Stage at diagnosis and early mortality from cancer in England

S McPhail, S Johnson, D Greenberg, M Peake, B Rous, S McPhail, S Johnson, D Greenberg, M Peake, B Rous

Abstract

Background: Stage at diagnosis is a key predictor of overall cancer outcome. For the first time, stage completeness is high enough for robust analysis for the whole of England.

Methods: We analysed data from the National Cancer Registration Service's (NCRS) Cancer Analysis System on persons diagnosed with breast, colorectal, lung, prostate or ovarian cancers in England in 2012. One-year relative survival (followed-up to the end of 2013) was calculated along with adjusted excess rate ratios, for mortality within 1 year.

Results: One-year relative survival decreased with increasing stage at diagnosis. For breast, prostate and colorectal cancers survival showed a major reduction for stage 4 cancers, whereas for lung and ovarian cancers there were substantial decreases in relative survival for each level of increase in stage. Excess rate ratios for mortality within 1 year of diagnosis showed that stage and age were the most important cofactors, but they also identified the statistically significant effects of sex, income deprivation and geographic area of residence.

Conclusions: Further reductions in mortality may be most effectively achieved by diagnosing all cancers before they progress to stage 4, but for lung and ovarian cancers there is also a need for a stage shift to earlier stages together with efforts to improve stage-specific survival at all stages.

