总体目标的四分之一。
Objective To estimate holy many deaths from cancer have been avoided in England and Wales because of recent improvements in survival.Design Analysis of national statistics.Setting England and Wales.Subjects 1.5 million adults with diagnosis of one of 47 different cancers during 1981-5 or 1986-90.Main outcome measures Reduction in number of cancer deaths within five years of diagnosis among patients with cancer diagnosed during 1986-90 compared with patients with cancer diagnosed during 1981-5,Results 17 041 deaths were avoided within five years of diagnosis among patients with cancer diagnosed during 1986-90. This represents 3.3% of the cancer deaths that would have been expected if survival had been the same as for patients with cancer diagnosed during 1981-5, Two thirds of the avoided deaths arose from improvements in survival for just five cancers: female br east cancer (4822), cancers of the colon (2560), rectum (1090), and bladder (1157), and melanoma of the skin (1098). The largest proportionate reductions in excess deaths were for melanoma of the skin (23%) and cancers of the testis (17%) and bone (17%). About 12 000 (70%) of the avoided deaths arose among adults aged under 75 at death. Improvements in survival from cancers of lung, prostate, stomach, ovary, and brain were small: the) accounted for 33% of all cancers but only 11% of avoided deaths.Conclusions Small gains in survival from common cancers save more lives than larger gains for uncommon cancers. If recent rates of improvement in cancer survival continue, about 24 000 deaths within five years of diagnosis would be avoided in patents aged under 75 by the year 2010, representing about a quarter of the government's overall target of 100 000 fewer cancer deaths.