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000132724 0247_ $$2doi$$a10.1016/j.ejca.2018.01.084
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000132724 0247_ $$2ISSN$$a1879-0852
000132724 0247_ $$2ISSN$$a1879-2995
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000132724 037__ $$aDKFZ-2018-00378
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000132724 1001_ $$aMinicozzi, Pamela$$b0
000132724 245__ $$aIs low survival for cancer in Eastern Europe due principally to late stage at diagnosis?
000132724 260__ $$aAmsterdam [u.a.]$$bElsevier$$c2018
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000132724 500__ $$aEUROCARE-5 Working Group: Collaborator from DKFZ: Brenner H
000132724 520__ $$aCancer survival has persistently been shown to be worse for Eastern European and UK/Ireland patients than those of other European regions. This is often attributed to later stage at diagnosis. However, few stage-specific survival comparisons are available, so it is unclear whether poorer quality treatment or other factors also contribute. For the first time, European cancer registries have provided stage-at-diagnosis data to EUROCARE, enabling population-based stage-specific survival estimates across Europe.In this retrospective observational study, stage at diagnosis (as TNM, condensed TNM, or Extent of Disease) was analysed for patients (≥15 years) from 15 countries grouped into 4 regions (Northern Europe: Norway; Central Europe: Austria, France, Germany, Switzerland, The Netherlands; Southern Europe: Croatia, Italy, Slovenia, and Spain; and Eastern Europe: Bulgaria, Estonia, Lithuania, Poland, and Slovakia), diagnosed with 7 malignant cancers in 2000-2007, and followed to end of 2008. A new variable (reconstructed stage) was created which used all available stage information. Age-standardised 5-year relative survival (RS) by reconstructed stage was estimated and compared between regions. Excess risks of cancer death in the 5 years after diagnosis were also estimated, taking age, sex and stage into account.Low proportions of Eastern European patients were diagnosed with local stage cancers and high proportions with metastatic stage cancers. Stage-specific RS (especially for non-metastatic disease) was generally lower for Eastern European patients. After adjusting for age, sex, and stage, excess risks of death remained higher for Eastern European patients than for European patients in general.Late diagnosis alone does not explain worse cancer survival in Eastern Europe: greater risk of cancer death together with worse stage-specific survival suggest less effective care, probably in part because fewer resources are allocated to health care than in the rest of Europe. We recommend that Eastern European cancer registries and other involved bodies to draw attention to poor cancer survival, so as to stimulate research and inform policies to improve outcomes.
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000132724 7001_ $$aWalsh, Paul M$$b1
000132724 7001_ $$aSánchez, Maria-José$$b2
000132724 7001_ $$aTrama, Annalisa$$b3
000132724 7001_ $$aInnos, Kaire$$b4
000132724 7001_ $$aMarcos-Gragera, Rafael$$b5
000132724 7001_ $$aDimitrova, Nadya$$b6
000132724 7001_ $$aBotta, Laura$$b7
000132724 7001_ $$aJohannesen, Tom B$$b8
000132724 7001_ $$aRossi, Silvia$$b9
000132724 7001_ $$aSant, Milena$$b10
000132724 7001_ $$aGroup, EUROCARE-5 Working$$b11$$eCollaboration Author
000132724 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b12$$udkfz
000132724 773__ $$0PERI:(DE-600)1468190-0$$a10.1016/j.ejca.2018.01.084$$gVol. 93, p. 127 - 137$$p127 - 137$$tEuropean journal of cancer$$v93$$x0959-8049$$y2018
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