Cancer survival in five continents: a worldwide population-based study (CONCORD)
Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15–99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990–94 and followed up to 1999, by use of individual tum...
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| Published in | The lancet oncology Vol. 9; no. 8; pp. 730 - 756 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Elsevier Ltd
01.08.2008
Elsevier Limited |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1470-2045 1474-5488 1474-5488 |
| DOI | 10.1016/S1470-2045(08)70179-7 |
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| Abstract | Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15–99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990–94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets.
To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer.
Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2–4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now.
Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control.
Centers for Disease Control and Prevention (Atlanta, GA, USA), Department of Health (London, UK), Cancer Research UK (London, UK). |
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| AbstractList | Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1.9 million adults (aged 15-99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990-94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets.
To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer.
Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2-4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now.
Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1.9 million adults (aged 15-99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990-94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2-4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. Summary Background Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15–99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990–94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. Methods To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Findings Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2–4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Interpretation Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. Funding Centers for Disease Control and Prevention (Atlanta, GA, USA), Department of Health (London, UK), Cancer Research UK (London, UK). Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15–99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990–94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2–4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. Centers for Disease Control and Prevention (Atlanta, GA, USA), Department of Health (London, UK), Cancer Research UK (London, UK). Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1.9 million adults (aged 15-99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990-94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets.BACKGROUNDCancer survival varies widely between countries. The CONCORD study provides survival estimates for 1.9 million adults (aged 15-99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990-94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets.To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer.METHODSTo compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer.Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2-4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now.FINDINGSGlobal variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2-4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now.Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control.INTERPRETATIONUntil now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. |
| Author | Santaquilani, Mariano Quaresma, Manuela Lutz, Jean-Michel Weir, Hannah K Elwood, J Mark Gatta, Gemma Capocaccia, Riccardo Francisci, Silvia Tsukuma, Hideaki Verdecchia, Arduino Koifman, Sergio Berrino, Franco De Angelis, Roberta Coleman, Michel P Micheli, Andrea Baili, Paolo e Silva, Gulnar Azevedo Hakulinen, Timo Sant, Milena Rachet, Bernard Young, John L Storm, Hans H |
| Author_xml | – sequence: 1 givenname: Michel P surname: Coleman fullname: Coleman, Michel P email: michel.coleman@lshtm.ac.uk organization: Cancer Research UK Cancer Survival Group, Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK – sequence: 2 givenname: Manuela surname: Quaresma fullname: Quaresma, Manuela organization: Cancer Research UK Cancer Survival Group, Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK – sequence: 3 givenname: Franco surname: Berrino fullname: Berrino, Franco organization: Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy – sequence: 4 givenname: Jean-Michel surname: Lutz fullname: Lutz, Jean-Michel organization: Geneva Cancer Registry, Geneva, Switzerland – sequence: 5 givenname: Roberta surname: De Angelis fullname: De Angelis, Roberta organization: National Centre for Epidemiology, Surveillance and Health Promotion, Department of Cancer Epidemiology, Istituto Superiore di Sanità, Rome, Italy – sequence: 6 givenname: Riccardo surname: Capocaccia fullname: Capocaccia, Riccardo organization: National Centre for Epidemiology, Surveillance and Health Promotion, Department of Cancer Epidemiology, Istituto Superiore di Sanità, Rome, Italy – sequence: 7 givenname: Paolo surname: Baili fullname: Baili, Paolo organization: Descriptive Epidemiology and Health Planning Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy – sequence: 8 givenname: Bernard surname: Rachet fullname: Rachet, Bernard organization: Cancer Research UK Cancer Survival Group, Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK – sequence: 9 givenname: Gemma surname: Gatta fullname: Gatta, Gemma organization: Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy – sequence: 10 givenname: Timo surname: Hakulinen fullname: Hakulinen, Timo organization: Finnish Cancer Registry, Helsinki, Finland – sequence: 11 givenname: Andrea surname: Micheli fullname: Micheli, Andrea organization: Descriptive Epidemiology and Health Planning Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy – sequence: 12 givenname: Milena surname: Sant fullname: Sant, Milena organization: Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy – sequence: 13 givenname: Hannah K surname: Weir fullname: Weir, Hannah K organization: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA – sequence: 14 givenname: J Mark surname: Elwood fullname: Elwood, J Mark organization: British Columbia Cancer Agency, Vancouver, BC, Canada – sequence: 15 givenname: Hideaki surname: Tsukuma fullname: Tsukuma, Hideaki organization: Osaka Cancer Registry, Department of Cancer Control and Statistics, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan – sequence: 16 givenname: Sergio surname: Koifman fullname: Koifman, Sergio organization: Department of Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, Brazil – sequence: 17 givenname: Gulnar Azevedo surname: e Silva fullname: e Silva, Gulnar Azevedo organization: Institute of Social Medicine, University of Rio de Janeiro, Rio de Janeiro, Brazil – sequence: 18 givenname: Silvia surname: Francisci fullname: Francisci, Silvia organization: National Centre for Epidemiology, Surveillance and Health Promotion, Department of Cancer Epidemiology, Istituto Superiore di Sanità, Rome, Italy – sequence: 19 givenname: Mariano surname: Santaquilani fullname: Santaquilani, Mariano organization: National Centre for Epidemiology, Surveillance and Health Promotion, Department of Cancer Epidemiology, Istituto Superiore di Sanità, Rome, Italy – sequence: 20 givenname: Arduino surname: Verdecchia fullname: Verdecchia, Arduino organization: National Centre for Epidemiology, Surveillance and Health Promotion, Department of Cancer Epidemiology, Istituto Superiore di Sanità, Rome, Italy – sequence: 21 givenname: Hans H surname: Storm fullname: Storm, Hans H organization: Department of Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark – sequence: 22 givenname: John L surname: Young fullname: Young, John L organization: Metropolitan Atlanta SEER Registry, Georgia Center for Cancer Statistics, Department of Epidemiology, Rollins School of Public Health at Emory University, Atlanta, GA, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/18639491$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | 2008 Elsevier Ltd Elsevier Ltd Copyright Elsevier Limited Aug 2008 |
| Copyright_xml | – notice: 2008 Elsevier Ltd – notice: Elsevier Ltd – notice: Copyright Elsevier Limited Aug 2008 |
| CorporateAuthor | the CONCORD Working Group CONCORD Working Group |
| CorporateAuthor_xml | – name: the CONCORD Working Group – name: CONCORD Working Group |
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| Snippet | Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15–99 years) diagnosed with a... Summary Background Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15–99 years)... Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1.9 million adults (aged 15-99 years) diagnosed with a... |
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| SubjectTerms | Adolescent Adult Age Distribution Aged Aged, 80 and over Breast cancer Cause of Death Confidence Intervals Cross-Sectional Studies Disease control Disease-Free Survival Epidemiology Estimates Female Global Health Health Surveys Hematology, Oncology and Palliative Medicine Humans Incidence Male Middle Aged Mortality Neoplasms - mortality Probability Prostate cancer Registries Risk Factors SEER Program Sex Distribution Surveillance Survival Analysis Womens health |
| Title | Cancer survival in five continents: a worldwide population-based study (CONCORD) |
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