Magdalena Bielska-Lasota1, Silvia Rossi2, Michalina Krzyżak3, Annemie Haelens4, Augius Domenic5, Roberta De Angelis2, Adam Maciejczyk6, Miguel Rodríguez-Barranco7,8, Vesna Zadnik9, Pamela Minicozzi10,11. 1. Department of Health Promotion and Chronic Diseases Prevention, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland. 2. Department of Oncology and Molecular Medicine, Istituto Superiore Di Sanità, Rome, Italy. 3. Department of Hygiene, Epidemiology and Ergonomics, Medical University of Bialystok, Bialystok, Poland. 4. Research Department, Belgian Cancer Registry, Brussels, Belgium. 5. Malta National Cancer Registry, DHIR, G'Mangia, Malta. 6. Lower Silesia Oncology Centre, Wroclaw, Poland. 7. Andalusian School of Public Health, Instituto de Investigación Biosanitaria de Granada (Ibs.Granada), Granada, Spain. 8. Centro de Investigación Biomédica en Red de Epidemiologia Y Salud Pública (CIBERESP), Madrid, Spain. 9. Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia. 10. Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy. pamela.minicozzi@lshtm.ac.uk. 11. Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. pamela.minicozzi@lshtm.ac.uk.
Abstract
PURPOSE: With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis (local, regional and metastatic), morphology (mainly squamous versus glandular tumours) and patients' age. METHODS: We analysed 101,714 CC women diagnosed in 2000-2007 and followed-up to December 2008. Age-standardised 5-year relative survival (RS) and the excess risks of cancer death in the 5 years after diagnosis were computed. RESULTS: EE women were older and less commonly diagnosed with glandular tumours. Proportions of local stage cancers were similar across Europe, while morphology- and stage-specific RS (especially for non-metastatic disease) were lower in Eastern Europe. Adjusting for age and morphology, excess risk of local stage CC death for EE patients remained higher than that for other European women. CONCLUSION: Stage, age and morphology alone do not explain worse survival in Eastern Europe: less effective care may play a role, probably partly due to fewer or inadequate resources being allocated to health care in this area, compared to the rest of Europe.
PURPOSE: With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis (local, regional and metastatic), morphology (mainly squamous versus glandular tumours) and patients' age. METHODS: We analysed 101,714 CCwomen diagnosed in 2000-2007 and followed-up to December 2008. Age-standardised 5-year relative survival (RS) and the excess risks of cancer death in the 5 years after diagnosis were computed. RESULTS: EE women were older and less commonly diagnosed with glandular tumours. Proportions of local stage cancers were similar across Europe, while morphology- and stage-specific RS (especially for non-metastatic disease) were lower in Eastern Europe. Adjusting for age and morphology, excess risk of local stage CCdeath for EE patients remained higher than that for other European women. CONCLUSION: Stage, age and morphology alone do not explain worse survival in Eastern Europe: less effective care may play a role, probably partly due to fewer or inadequate resources being allocated to health care in this area, compared to the rest of Europe.
Authors: Michael J Birrer; Keiichi Fujiwara; Ana Oaknin; Leslie Randall; Laureen S Ojalvo; Christian Valencia; Isabelle Ray-Coquard Journal: Front Oncol Date: 2022-02-23 Impact factor: 6.244
Authors: Mindaugas Stankūnas; Kersti Pärna; Anna Tisler; Anda Ķīvīte-Urtāne; Una Kojalo; Jana Zodzika; Nicholas Baltzer; Jan Nygard; Mari Nygard; Anneli Uuskula Journal: Acta Med Litu Date: 2022-06-29