Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data

Summary Background Cancer survival is a key measure of the effectiveness of health-care systems. Persistent regional and international differences in survival represent many avoidable deaths. Differences in survival have prompted or guided cancer control strategies. This is the first study in a prog...

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Bibliographic Details
Published in:The Lancet (British edition) 2011, Vol.377 (9760), p.127-138
Main Authors: Coleman, MP, Prof, Forman, D, PhD, Bryant, H, Prof, Butler, J, MRCOG, Rachet, B, PhD, Maringe, C, MSc, Nur, U, PhD, Tracey, E, MPH, Coory, M, PhD, Hatcher, J, PhD, McGahan, CE, MSc, Turner, D, PhD, Marrett, L, Prof, Gjerstorff, ML, MSc, Johannesen, TB, MD, Adolfsson, J, MD, Lambe, M, MD, Lawrence, G, PhD, Meechan, D, MPH, Morris, EJ, PhD, Middleton, R, PhD, Steward, J, FFPH, Richards, MA, Prof
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
Australia - epidemiology
Benchmarking
Biological and medical sciences
Breast Neoplasms - mortality
Canada - epidemiology
Cancer
Colorectal carcinoma
Colorectal Neoplasms - mortality
Data collection
Denmark - epidemiology
Design
Epidemiology
Fast track
Female
General aspects
Health care access
Health policy
Health services
Humans
Incidence
Internal Medicine
International Cooperation
Jurisdiction
Life Tables
Lung Neoplasms - mortality
Male
Medical sciences
Medicin och hälsovetenskap
Middle Aged
Miscellaneous
Mortality
Mortality - trends
Neoplasms - epidemiology
Neoplasms - mortality
Norway - epidemiology
Ovarian cancer
Ovarian Neoplasms - mortality
Preventable deaths
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quality Control
Registries
Research Design
Studies
Survival
Survival Rate
Sweden - epidemiology
Tumors
United Kingdom - epidemiology
Young Adult
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Summary:Summary Background Cancer survival is a key measure of the effectiveness of health-care systems. Persistent regional and international differences in survival represent many avoidable deaths. Differences in survival have prompted or guided cancer control strategies. This is the first study in a programme to investigate international survival disparities, with the aim of informing health policy to raise standards and reduce inequalities in survival. Methods Data from population-based cancer registries in 12 jurisdictions in six countries were provided for 2·4 million adults diagnosed with primary colorectal, lung, breast (women), or ovarian cancer during 1995–2007, with follow-up to Dec 31, 2007. Data quality control and analyses were done centrally with a common protocol, overseen by external experts. We estimated 1-year and 5-year relative survival, constructing 252 complete life tables to control for background mortality by age, sex, and calendar year. We report age-specific and age-standardised relative survival at 1 and 5 years, and 5-year survival conditional on survival to the first anniversary of diagnosis. We also examined incidence and mortality trends during 1985–2005. Findings Relative survival improved during 1995–2007 for all four cancers in all jurisdictions. Survival was persistently higher in Australia, Canada, and Sweden, intermediate in Norway, and lower in Denmark, England, Northern Ireland, and Wales, particularly in the first year after diagnosis and for patients aged 65 years and older. International differences narrowed at all ages for breast cancer, from about 9% to 5% at 1 year and from about 14% to 8% at 5 years, but less or not at all for the other cancers. For colorectal cancer, the international range narrowed only for patients aged 65 years and older, by 2–6% at 1 year and by 2–3% at 5 years. Interpretation Up-to-date survival trends show increases but persistent differences between countries. Trends in cancer incidence and mortality are broadly consistent with these trends in survival. Data quality and changes in classification are not likely explanations. The patterns are consistent with later diagnosis or differences in treatment, particularly in Denmark and the UK, and in patients aged 65 years and older. Funding Department of Health, England; and Cancer Research UK.
ISSN:0140-6736
1474-547X
1474-547X
DOI:10.1016/S0140-6736(10)62231-3