Roberta De Angelis1, Pamela Minicozzi2, Milena Sant2, Luigino Dal Maso3, David H Brewster4, Gemma Osca-Gelis5, Otto Visser6, Marc Maynadié7, Rafael Marcos-Gragera8, Xavier Troussard9, Dominic Agius10, Paolo Roazzi11, Elisabetta Meneghini2, Alain Monnereau12. 1. Centro Nazionale di Epidemiologia, Sorveglianza e promozione della Salute (CNESPS), Istituto Superiore di Sanità (ISS), Rome, Italy. Electronic address: roberta.deangelis@iss.it. 2. Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 3. Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy. 4. Scottish Cancer Registry, Public Health & Intelligence, NHS National Services Scotland, Edinburgh EH12 9EB, UK. 5. Epidemiology Unit and Girona Cancer Registry (Oncology Coordination Plan), Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute, Girona, Spain; Research Group on Statistics, Econometrics and Health (GRECS), Universitat de Girona, Girona, Spain. 6. Department of registration, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands. 7. Registre des Hémopathies Malignes de Côte d'Or, EA 4184, Université de Bourgogne, Service d'Hématologie Biologique, CHU de Dijon, France. 8. Epidemiology Unit and Girona Cancer Registry (Oncology Coordination Plan), Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute, Girona, Spain. 9. Registre Régional des Hémopathies Malignes de Basse Normandie, CHU Côte de Nacre, France. 10. Malta National Cancer Registry, Malta. 11. Servizio Elaborazione Dati (SIDBAE), Istituto Superiore di Sanità (ISS), Roma, Italy. 12. Registre des hémopathies malignes de la Gironde, Institut Bergonié, Bordeaux, France 12 Centre Inserm U897, CIC 1401, Bordeaux, France.
Abstract
BACKGROUND: Significant advances in the management of patients with lymphoid and myeloid malignancies entered clinical practice in the early 2000's. The EUROCARE-5 study database provides an opportunity to assess the impact of these changes at the population level by country in Europe. We provide survival estimates for clinically relevant haematological malignancies (HM), using the International Classification of Diseases for Oncology 3, by country, gender and age in Europe. METHODS: We estimated age-standardised relative survival using the complete cohort approach for 625,000 adult patients diagnosed in 2000-2007 and followed up to 2008. Survival information was provided by 89 participating cancer registries from 29 European countries. Mean survival in Europe was calculated as the population weighted average of country-specific estimates. RESULTS: On average in Europe, 5-year relative survival was highest for Hodgkin lymphoma (81%; 40,625 cases), poorest for acute myeloid leukaemia (17%; 57,026 cases), and intermediate for non-Hodgkin lymphoma (59%; 329,204 cases), chronic myeloid leukaemia (53%; 17,713 cases) and plasma cell neoplasms (39%; 94,024 cases). Survival was generally lower in Eastern Europe and highest in Central and Northern Europe. Wider between country differences (>10%) were observed for malignancies that benefited from therapeutic advances, such as chronic myeloid leukaemia, chronic lymphocytic leukaemia, follicular lymphoma, diffuse large B-cell lymphoma and multiple myeloma. Lower differences (<10%) were observed for Hodgkin lymphoma. CONCLUSIONS: Delayed or reduced access to innovative and appropriate therapies could plausibly have contributed to the observed geographical disparities between European regions and countries. Population based survival by morphological sub-type is important for measuring outcomes of HM management. To better inform quality of care research, the collection of detailed clinical information at the population level should be prioritised.
BACKGROUND: Significant advances in the management of patients with lymphoid and myeloid malignancies entered clinical practice in the early 2000's. The EUROCARE-5 study database provides an opportunity to assess the impact of these changes at the population level by country in Europe. We provide survival estimates for clinically relevant haematological malignancies (HM), using the International Classification of Diseases for Oncology 3, by country, gender and age in Europe. METHODS: We estimated age-standardised relative survival using the complete cohort approach for 625,000 adult patients diagnosed in 2000-2007 and followed up to 2008. Survival information was provided by 89 participating cancer registries from 29 European countries. Mean survival in Europe was calculated as the population weighted average of country-specific estimates. RESULTS: On average in Europe, 5-year relative survival was highest for Hodgkin lymphoma (81%; 40,625 cases), poorest for acute myeloid leukaemia (17%; 57,026 cases), and intermediate for non-Hodgkin lymphoma (59%; 329,204 cases), chronic myeloid leukaemia (53%; 17,713 cases) and plasma cell neoplasms (39%; 94,024 cases). Survival was generally lower in Eastern Europe and highest in Central and Northern Europe. Wider between country differences (>10%) were observed for malignancies that benefited from therapeutic advances, such as chronic myeloid leukaemia, chronic lymphocytic leukaemia, follicular lymphoma, diffuse large B-cell lymphoma and multiple myeloma. Lower differences (<10%) were observed for Hodgkin lymphoma. CONCLUSIONS: Delayed or reduced access to innovative and appropriate therapies could plausibly have contributed to the observed geographical disparities between European regions and countries. Population based survival by morphological sub-type is important for measuring outcomes of HM management. To better inform quality of care research, the collection of detailed clinical information at the population level should be prioritised.
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