Trends in survival of patients diagnosed with cancer of the digestive organs in the Nordic countries 1964-2003 followed up to the end of 2006
Trends in survival of patients diagnosed with cancer of the digestive organs in the Nordic countries 1964-2003 followed up to the end of 2006
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DOI：
10.3109/02841861003739330
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发表时间：
2010-06-01
期刊：
影响因子：
3.1
通讯作者：
Bray, Freddie
中科院分区：
文献类型：
--
作者：
Klint, Asa;Engholm, Gerda;Bray, Freddie
消化器官癌症（包括食道、胃、小肠、结肠、直肠和肛门、肝、胆囊和胰腺）占北欧国家所有癌症病例的五分之一，是一组具有不同时间趋势和对公共卫生不同后果的疾病。在这项研究中，我们研究了1964-2003年期间北欧国家相对生存率与相应发病率和死亡率的趋势。材料和方法。从NORDCAN数据库中检索1964年至2003年期间的数据，分为8个5年的诊断期。患者随访至2006年底。分析包括5年相对生存率、超额死亡率和年龄特异性相对生存率的趋势。结果在观察期间，结肠癌和直肠癌患者的生存率不断提高，但丹麦患者落后于其他北欧国家。最大的国家间差异见于罕见的小肠癌症。诊断为肝癌、胆囊癌或胰腺癌的患者的预后几乎没有增加; 5年生存率通常低于15%。食管癌患者的生存率也始终较低，而除丹麦外，所有国家的胃癌患者的生存率均略有增加。至少自1964年以来，每个北欧国家的胃癌发病率和死亡率都在稳步下降。结论虽然死亡率和生存率的部位特异性变化在很大程度上反映了诊断和临床实践的变化和改善程度，但发病率趋势突出了风险因素调整的重要性。除了不断取得的临床进展外，有效的初级预防措施，包括控制酒精和烟草消费以及改变饮食模式，将减少北欧国家消化道癌症的发病率和死亡率。
Cancers of the digestive organs (including the oesophagus, stomach, small intestine, colon, rectum and anus, liver, gallbladder, and pancreas) constitute one-fifth of all cancer cases in the Nordic countries and is a group of diseases with diverse time trends and varying consequences for public health. In this study we examine trends in relative survival in relation to the corresponding incidence and mortality rates in the Nordic countries during the period 1964-2003. Material and methods. Data were retrieved from the NORDCAN database for the period 1964 to 2003, grouped into eight 5-year periods of diagnosis. The patients were followed up until the end of 2006. Analysis comprised trends in 5-year relative survival, excess mortality and age-specific relative survival. Results. Survival following cancers of the colon and rectum has increased continuously over the observed period, yet Danish patients fall behind those in the other Nordic countries. The largest inter-country variation is seen for the rare cancers in the small intestine. There has been little increase in prognosis for patients diagnosed with cancers of the liver, gallbladder or pancreas; 5-year survival is generally below 15%. Survival also remains consistently low for patients with oesophageal cancer, while minor increases in survival are seen among stomach cancer patients in all countries except Denmark. The concomitant incidence and mortality rates of stomach cancer have steadily decreased in each Nordic country at least since 1964. Conclusion. While the site-specific variations in mortality and survival largely reflect the extent of changing and improving diagnostic and clinical practices, the incidence trends highlight the importance of risk factor modification. Alongside the ongoing clinical advances, effective primary prevention measures, including the control of alcohol and tobacco consumption as well as changing dietary pattern, will reduce the incidence and mortality burden of digestive cancers in the Nordic countries.