The cancer survival gap between elderly and middle-aged patients in Europe is widening.
Shack, Lorraine G
AffiliationLiguria Cancer Registry, National Cancer Research Institute, Genoa 16132, Italy. email@example.com
MetadataShow full item record
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.
CitationThe cancer survival gap between elderly and middle-aged patients in Europe is widening. 2009, 45 (6):1006-16 Eur. J. Cancer
JournalEuropean Journal of Cancer
- Relative survival in elderly European cancer patients: evidence for health care inequalities. The EUROCARE Working Group.
- Authors: Vercelli M, Capocaccia R, Quaglia A, Casella C, Puppo A, Coebergh JW
- Issue date: 2000 Sep
- Clinical relevance of conditional survival of cancer patients in europe: age-specific analyses of 13 cancers.
- Authors: Janssen-Heijnen ML, Gondos A, Bray F, Hakulinen T, Brewster DH, Brenner H, Coebergh JW
- Issue date: 2010 May 20
- Survival trends in European cancer patients diagnosed from 1988 to 1999.
- Authors: Verdecchia A, Guzzinati S, Francisci S, De Angelis R, Bray F, Allemani C, Tavilla A, Santaquilani M, Sant M, EUROCARE Working Group.
- Issue date: 2009 Apr
- Trends in the overall survival of cancer patients diagnosed 1964-2003 in the Nordic countries followed up to the end of 2006: the importance of case-mix.
- Authors: Storm HH, Kejs AM, Engholm G, Tryggvadóttir L, Klint A, Bray F, Hakulinen T
- Issue date: 2010 Jun
- Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s.
- Authors: Karim-Kos HE, de Vries E, Soerjomataram I, Lemmens V, Siesling S, Coebergh JW
- Issue date: 2008 Jul