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Rudolph C, Engholm G, Pritzkuleit R, Storm HH, Katalinic A. Colorectal Cancer Survival in German-Danish Border Regions-A Registry-Based Cohort Study. Cancers (Basel) 2023; 15:4474. [PMID: 37760444 PMCID: PMC10526529 DOI: 10.3390/cancers15184474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this study was (i) to update the reporting of colorectal cancer survival differences over time in the German-Danish border region (Schleswig-Holstein, Southern Denmark, and Zealand) and (ii) to assess the extent to which it can be explained by stage and primary treatment. Incident invasive colorectal cancer cases diagnosed from 2004 to 2016 with a follow-up of vital status through 31 December 2017 were extracted from cancer registries. Analyses were conducted by anatomical subsite and for four consecutive periods. Kaplan-Meier curves and log-rank tests were computed. Cox regression models using data from Schleswig-Holstein from 2004 to 2007 as the reference category were run while controlling for age, sex, stage, and treatment. The cox regression models showed decreasing hazard ratios of death for all three regions over time for both anatomical subsites. The improvement was stronger in the Danish regions, and adjustment for age, sex, stage, and treatment attenuated the results only slightly. In 2014-2016, colon cancer survival was similar across regions, while rectal cancer survival was significantly superior in the Danish regions. Regional survival differences can only partially be explained by differing stage distribution and treatment and may be linked additionally to healthcare system reforms and screening efforts.
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Affiliation(s)
- Christiane Rudolph
- Institute for Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Gerda Engholm
- Danish Cancer Society, Strandboulevarden 49, 2100 København, Denmark
| | - Ron Pritzkuleit
- Institute for Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Hans H. Storm
- Danish Cancer Society, Strandboulevarden 49, 2100 København, Denmark
| | - Alexander Katalinic
- Institute for Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
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Rudolph CES, Engholm G, Pritzkuleit R, Storm HH, Katalinic A. Survival of breast cancer patients in German-Danish border regions - A registry-based cohort study. Cancer Epidemiol 2021; 74:102001. [PMID: 34450451 DOI: 10.1016/j.canep.2021.102001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/14/2021] [Accepted: 08/01/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIM Denmark reports slightly lower breast cancer survival before 2010 than its neighbouring country Germany. Previous research is limited by lacking stage and treatment information. This study aims to investigate differences in breast cancer survival between the bordering regions Schleswig-Holstein (Germany), Southern Denmark and Zealand (Denmark) using registry data including stage and treatment information. METHOD Invasive female breast cancer cases diagnosed during 2004-2013 with follow up through 31st December 2014 were extracted from cancer registries. Cases notified by death certificates only and those aged 90+ years were excluded. Kaplan-Meier curves and log-rank tests were computed. Cox regression analysis was conducted with adjustment for year of diagnosis, age, stage, and treatment. RESULTS The analytical sample included 42,966 cases. Kaplan-Meier curves and log-rank tests show significant survival differences between the regions. The Cox regression model adjusted for year of diagnosis and age shows significantly worse overall survival of breast cancer patients in both Danish regions compared to Schleswig-Holstein with hazard ratios (HR) of 1.09 (95 % CI: 1.04; 1.15) for patients from Southern Denmark (SD) and 1.25 (95 % CI: 1.18; 1.32) for residents of Zealand (ZL). This effect diminished after adjustment for stage and treatment (HR: 1.05 (SD), 1.09 (ZL) 95 % CI: 0.99; 1.10 (SD), 1.03; 1.15 (ZL)). CONCLUSION Survival differences can be explained by differing stage distribution and treatment administration, which formerly were more favourable in Schleswig-Holstein. The survival gap will probably close due to Denmark's national screening program and increased use of adjuvant cancer therapy.
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Affiliation(s)
- Christiane E S Rudolph
- Institute for Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Gerda Engholm
- Danish Cancer Society, Strandboulevarden 49, 2100, København, Denmark
| | - Ron Pritzkuleit
- Institute for Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Hans H Storm
- Danish Cancer Society, Strandboulevarden 49, 2100, København, Denmark
| | - Alexander Katalinic
- Institute for Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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Breugom A, Bastiaannet E, Guren M, Kørner H, Boelens P, Dekker F, Kapiteijn E, Gelderblom H, Larsen I, Liefers G, van de Velde C. Treatment strategies and overall survival for incurable metastatic colorectal cancer – A EURECCA international comparison including 21,196 patients from the Netherlands and Norway. Eur J Surg Oncol 2020; 46:1167-1173. [DOI: 10.1016/j.ejso.2020.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/15/2020] [Accepted: 02/10/2020] [Indexed: 12/26/2022] Open
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Ravaioli A, Crocetti E, Mancini S, Baldacchini F, Giuliani O, Vattiato R, Bucchi L, Falcini F. Suicide death among cancer patients: new data from northern Italy, systematic review of the last 22 years and meta-analysis. Eur J Cancer 2020; 125:104-113. [DOI: 10.1016/j.ejca.2019.08.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/13/2019] [Accepted: 08/15/2019] [Indexed: 10/25/2022]
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Piñeros M, Parkin DM, Ward K, Chokunonga E, Ervik M, Farrugia H, Gospodarowicz M, O'Sullivan B, Soerjomataram I, Swaminathan R, Znaor A, Bray F, Brierley J. Essential TNM: a registry tool to reduce gaps in cancer staging information. Lancet Oncol 2019; 20:e103-e111. [PMID: 30712797 DOI: 10.1016/s1470-2045(18)30897-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/20/2018] [Accepted: 11/20/2018] [Indexed: 01/09/2023]
Abstract
Accurate information on the extent of disease around the time of diagnosis is an important component of cancer care, in defining disease prognosis, and evaluating national and international cancer control policies. However, the collection of stage data by population-based cancer registries remains a challenge in both high-income and low and middle-income countries. We emphasise the lack of availability and comparability of staging information in many population-based cancer registries and propose Essential TNM, a simplified staging system for cancer registries when information on full Tumour, Node, Metastasis (TNM) is absent. Essential TNM aims at staging cancer in its most advanced disease form by summarising the extent of disease in the order of distant metastasis (M), regional lymph node involvement (N), and tumour size or extension, or both (T). Flowcharts and rules have been developed for coding these elements in breast, cervix, prostate, and colon cancers, and combining them into stage groups (I-IV) that correspond to those obtained by full TNM staging. Essential TNM is comparable to the Union for International Cancer Control TNM stage groups and is an alternative to providing staging information by the population-based cancer registries that complies with the objectives of the Global Initiative for Cancer Registry Development.
