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

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    Authors
    Quaglia, Alberto
    Tavilla, Andrea
    Shack, Lorraine G
    Brenner, Hermann
    Janssen-Heijnen, Maryska
    Allemani, Claudia
    Colonna, Marc
    Grande, Enrico
    Grosclaude, Pascale
    Vercelli, Marina
    Affiliation
    Liguria Cancer Registry, National Cancer Research Institute, Genoa 16132, Italy. alberto.quaglia@istge.it
    Issue Date
    2009-04
    
    Metadata
    Show full item record
    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.
    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
    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
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ejca.2008.11.028
    Scopus Count
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    North West Cancer Intelligence Service

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