Cancer survival in England and the influence of early diagnosis: what can we learn from recent EUROCARE results?
Cancer survival in England and the influence of early diagnosis: what can we learn from recent EUROCARE results?
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DOI：
10.1038/sj.bjc.6605399
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发表时间：
2009-12-03
影响因子：
8.8
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中科院分区：
文献类型：
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对EUROCARE-4结果的这一综述试图区分早期和晚期死亡率的影响，这些影响导致英国癌症患者的5年生存率普遍低于其他欧洲国家的26个癌症部位。1996-1999年在23个欧洲国家诊断为癌症的患者被纳入分析。比较了英国和“欧洲平均值”数据之间的1年、5年和5 - 1年（即仅包括存活至1年的患者）生存率估计值。这项分析是为了强调早期诊断的相对贡献，使用1年生存率作为替代指标，对不同部位癌症的5年生存率。根据1年、5年和5 - 1年生存率差异是否具有统计学意义，确定了三组癌症部位。在英国，乳腺癌的1年和5年生存率明显较差，但5年和1年生存率没有显著差异。因此，围绕提高认识和早期发现的成功举措可以消除生存差距。相比之下，肺癌、结直肠癌和前列腺癌的5 - 1年生存率估计值仍然显著更差，这表明尽管早期发现可能会产生一些差异，但患者的治疗和管理等晚期效应也会影响英国和欧洲之间的长期结局差异。
This review of the EUROCARE-4 results attempts to separate out the early and late mortality effects contributing to the widely reported poorer 5-year survival rates for cancer patients in the United Kingdom compared with other European countries for 26 cancer sites. Patients diagnosed with cancer in 1996–1999 in 23 European countries were included in the analyses. Comparison of 1-year, 5-year and 5∣1-year (i.e. only including those patients who had survived to 1 year) survival estimates between data for England and the ‘European average’ was undertaken. This analysis was to highlight the relative contribution of early diagnosis, using 1-year survival as a proxy measure, on 5-year survival for the different sites of cancer. Three groups of cancer sites were identified according to whether the survival differences at 1, 5 and 5∣1 years were statistically significant. Breast cancer showed significantly poorer 1- and 5-year survival estimates in England, but the 5∣1-year survival figure was not significantly different. Thus, successful initiatives around awareness and early detection could eradicate the survival gap. In contrast, the 5∣1-year survival estimates remained significantly worse for lung, colorectal and prostate cancers, showing that although early detection could make some difference, late effects such as treatment and management of the patients were also influencing long-term outcome differences between England and Europe.
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