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      Cancer cure for 32 cancer types: results from the EUROCARE-5 study

      1 , 1 , 2 , 3 , 1 , 2 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 1 , 4 , 11 , 10 , 5 , 12 , 13 , 10 , 5 , 3 , 14 , 2 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , EUROCARE-5 Working Group
      International Journal of Epidemiology
      Oxford University Press (OUP)

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          Abstract

          Background

          Few studies have estimated the probability of being cured for cancer patients. This study aims to estimate population-based indicators of cancer cure in Europe by type, sex, age and period.

          Methods

          7.2 million cancer patients (42 population-based cancer registries in 17 European countries) diagnosed at ages 15–74 years in 1990–2007 with follow-up to 2008 were selected from the EUROCARE-5 dataset. Mixture-cure models were used to estimate: (i) life expectancy of fatal cases (LEF); (ii) cure fraction (CF) as proportion of patients with same death rates as the general population; (iii) time to cure (TTC) as time to reach 5-year conditional relative survival (CRS) >95%.

          Results

          LEF ranged from 10 years for chronic lymphocytic leukaemia patients to <6 months for those with liver, pancreas, brain, gallbladder and lung cancers. It was 7.7 years for patients with prostate cancer at age 65–74 years and >5 years for women with breast cancer. The CF was 94% for testis, 87% for thyroid cancer in women and 70% in men, 86% for skin melanoma in women and 76% in men, 66% for breast, 63% for prostate and <10% for liver, lung and pancreatic cancers. TTC was <5 years for testis and thyroid cancer patients diagnosed below age 55 years, and <10 years for stomach, colorectal, corpus uteri and melanoma patients of all ages. For breast and prostate cancers, a small excess (CRS < 95%) remained for at least 15 years.

          Conclusions

          Estimates from this analysis should help to reduce unneeded medicalization and costs. They represent an opportunity to improve patients’ quality of life.

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          Most cited references35

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          Causes of death among cancer patients

          The purpose of our study was to characterize the causes of death among cancer patients as a function of objectives: (i) calendar year, (ii) patient age, and (iii) time after diagnosis.
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            Is Open Access

            Cost of care for cancer patients in England: evidence from population-based patient-level data

            Background: Health systems are facing the challenge of providing care to an increasing population of patients with cancer. However, evidence on costs is limited due to the lack of large longitudinal databases. Methods: We matched cost of care data to population-based, patient-level data on cancer patients in England. We conducted a retrospective cohort study including all patients age 18 and over with a diagnosis of colorectal (275 985 patients), breast (359 771), prostate (286 426) and lung cancer (283 940) in England between 2001 and 2010. Incidence costs, prevalence costs, and phase of care costs were estimated separately for patients age 18–64 and ⩾65. Costs of care were compared by patients staging, before and after diagnosis, and with a comparison population without cancer. Results: Incidence costs in the first year of diagnosis are noticeably higher in patients age 18–64 than age ⩾65 across all examined cancers. A lower stage diagnosis is associated with larger cost savings for colorectal and breast cancer in both age groups. The additional costs of care because of the main four cancers amounts to £1.5 billion in 2010, namely 3.0% of the total cost of hospital care. Conclusions: Population-based, patient-level data can be used to provide new evidence on the cost of cancer in England. Early diagnosis and cancer prevention have scope for achieving large cost savings for the health system.
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              Clinical relevance of conditional survival of cancer patients in europe: age-specific analyses of 13 cancers.

              When cancer survivors wish to receive accurate information on their current prognosis during follow-up, conditional 5-year relative survival may be most suitable. We have estimated conditional 5-year relative survival for 13 cancers using a large European database-European Network for Indicators on Cancer (EUNICE)-of 10 dedicated long-standing cancer registries across Europe. Patients age 15 years and older diagnosed between 1985 and 2004 were included. Conditional 5-year relative survival for each age group was computed for every additional year survived up to 10 years. Period analysis with follow-up period 2000 to 2004 was used. All patients with cutaneous melanoma or colorectal, endometrial, or testis cancer and younger patients with stomach, glottis, cervix, ovary, or thyroid cancer or non-Hodgkin's lymphoma exhibited hardly any excess mortality (conditional 5-year relative survival > 95%) given that they were alive at a defined time point within 10 years of initial diagnosis. However, patients with supraglottis, lung, breast, and kidney cancer, as well as older patients with most cancers exhibited substantial excess mortality (conditional 5-year relative survival < 90%). Initial differences in relative survival at diagnosis between age groups largely disappeared with time since initial diagnosis for melanoma, or stomach, colorectal, corpus uteri, or testicular cancer but persisted for patients diagnosed with other tumors. Differences between stage groups became smaller over time or disappeared. Conditional relative survival shows clinically relevant variations according to time since diagnosis, type of cancer, and age, and can help serve as a guide for cancer survivors in planning for their future and for doctors in planning schedules for surveillance.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                International Journal of Epidemiology
                Oxford University Press (OUP)
                0300-5771
                1464-3685
                September 28 2020
                September 28 2020
                Affiliations
                [1 ]Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
                [2 ]National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy
                [3 ]Veneto Tumour Registry, Azienda Zero, Padua, Italy
                [4 ]Evaluative Epidemiology Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
                [5 ]Registre Bourguignon des Cancers Digestifs, INSERM UMR 1231, CHU de Dijon, Université de Bourgogne, Dijon, France
                [6 ]Editorial Board, Epidemiologia & Prevenzione, Milan, Italy
                [7 ]Registre du Cancer de l'Isère, Grenoble, France
                [8 ]Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, ItalyAzienda Usl della Romagna, Forlì, Italy
                [9 ]National Institute for Health and Medical Research (INSERM), Paris, France
                [10 ]European Commission, Joint Research Centre (JRC), Ispra, Italy
                [11 ]Institute for Research on Population and Social Policies, National Research Council, Rome, Italy
                [12 ]Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
                [13 ]Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
                [14 ]Department of Oncology and Molecular Medicine, Italian National Institute of Health (ISS), Rome, Italy
                Article
                10.1093/ije/dyaa128
                32984907
                7dcbb8d8-f4fd-4d8e-8069-d3f050dfc2c1
                © 2020

                https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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