The cancer survival gap between elderly and middle-aged patients in Europe is widening.

2.50
Hdl Handle:
http://hdl.handle.net/10541/74024
Title:
The cancer survival gap between elderly and middle-aged patients in Europe is widening.
Authors:
Quaglia, Alberto; Tavilla, Andrea; Shack, Lorraine G; Brenner, Hermann; Janssen-Heijnen, Maryska; Allemani, Claudia; Colonna, Marc; Grande, Enrico; Grosclaude, Pascale; Vercelli, Marina
Abstract:
The present study is aimed to compare survival and prognostic changes over time between elderly (70-84 years) and middle-aged cancer patients (55-69 years). We considered seven cancer sites (stomach, colon, breast, cervix and corpus uteri, ovary and prostate) and all cancers combined (but excluding prostate and non-melanoma skin cancers). Five-year relative survival was estimated for cohorts of patients diagnosed in 1988-1999 in a pool of 51 European populations covered by cancer registries. Furthermore, we applied the period-analysis method to more recent incidence data from 32 cancer registries to provide 1- and 5-year relative survival estimates for the period of follow-up 2000-2002. A significant survival improvement was observed from 1988 to 1999 for all cancers combined and for every cancer site, except cervical cancer. However, survival increased at a slower rate in the elderly, so that the gap between younger and older patients widened, particularly for prostate cancer in men and for all considered cancers except cervical cancer in women. For breast and prostate cancers, the increasing gap was likely attributable to a larger use of, respectively, mammographic screening and PSA test in middle-aged with respect to the elderly. In the period analysis of the most recent data, relative survival was much higher in middle-aged patients than in the elderly. The differences were higher for breast and gynaecological cancers, and for prostate cancer. Most of this age gap was due to a very large difference in survival after the 1st year following the diagnosis. Differences were much smaller for conditional 5-year relative survival among patients who had already survived the first year. The increase of survival in elderly men is encouraging but the lesser improvement in women and, in particular, the widening gap for breast cancer suggest that many barriers still delay access to care and that enhanced prevention and clinical management remain major issues.
Affiliation:
Liguria Cancer Registry, National Cancer Research Institute, Genoa 16132, Italy. alberto.quaglia@istge.it
Citation:
The cancer survival gap between elderly and middle-aged patients in Europe is widening. 2009, 45 (6):1006-16 Eur. J. Cancer
Journal:
European Journal of Cancer
Issue Date:
Apr-2009
URI:
http://hdl.handle.net/10541/74024
DOI:
10.1016/j.ejca.2008.11.028
PubMed ID:
19121578
Type:
Article
Language:
en
ISSN:
1879-0852
Appears in Collections:
All Christie Publications ; North West Cancer Intelligence Service

Full metadata record

DC FieldValue Language
dc.contributor.authorQuaglia, Alberto-
dc.contributor.authorTavilla, Andrea-
dc.contributor.authorShack, Lorraine G-
dc.contributor.authorBrenner, Hermann-
dc.contributor.authorJanssen-Heijnen, Maryska-
dc.contributor.authorAllemani, Claudia-
dc.contributor.authorColonna, Marc-
dc.contributor.authorGrande, Enrico-
dc.contributor.authorGrosclaude, Pascale-
dc.contributor.authorVercelli, Marina-
dc.date.accessioned2009-07-15T16:22:02Z-
dc.date.available2009-07-15T16:22:02Z-
dc.date.issued2009-04-
dc.identifier.citationThe cancer survival gap between elderly and middle-aged patients in Europe is widening. 2009, 45 (6):1006-16 Eur. J. Canceren
dc.identifier.issn1879-0852-
dc.identifier.pmid19121578-
dc.identifier.doi10.1016/j.ejca.2008.11.028-
dc.identifier.urihttp://hdl.handle.net/10541/74024-
dc.description.abstractThe present study is aimed to compare survival and prognostic changes over time between elderly (70-84 years) and middle-aged cancer patients (55-69 years). We considered seven cancer sites (stomach, colon, breast, cervix and corpus uteri, ovary and prostate) and all cancers combined (but excluding prostate and non-melanoma skin cancers). Five-year relative survival was estimated for cohorts of patients diagnosed in 1988-1999 in a pool of 51 European populations covered by cancer registries. Furthermore, we applied the period-analysis method to more recent incidence data from 32 cancer registries to provide 1- and 5-year relative survival estimates for the period of follow-up 2000-2002. A significant survival improvement was observed from 1988 to 1999 for all cancers combined and for every cancer site, except cervical cancer. However, survival increased at a slower rate in the elderly, so that the gap between younger and older patients widened, particularly for prostate cancer in men and for all considered cancers except cervical cancer in women. For breast and prostate cancers, the increasing gap was likely attributable to a larger use of, respectively, mammographic screening and PSA test in middle-aged with respect to the elderly. In the period analysis of the most recent data, relative survival was much higher in middle-aged patients than in the elderly. The differences were higher for breast and gynaecological cancers, and for prostate cancer. Most of this age gap was due to a very large difference in survival after the 1st year following the diagnosis. Differences were much smaller for conditional 5-year relative survival among patients who had already survived the first year. The increase of survival in elderly men is encouraging but the lesser improvement in women and, in particular, the widening gap for breast cancer suggest that many barriers still delay access to care and that enhanced prevention and clinical management remain major issues.en
dc.language.isoenen
dc.subjectCanceren
dc.subject.meshAge Distribution-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshEurope-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshLife Expectancy-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshNeoplasms-
dc.subject.meshPrognosis-
dc.subject.meshSex Distribution-
dc.subject.meshSurvival Analysis-
dc.titleThe cancer survival gap between elderly and middle-aged patients in Europe is widening.en
dc.typeArticleen
dc.contributor.departmentLiguria Cancer Registry, National Cancer Research Institute, Genoa 16132, Italy. alberto.quaglia@istge.iten
dc.identifier.journalEuropean Journal of Canceren

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