Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004-2007

Sarah Walters, Camille Maringe, Michel P Coleman, Michael D Peake, John Butler, Nicholas Young, Stefan Bergström, Louise Hanna, Erik Jakobsen, Karl Kölbeck, Stein Sundstrøm, Gerda Engholm, Anna Gavin, Marianne L Gjerstorff, Juanita Hatcher, Tom Børge Johannesen, Karen M Linklater, Colleen E McGahan, John Steward, Elizabeth Tracey, Donna Turner, Michael A Richards, Bernard Rachet, ICBP Module 1 Working Group, Søren Brostrøm, Heather Bryant, David Currow, Anna Gavin, Gunilla Gunnarsson, Jane Hanson, Todd Harper, Stein Kaasa, Michael A Richards, Michael Sherar, Bob Thomas, Jan Adolfsson, Ole Andersen, Heather Bryant, Andy Coldman, Dhali Dhaliwal, Gerda Engholm, Anna Gavin, David Forman, Marianne L Gjerstorff, Juanita Hatcher, Charlotte Hosbond, Tom B Johannesen, Mats Lambe, Karen M Linklater, Loraine Marrett, Colleen E McGahan, John McLaughlin, David Meechan, Richard Middleton, Kamini Milnes, Diane Nishri, Nicola Quin, Linda Rabenek, Carol Russell, Janey Shin, John Steward, Elizabeth Tracey, Donna Turner, Stefan Bergström, Michael Boyer, John Butler, William Evans, Louise Hanna, Erik Jakobsen, Karl Kölbeck, Jason Lester, Jonathan McAleese, Michael D Peake, Stein Sundstrøm, Nicholas Young, Ian Williamson, Sarah Walters, Camille Maringe, Michel P Coleman, Rachet Bernard, Sarah Walters, Camille Maringe, Michel P Coleman, Michael D Peake, John Butler, Nicholas Young, Stefan Bergström, Louise Hanna, Erik Jakobsen, Karl Kölbeck, Stein Sundstrøm, Gerda Engholm, Anna Gavin, Marianne L Gjerstorff, Juanita Hatcher, Tom Børge Johannesen, Karen M Linklater, Colleen E McGahan, John Steward, Elizabeth Tracey, Donna Turner, Michael A Richards, Bernard Rachet, ICBP Module 1 Working Group, Søren Brostrøm, Heather Bryant, David Currow, Anna Gavin, Gunilla Gunnarsson, Jane Hanson, Todd Harper, Stein Kaasa, Michael A Richards, Michael Sherar, Bob Thomas, Jan Adolfsson, Ole Andersen, Heather Bryant, Andy Coldman, Dhali Dhaliwal, Gerda Engholm, Anna Gavin, David Forman, Marianne L Gjerstorff, Juanita Hatcher, Charlotte Hosbond, Tom B Johannesen, Mats Lambe, Karen M Linklater, Loraine Marrett, Colleen E McGahan, John McLaughlin, David Meechan, Richard Middleton, Kamini Milnes, Diane Nishri, Nicola Quin, Linda Rabenek, Carol Russell, Janey Shin, John Steward, Elizabeth Tracey, Donna Turner, Stefan Bergström, Michael Boyer, John Butler, William Evans, Louise Hanna, Erik Jakobsen, Karl Kölbeck, Jason Lester, Jonathan McAleese, Michael D Peake, Stein Sundstrøm, Nicholas Young, Ian Williamson, Sarah Walters, Camille Maringe, Michel P Coleman, Rachet Bernard

Abstract

Background: The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007.

Methods: Routinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis.

Results: Age-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer.

Conclusions: There are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved.

Keywords: Clinical Epidemiology; Non-Small Cell Lung Cancer; Small Cell Lung Cancer.

Source: PubMed

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