Dataset Information

Breast cancer survival in the US and Europe: a CONCORD high-resolution study.

ABSTRACT: Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5-6%). Net survival in Northern, Western and Southern Europe (81-84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70-99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment.

SUBMITTER: Allemani C

PROVIDER: S-EPMC4706735 | biostudies-literature | 2013 Mar

REPOSITORIES: biostudies-literature

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Breast cancer survival in the US and Europe: a CONCORD high-resolution study.

Allemani Claudia C Sant Milena M Weir Hannah K HK Richardson Lisa C LC Baili Paolo P Storm Hans H Siesling Sabine S Torrella-Ramos Ana A Voogd Adri C AC Aareleid Tiiu T Ardanaz Eva E Berrino Franco F Bielska-Lasota Magdalena M Bolick Susan S Cirilli Claudia C Colonna Marc M Contiero Paolo P Cress Rosemary R Crocetti Emanuele E Fulton John P JP Grosclaude Pascale P Hakulinen Timo T Izarzugaza M Isabel MI Malmström Per P Peignaux Karin K Primic-Žakelj Maja M Rachtan Jadwiga J Safaei Diba Chakameh C Sánchez Maria-José MJ Schymura Maria J MJ Shen Tiefu T Traina Adele A Tryggvadottir Laufey L Tumino Rosario R Velten Michel M Vercelli Marina M Wolf Holly J HJ Woronoff Anne-Sophie AS Wu Xiaocheng X Coleman Michel P MP

International journal of cancer 20120918 5

Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival ...[more]

PMID: 22815141

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Project description:BACKGROUND:In the first CONCORD study (2008), 5-year survival for patients diagnosed with colon cancer between 1990 and 1994 in the United States was among the highest in the world (60%), but there were large racial disparities in most participating states. The CONCORD-2 study (2015) enabled the examination of survival trends between 1995 and 2009 for US states by race and stage. METHODS:The authors analyzed data from 37 state population-based cancer registries, covering approximately 80% of the US population, for patients who were diagnosed with colon cancer between 2001 and 2009 and were followed through 2009. Survival up to 5 years was corrected for background mortality (net survival) using state-specific and race-specific life tables and age-standardized using the International Cancer Survival Standard weights. Survival is presented by race (all, black, white), stage, state, and calendar period (2001-2003 and 2004-2009) to account for changes in methods used to collect stage. RESULTS:Five-year net survival increased by 0.9%, from 63.7% between 2001 and 2003 to 64.6% between 2004 and 2009. More black than white patients were diagnosed with distant-stage disease between 2001 and 2003 (21.5% vs 17.2%) and between 2004 and 2009 (23.3% vs 18.8%). Survival improved for both blacks and whites, but 5-year net survival was 9-10% lower for blacks than for whites both between 2001 and 2003 (54.7% vs 64.5%) and between 2004 and 2009 (56.6% vs 65.4%). The absolute difference between blacks and whites decreased by only 1% during the decade. CONCLUSIONS:Five-year net survival from colon cancer increased slightly over time. Survival among blacks diagnosed between 2004 and 2009 had still not reached the level of that among whites diagnosed between 1990 and 1994, some 15 to 20 years earlier. These findings suggest a need for more targeted efforts to improve screening and to ensure timely, appropriate treatment, especially for blacks, to reduce this large and persistent disparity in survival. Cancer 2017;123:5014-36. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Dataset Information

Breast cancer survival in the US and Europe: a CONCORD high-resolution study.

Publications

Breast cancer survival in the US and Europe: a CONCORD high-resolution study.

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