Colorectal cancer survival in the Nordic countries and the United Kingdom: Excess mortality risk analysis of 5 year relative period survival in the period 1999 to 2000
Colorectal cancer survival in the Nordic countries and the United Kingdom: Excess mortality risk analysis of 5 year relative period survival in the period 1999 to 2000
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DOI：
10.1002/ijc.22737
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发表时间：
2007-09-01
影响因子：
6.4
通讯作者：
Storm, Hans H.
中科院分区：
文献类型：
--
作者：
Engholm, Gerda;Kejs, Anne Mette T.;Storm, Hans H.
EUROCARE研究发现，与瑞典、挪威和芬兰相比，丹麦和英国的结直肠癌生存率不足。我们开始探索这些差异是否仍然存在。1994-2000年期间，15-89岁时首次确诊为浸润性癌症的结直肠癌患者的数据来自英国11个癌症登记处和4个北欧国家。使用1994-2000年诊断出癌症后的1999-2000年死亡人数，用超额死亡风险模型分析了五年相对期生存率。以年龄作为效应修正因子的自诊断后半年随访时间是最重要的因素，诊断后即刻死亡的超额风险最高，年龄越大，随随访时间的延长而降低。国家之间的差异在诊断后的前半年比在0.5-5年的间隔更大，英国和丹麦的风险高出约30%。即使自EUROCARE研究以来，5年相对生存率有所改善，但国家之间的差异仍然很大，顺序也没有改变。患者管理、诊断和合并症可能解释了英国和丹麦前6个月的死亡率过高。阶段和管理和治疗的质量的影响应在基于人群的研究中进行检查，并提供详细的患者信息。使用更详细的年龄间隔比传统的应用在生存研究中被证明是重要的统计建模，并建议在未来的研究。(C)2007 Wiley-Liss，Inc.
A deficit in colorectal cancer survival in Denmark and in the UK compared to Sweden, Norway and Finland was found in the EUROCARE studies. We set out to explore if these differences still exist. Patients diagnosed with colorectal cancer as their first invasive cancer at age 15-89 in the period 1994-2000 were identified using data from 11 cancer registries in the UK and from four Nordic countries. Five-year relative period survival using deaths in 1999-2000 following cancers diagnosed in 1994-2000 was analysed with excess mortality risk modelling. Follow-up time since diagnosis with age as an effect-modifier in the first half year was the most important factor with the highest excess risk of death immediately after diagnosis and with higher age and decreasing with length of follow-up. Variations between countries were bigger in the first half year following diagnosis than in the interval 0.5-5 years with about 30% higher risk in UK and Denmark. The differences between countries are still substantial and the order has not changed, even if the five year relative survival has improved since the EUROCARE studies. Patient management, diagnostics, and comorbidity likely explain the excess deaths in UK and Denmark during the first 6 months. The effect of stage and quality of management and treatment should be examined in population based studies with detailed patient information. Use of more detailed age-intervals than conventionally applied in survival studies proved to be important in statistical modelling and is recommended for future studies. (C) 2007 Wiley-Liss, Inc.