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@ARTICLE{Minicozzi:132724,
      author       = {P. Minicozzi and P. M. Walsh and M.-J. Sánchez and A.
                      Trama and K. Innos and R. Marcos-Gragera and N. Dimitrova
                      and L. Botta and T. B. Johannesen and S. Rossi and M. Sant
                      and H. Brenner$^*$},
      collaboration = {E. W. Group},
      title        = {{I}s low survival for cancer in {E}astern {E}urope due
                      principally to late stage at diagnosis?},
      journal      = {European journal of cancer},
      volume       = {93},
      issn         = {0959-8049},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2018-00378},
      pages        = {127 - 137},
      year         = {2018},
      note         = {EUROCARE-5 Working Group: Collaborator from DKFZ: Brenner
                      H},
      abstract     = {Cancer 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.},
      cin          = {C070 / G110},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29518726},
      doi          = {10.1016/j.ejca.2018.01.084},
      url          = {https://inrepo02.dkfz.de/record/132724},
}