National comparisons of lung cancer survival in England, Norway and Sweden 2001-2004: differences occur early in follow-up
National comparisons of lung cancer survival in England, Norway and Sweden 2001-2004: differences occur early in follow-up
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DOI：
10.1136/thx.2009.124222
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发表时间：
2010-05-01
期刊：
影响因子：
10
通讯作者：
Moller, Henrik
中科院分区：
文献类型：
--
作者：
Holmberg, Lars;Sandin, Fredrik;Moller, Henrik
背景欧洲医疗保健支出相似的国家在肺癌生存率方面存在差异。方法收集1996 - 2004年英国、挪威和瑞典肺癌患者250828例、挪威18386例和瑞典24886例，分别在英国、挪威和瑞典进行了肺癌生存率的研究。排除仅通过死亡证明登记的患者或存活时间缺失、为零或为负的患者后。5-年相对生存率采用周期法计算。国家之间的超额死亡率进行了比较，使用Poisson回归model.Results在所有的年龄，性别和随访期间的亚类，5年生存率在英国低于挪威和瑞典。2001-2004年，在这两个国家，年龄标准化生存率估计值分别为男性6.5%、9.3%和11.3%，女性8.4%、13.5%和15.9%。这些国家之间死亡风险的差异主要局限于随访的第一年。2001-2004年英格兰与挪威在前3个月随访期间的相对超额风险比在1.23和1.46之间变化，取决于性别和年龄，而英格兰与瑞典在1.56和1.91之间比较。结论获得医疗保健和人口意识可能是差异的主要原因。但不能排除诊断和治疗活性发挥作用。肺癌管理的未来改善可能在随访早期看到。
Background Countries with a similar expenditure on healthcare within Europe exhibit differences in lung cancer survival. Survival in lung cancer was studied in 2001-2004 in England, Norway and Sweden.Methods Nationwide cancer registries in England, Norway and Sweden were used to identify 250 828 patients with lung cancer from England, 18 386 from Norway and 24 886 from Sweden diagnosed between 1996 and 2004, after exclusion of patients registered through death certificate only or with missing, zero or negative survival times. 5-Year relative survival was calculated by application of the period approach. The excess mortality between the countries was compared using a Poisson regression model.Results In all subcategories of age, sex and follow-up period, the 5-year survival was lower in England than in Norway and Sweden. The age-standardised survival estimates were 6.5%, 9.3% and 11.3% for men and 8.4%, 13.5% and 15.9% for women in the respective countries in 2001-2004. The difference in excess risk of dying between the countries was predominantly confined to the first year of follow-up. The relative excess risk ratio during the first 3 months of follow-up comparing England with Norway 2001-2004 varied between 1.23 and 1.46, depending on sex and age, and between 1.56 and 1.91 comparing England with Sweden.Conclusion Access to healthcare and population awareness are likely to be major reasons for the differences, but it cannot be excluded that diagnostic and therapeutic activity play a role. Future improvements in lung cancer management may be seen early in follow-up.