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Affiliation(s)
- Marion Piñeros
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
| | - D Maxwell Parkin
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France; African Cancer Registry Network, Oxford, England
| | - Kevin Ward
- Georgia Center for Cancer Statistics, Atlanta, GA, USA; Board of Directors, International Association of Cancer Registries, Lyon, France
| | | | - Morten Ervik
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Helen Farrugia
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Mary Gospodarowicz
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada; Union for International Cancer Control, Geneva, Switzerland
| | - Brian O'Sullivan
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada; Union for International Cancer Control, Geneva, Switzerland
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Rajaraman Swaminathan
- Division of Epidemiology, Biostatistics and Cancer Registry, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - Ariana Znaor
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - James Brierley
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada; Union for International Cancer Control, Geneva, Switzerland
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To accelerate cancer prevention in Europe: Challenges for cancer registries. Eur J Cancer 2018; 104:151-159. [DOI: 10.1016/j.ejca.2018.09.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/29/2018] [Accepted: 09/04/2018] [Indexed: 01/05/2023]
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Breugom AJ, Bastiaannet E, Boelens PG, Iversen LH, Martling A, Johansson R, Evans T, Lawton S, O'Brien KM, Van Eycken E, Janciauskiene R, Liefers GJ, Cervantes A, Lemmens VEPP, van de Velde CJH. Adjuvant chemotherapy and relative survival of patients with stage II colon cancer - A EURECCA international comparison between the Netherlands, Denmark, Sweden, England, Ireland, Belgium, and Lithuania. Eur J Cancer 2016; 63:110-7. [PMID: 27299663 DOI: 10.1016/j.ejca.2016.04.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 04/14/2016] [Accepted: 04/20/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of the present EURECCA international comparison is to compare adjuvant chemotherapy and relative survival of patients with stage II colon cancer between European countries. METHODS Population-based national cohort data (2004-2009) from the Netherlands (NL), Denmark (DK), Sweden (SE), England (ENG), Ireland (IE), and Belgium (BE) were obtained, as well as single-centre data from Lithuania. All surgically treated patients with stage II colon cancer were included. The proportion of patients receiving adjuvant chemotherapy was calculated and compared between countries. Besides, relative survival was calculated and compared between countries. RESULTS Overall, 59,154 patients were included. The proportion of patients receiving adjuvant chemotherapy ranged from 7.1% to 29.0% (p < 0.001). Compared with NL, a better adjusted relative survival was observed in SE (stage II: relative excess risks (RER) 0.53, 95% confidence interval (CI) 0.44-0.64; p < 0.001), and BE (stage II: RER 0.84, 95% CI 0.76-0.92; p < 0.001), and in IE for patients with stage IIA disease (RER 0.80, 95% CI 0.65-0.98; p = 0.03). CONCLUSION The proportion of patients with stage II colon cancer receiving adjuvant chemotherapy varied largely between seven European countries. No clear linear pattern between adjuvant chemotherapy and adjusted relative survival was observed. Compared with NL, SE and BE showed an improved adjusted relative survival for stage II disease, and IE for patients with stage IIA disease only. Further research into selection criteria for adjuvant chemotherapy could eventually lead to individually tailored, optimal treatment of patients with stage II colon cancer.
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Affiliation(s)
- A J Breugom
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - E Bastiaannet
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - P G Boelens
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - L H Iversen
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - A Martling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - R Johansson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - T Evans
- Public Health England, Birmingham, United Kingdom
| | - S Lawton
- Public Health England, York, United Kingdom
| | - K M O'Brien
- National Cancer Registry Ireland, Cork, Ireland
| | | | - R Janciauskiene
- Oncology Institute of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - G J Liefers
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - A Cervantes
- Department of Haematology and Medical Oncology, Institute of Health Research INCLIVA, University of Valencia, Valencia, Spain
| | - V E P P Lemmens
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Eindhoven, The Netherlands; Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - C J H van de Velde
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
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Coebergh JW, van den Hurk C, Rosso S, Comber H, Storm H, Zanetti R, Sacchetto L, Janssen-Heijnen M, Thong M, Siesling S, van den Eijnden-van Raaij J. EUROCOURSE lessons learned from and for population-based cancer registries in Europe and their programme owners: Improving performance by research programming for public health and clinical evaluation. Eur J Cancer 2015; 51:997-1017. [DOI: 10.1016/j.ejca.2015.02.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/03/2015] [Accepted: 02/03/2015] [Indexed: 01/20/2023]
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