References

    1. Abdel-Rahman M, Stockton D, Rachet B, Hakulinen T, Coleman MP. What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable. Br J Cancer. 2009;101:S115–S124.
    1. Cancer Research UK Cancer Survival Group 2006. Life tables for cancer survival analysis. Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK. 2014. Available at .
    1. Coleman MP, Forman D, Bryant H, Butler J, Rachet B, Maringe C, Nur U, Tracey E, Coory M, Hatcher J, McGahan CE, Turner D, Marrett L, Gjerstorff ML, Johannesen TB, Adolfsson J, Lambe M, Lawrence G, Meechan D, Morris EJ, Middleton R, Steward J, Richards MA, ICBP Module 1 Working Group 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. Lancet. 2011;377:9760.
    1. Communities and Local Government 2011. The English Indices of Deprivation 2010. Available at .
    1. Corazziari I, Quinn M, Capocaccia R. Standard cancer patient population for age standardising survival ratios. Eur J Cancer. 2004;40:2307–2316.
    1. De Angelis R, Sant M, Coleman MP, Francisci S, Baili P, Pierannunzio D, Trama A, Visser O, Brenner H, Ardanaz E, Bielska-Lasota M, Engholm G, Nennecke A, Siesling S, Berrino F, Capocaccia R, EUROCARE-5 Working Group Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE—5-a population-based study. Lancet Oncol. 2014;15:23–34.
    1. Department of Health . Improving Outcomes: A Strategy for Cancer. Department of Health: London, UK; 2011.
    1. Dickman PW, Sloggett A, Hills M, Hakulinen T. Regression models for relative survival. Stat Med. 2004;23:51–64.
    1. Foot C, Harrison T.2011. How to improve cancer survival: Explaining England's relatively poor rates. The Kings Fund.
    1. Health and Social Care Information Centre National Lung Cancer Audit annual reports from 2007 to 2012. 2013.
    1. Holmberg L, Sandin F, Bray F, Richards M, Spicer J, Lambe M, Klint A, Peake M, Strand TE, Linklater K, Robinson D, Møller H. National comparisons of lung cancer survival in England, Norway and Sweden 2001-2004: differences occur early in follow-up. Thorax. 2010;65:436–441.
    1. Khakwani A, Rich A, Powell H, Tata L, Stanley R, Baldwin D, Duffy J, Hubbard R. Lung cancer survival in England: trends in non-small-cell lung cancer survival over the duration of the National Lung Cancer Audit. Br J Cancer. 2013;109:2058–2065.
    1. Maringe C, Walters S, Butler J, Coleman MP, Hacker N, Hanna L, Mosgaard BJ, Nordin A, Rosen B, Engholm G, Gjerstorff ML, Hatcher J, Johannesen TB, McGahan CE, Meechan D, Middleton R, Tracey E, Turner D, Richards MA, Rachet B, ICBP Module 1 Working Group Stage at diagnosis and ovarian cancer survival: evidence from the International Cancer Benchmarking Partnership. Gynecol Oncol. 2012;127:75–82.
    1. Maringe C, Walters S, Rachet B, Butler J, Fields T, Finan P, Maxwell R, Nedrebø B, Påhlman L, Sjövall A, Spigelman A, Engholm G, Gavin A, Gjerstorff ML, Hatcher J, Johannesen TB, Morris E, McGahan CE, Tracey E, Turner D, Richards MA, Coleman MP, ICBP Module 1 Working Group Stage at diagnosis and colorectal cancer survival in six high-income countries: a population-based study of patients diagnosed during 2000-2007. Acta Oncol. 2013;52:919–932.
    1. McPhail S, Elliss-Brookes L, Shelton J, Ives A, Greenslade M, Vernon S, Morris EJA, Richards M. Emergency presentation of cancer and short-term mortality. Br J Cancer. 2013;109:2027–2034.
    1. Peake MD. Deprivation, distance and death in lung cancer. Thorax. 2014;70:108–109.
    1. Riaz S, Linklater KM, Møller H, Lüchtenborg M.2013. Diverging trends in lung cancer survival between males and females 1999–2008. NCIN short report. Available at .
    1. Richards M. EUROCARE-4 studies bring new data on cancer survival. Lancet Oncol. 2007;8:752–753.
    1. Richards M. The National Awareness and Early Diagnosis Initiative in England: assembling the evidence. Br J Cancer. 2009;101:S1–S4.
    1. Richards M. The size of the prize for earlier diagnosis of cancer in England. Br J Cancer. 2009;101:S125–S129.
    1. Sant M, Allemani C, Capocaccia R, Hakulinen T, Aareleid T, Coebergh JW, Coleman MP, Grosclaude P, Martinez C, Bell J, Youngson J, Berrino F, EUROCARE Working Group Stage at diagnosis is a key explanation of differences in breast cancer survival across Europe. Int J Cancer. 2003;106:416–422.
    1. Sobin LH, Gospodarowicz MK, Wittekind Ch.(eds) (2009TNM Classification of Malignant Tumors7th ednWiley-Blackwell: Oxford, UK; ISBN 978-1-4443-3241-4:310.
    1. Solomon T, Rachet B, Drummond R, Rowlands S, Brown P, Bannister N, Gordon E, Coleman MP.2014Cancer survival in England: adults diagnosed 2008 to 2012, followed up to 2013 ONS Stat Bull 1–17. . .
    1. Solomon T, Rachet B, Whitehead S, Coleman MP.2013Cancer survival in England: patients diagnosed 2007–2011 and followed up to 2012 ONS Stat Bull 1–12. . .
    1. StataCorp. Stata Statistical Software: Release 12. StataCorp LP: College Station, TX, USA; 2011.
    1. Thomson C, Forman D. Cancer survival in England and the influence of early diagnosis: what can we learn from recent EUROCARE results. Br J Cancer. 2009;101:S102–S109.
    1. Verdecchia A, Francisci S, Brenner H, Gatta G, Micheli A, Mangone L, Kunkler I. EUROCARE-4 Working Group. Recent cancer survival in Europe: a period analysis 2000–2002 of the EUROCARE-4 data. Lancet Oncol. 2007;8:784–796.
    1. Walters S, Maringe C, Butler J, Rachet B, Barrett-Lee P, Bergh J, Boyages J, Christiansen P, Lee M, Wärnberg F, Allemani C, Engholm G, Fornander T, Gjerstorff ML, Johannesen TB, Lawrence G, McGahan CE, Middleton R, Steward J, Tracey E, Turner D, Richards MA, Coleman MP, ICBP Module 1 Working Group Breast cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK, 2000-2007: a population-based study. Br J Cancer. 2013;108:1195–1208.
    1. Walters S, Maringe M, Coleman P, Peake M, Butler J, Young N, Bergström S, Hanna L, Jakobsen E, Kölbeck K, Sundstrøm S, Engholm G, Gavin A, Gjerstorff ML, Hatcher J, Johannesen TB, Linklater KM, McGahan CE, Steward J, Tracey E, Turner D, Richards MA, Rachet B, ICBP Module 1 Working Group Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the United Kingdom: a population-based study, 2004-2007. Thorax. 2013;68:551–564.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner