Trends in survival rates of cancer in Cuba.

Reports of population-based survival rates of cancer from developing countries are infrequent. In Latin America, only the Cancer Registry of Puerto Rico has published population-based survival data. The National Cancer Registry of Cuba has achieved three survival studies with cases incident in 1976, 1982 and 1988-1989. This article deals with the global observed and relative survival rates estimated in the latter study. Survival time trends are analysed. In the period 1988-1989, 12,985 primary cancer cases were included from the most common cancer sites, with the exclusion of cancer in situ cases and 8900 cases reported by 'death certificate only' (DCO) (35.8%). The vital status of cases was checked up to 31 December 1994 using a mixed follow-up system with the exclusion of 2900 cases lost to follow-up (11.2%). DCO proportions are shown for the major sites and compared to those of 1982. Observed survival rates were estimated by Kaplan-Meier method using the SPSS Statistical Software. The relative rates were estimated by the Hakulinen's Computer Program Package for Cancer Survival Studies (1988) using life tables from Cuban population. Statistical comparisons of survival curves by year of diagnosis were achieved by using the Log-Rank and Pearson statistic tests. Global results are shown by year of follow-up and a comparative analysis is done in time and with internationals values. Survival rates decreased in the period 1982/1988-1989 for colon, prostate and lung cancer. Prostate cancer shows a low five years relative survival rate when compared with the USA, but its observed rate is comparable with Puerto Rico's. Figures for mouth and lung cancer were comparable with the corresponding figures of the USA and Europe. Breast and cervix cancers rates are comparable with the European mean and the blacks in USA.