Colorectal cancer survival in the USA and Europe: a CONCORD high-resolution study

被引：63

作者：

Allemani, Claudia ^{[1
]}

Rachet, Bernard ^{[1
]}

Weir, Hannah K. ^{[2
]}

Richardson, Lisa C. ^{[2
]}

Lepage, Come ^{[3
]}

Faivre, Jean ^{[3
]}

Gatta, Gemma ^{[4
]}

Capocaccia, Riccardo ^{[5
]}

Sant, Milena ^{[6
]}

Baili, Paolo ^{[6
]}

Lombardo, Claudio ^{[7
]}

Aareleid, Tiiu ^{[8
]}

Ardanaz, Eva ^{[9
,10
]}

Bielska-Lasota, Magdalena ^{[11
]}

Bolick, Susan ^{[12
]}

Cress, Rosemary ^{[13
]}

Elferink, Marloes ^{[14
]}

Fulton, John P. ^{[15
]}

Galceran, Jaume ^{[16
]}

Gozdz, Stanislaw ^{[17
,18
]}

Hakulinen, Timo ^{[19
]}

Primic-Zakelj, Maja ^{[20
]}

Rachtan, Jadwiga ^{[21
]}

Diba, Chakameh Safaei ^{[22
]}

Sanchez, Maria-Jose ^{[23
,24
]}

Schymura, Maria J. ^{[25
]}

Shen, Tiefu ^{[26
]}

Tagliabue, Giovanna ^{[27
,28
]}

Tumino, Rosario ^{[29
,30
]}

Vercelli, Marina ^{[31
,32
]}

Wolf, Holly J. ^{[33
]}

Wu, Xiao-Cheng ^{[34
]}

Coleman, Michel P. ^{[1
]}

机构：

[1] London Sch Hyg & Trop Med, Dept Noncommunicable Dis Epidemiol, Canc Res UK Canc Survival Grp, London WC1, England

[2] Ctr Dis Control & Prevent, Div Canc Prevent & Control, Atlanta, GA USA

[3] Fac Med, Cote dOr Digest Canc Registry, Dijon, France

[4] Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Evaluat Epidemiol Unit, Milan, Italy

[5] Natl Inst Hlth, Natl Ctr Epidemiol Surveillance & Promot Hlth, Rome, Italy

[6] Fdn IRCCS Ist Nazl Tumori, Descript Studies & Hlth Planning Unit, Milan, Italy

[7] Alleanza Cancro Cancro, Rome, Italy

[8] Natl Inst Hlth Dev, Dept Epidemiol & Biostat, Tallinn, Estonia

[9] Navarra Publ Hlth Inst, Navarra Canc Registry, Navarra, Spain

[10] CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain

[11] Natl Inst Hyg, Natl Inst Publ Hlth, PL-00791 Warsaw, Poland

[12] Off Publ Hlth Stat & Informat Syst, South Carolina Cent Canc Registry, SC Dept Hlth & Environm Control, Columbia, SC USA

[13] Canc Registry Greater Calif, Publ Hlth Inst, Sacramento, CA USA

[14] Comprehens Canc Ctr Netherlands, Utrecht, Netherlands

[15] Rhode Isl Canc Registry, Rhode Isl Dept Hlth, Providence, RI USA

[16] Pere Virgili Hlth Res Inst, Fdn Soc Canc Res & Prevent, Tarragona Canc Registry, Tarragona, Spain

[17] Holycross Canc Ctr, Swietokrzyskie Centrum Onkol, Kielce, Poland

[18] Jan Kochanowski Univ Humanities & Sci Kielce, Fac Hlth Sci, Kielce, Poland

[19] Finnish Canc Registry, FIN-00170 Helsinki, Finland

[20] Inst Oncol Ljubljana, Epidemiol & Canc Registry, Ljubljana, Slovenia

[21] M Sklodowska Curie Mem Canc Inst, Cracow Canc Registry, Ctr Oncol, Krakow, Poland

[22] Natl Hlth Informat Ctr, Natl Canc Registry Slovakia, Bratislava, Slovakia

[23] Andalusian Sch Publ Hlth, Granada, Spain

[24] CIBERESP, Madrid, Spain

[25] New York State Canc Registry, New York State Dept Hlth, Albany, NY USA

[26] Illinois State Canc Registry, Illinois Dept Publ Hlth, Springfield, IL USA

[27] Fdn IRCCS Ist Nazl Tumori, Canc Registry, Milan, Italy

[28] Fdn IRCCS Ist Nazl Tumori, Environm Epidemiol Div, Milan, Italy

[29] ASP Ragusa, Civile MP Arezzo Hosp, Canc Registry, Ragusa, Italy

[30] ASP Ragusa, Civile MP Arezzo Hosp, Histopathol Unit, Ragusa, Italy

[31] IRCCS Azienda Osped Univ San Martino, USM IST, IST Ist Nazl Ric Cancro, UOS Epidemiol Descritt, Genoa, Italy

[32] Univ Genoa, Dipartimento Sci Salute, Sez Epidemiol Descritt, Genoa, Italy

[33] Univ Colorado, Ctr Canc, Colorado Sch Publ Hlth, Canc Prevent & Control Div, Aurora, CO USA

[34] LSU, Hlth Sci Ctr, Sch Publ Hlth, Louisiana Tumor Registry, New Orleans, LA USA

来源：

BMJ OPEN | 2013年 / 3卷 / 09期

关键词：

TOTAL MESORECTAL EXCISION; FLEXIBLE PARAMETRIC MODELS; QUALITY-OF-LIFE; PREOPERATIVE RADIOTHERAPY; RECTAL-CANCER; ADJUVANT CHEMOTHERAPY; RELATIVE SURVIVAL; ELDERLY-PATIENTS; COLON-CANCER; POPULATION;

D O I：

10.1136/bmjopen-2013-003055

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: To assess the extent to which stage at diagnosis and adherence to treatment guidelines may explain the persistent differences in colorectal cancer survival between the USA and Europe. Design: A high-resolution study using detailed clinical data on Dukes' stage, diagnostic procedures, treatment and follow-up, collected directly from medical records by trained abstractors under a single protocol, with standardised quality control and central statistical analysis. Setting and participants: 21 population-based registries in seven US states and nine European countries provided data for random samples comprising 12 523 adults (15-99 years) diagnosed with colorectal cancer during 1996-1998. Outcome measures: Logistic regression models were used to compare adherence to 'standard care' in the USA and Europe. Net survival and excess risk of death were estimated with flexible parametric models. Results: The proportion of Dukes' A and B tumours was similar in the USA and Europe, while that of Dukes' C was more frequent in the USA (38% vs 21%) and of Dukes' D more frequent in Europe (22% vs 10%). Resection with curative intent was more frequent in the USA (85% vs 75%). Elderly patients (75-99 years) were 70-90% less likely to receive radiotherapy and chemotherapy. Age-standardised 5-year net survival was similar in the USA (58%) and Northern and Western Europe (54-56%) and lowest in Eastern Europe (42%). The mean excess hazard up to 5 years after diagnosis was highest in Eastern Europe, especially among elderly patients and those with Dukes' D tumours. Conclusions: The wide differences in colorectal cancer survival between Europe and the USA in the late 1990s are probably attributable to earlier stage and more extensive use of surgery and adjuvant treatment in the USA.

引用

页数：11

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