Cancer survival in Sweden during three decades, 1961-1991.
Cancer survival in Sweden during three decades, 1961-1991.
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1961-1991 年瑞典三十年的癌症生存情况。
DOI：
10.3109/02841869509127200
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发表时间：
1995
期刊：
影响因子：
3.1
通讯作者：
L. Holm
中科院分区：
文献类型：
--
作者：
M. Stenbeck;M. Rosén;L. Holm
瑞典癌症登记处提供了一份综合报告，介绍了 1961 年至 1991 年瑞典的癌症生存情况。该报告展示了成功和失败，证实了一些早期发表的结果，并提出了一些值得进一步分析的新发现。女性乳腺癌、恶性黑色素瘤、睾丸癌和甲状腺癌、急性白血病和霍奇金病的生存率有所提高。对于多发性骨髓瘤或肝癌、胆囊癌和胰腺癌没有发现任何改善。结直肠癌以及胃癌、食道癌和肾癌的发病率略有增加。以组织学良性肿瘤为主的部位，即颅内神经鞘瘤、脑膜瘤和甲状旁腺肿瘤等内分泌腺癌，术后生存率有所增加。从1970-1972年到1980-1982年，男性的10年相对生存率（RSR）从30%增加到38%，女性从44%增加到51%。因此，所有病例的癌症生存率在一定程度上接近普通人群的生存率。大部分增长发生在 20 世纪 70 年代。预后较好的癌症部位的发病率分布变化约占观察到的 RSR 增加的 10-20%，而癌症人口的老龄化使所有病例的 RSR 上升趋势减少了约 1-2%。五年随访后，癌症患者的生存率比普通人群要差。结直肠癌约8-12年，宫颈癌约10年，恶性黑色素瘤约7-10年，肾癌约13-18年，女性乳腺癌和前列腺癌约19年以上。对于 1970 年至 1972 年诊断出的患者，诊断后 16 年发生这种情况，当所有癌症病例合并时，男性为 29%，女性为 43%。大多数癌症形式“统计治愈”所需的时间延长，这清楚地表明需要通过其他结果指标来增强常用的 5 年 RSR。如果癌症平均在今天较早发现，则 5 年 RSR 会夸大其随着时间的推移而有所改善的印象。在这种情况下，10 年 RSR 的变化是一个偏差较小的标准。
Cancer survival in Sweden in 1961-1991 is presented as a comprehensive report from the Swedish Cancer Registry. The report shows both successes and failures, confirms some earlier published results and presents some new findings worth further analysis. Survival has increased for female breast cancer, malignant melanoma, cancers of the testis and thyroid gland, acute leukemia, and Hodgkin's disease. No improvements are found for multiple myeloma or cancers of the liver, gall bladder, and pancreas. Small increases are shown for colorectal cancer and cancers of the stomach, oesophagus, and kidney. Increases in postoperative survival are shown for sites dominated by histologically benign tumors, i.e., intracranial neurinoma, meningioma, and cancers of the endocrine glands such as parathyroid tumors. From 1970-1972 to 1980-1982 the 10-year relative survival rate (RSR) increased from 30% to 38% for males and from 44% to 51% for females. Hence, cancer survival for all cases combined has approached the survival of the general population somewhat. Most of the increases took place in the 1970's. Changes in the distribution of incidence towards cancer sites with better prognoses account for some 10-20% of the observed increases in RSR, whereas the aging of the cancer population reduces the upward trend in RSR for all cases combined by some 1-2%. Cancer patients have poorer survival than the population long after 5 years of follow-up. They reach the survival of the population after about 8-12 years for colorectal cancer, 10 years for cervical cancer, 7-10 years for malignant melanoma, 13-18 years for kidney cancer, and more than 19 years for female breast and prostate cancer. For patients diagnosed in 1970-1972 this occurred 16 years after diagnosis at 29% for males and 43% for females when all cancer cases were combined. The extended time until 'statistical cure' for most cancer forms clearly indicates the need to augment the commonly used 5-year RSR with other outcome measures. If cancers on average are discovered earlier today, the 5-year RSR gives an exaggerated impression of the improvement over time. In this case the change in the 10-year RSR is a less biased criterion.