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Abstract：
BACKGROUND: The Cancer Survival in Africa, Asia, and South America project (SURVCAN-3) of the International Agency for Research on Cancer aims to fill gaps in the availability of population-level cancer survival estimates from countries in these regions. Here, we analysed survival for 18 cancers using data from member registries of the African Cancer Registry Network across 11 countries in sub-Saharan Africa.
METHODS: We included data on patients diagnosed with 18 cancer types between Jan 1, 2005, and Dec 31, 2014, from 13 population-based cancer registries in Cotonou (Benin), Abidjan (CÔte d\'Ivoire), Addis Ababa (Ethiopia), Eldoret and Nairobi (Kenya), Bamako (Mali), Mauritius, Namibia, Seychelles, Eastern Cape (South Africa), Kampala (Uganda), and Bulawayo and Harare (Zimbabwe). Patients were followed up until Dec 31, 2018. Patient-level data including cancer topography and morphology, age and date at diagnosis, vital status, and date of death (if applicable) were collected. The follow-up (survival) time was measured from the date of incidence until the date of last contact, the date of death, or until the end of the study, whichever occurred first. We estimated the 1-year, 3-year, and 5-year survival (observed, net, and age-standardised net survival) by sex, cancer type, registry, country, and human development index (HDI). 1-year and 3-year survival data were available for all registries and all cancer sites, whereas availability of 5-year survival data was slightly more variable; thus to provide medium-term survival prospects, we have focused on 3-year survival in the Results section.
RESULTS: 10 500 individuals from 13 population-based cancer registries in 11 countries were included in the survival analyses. 9177 (87·4%) of 10 500 cases were morphologically verified. Survival from cancers with a high burden and amenable to prevention was poor: the 3-year age-standardised net survival was 52·3% (95% CI 49·4-55·0) for cervical cancer, 18·1% (11·5-25·9) for liver cancer, and 32·4% (27·5-37·3) for lung cancer. Less than half of the included patients were alive 3 years after a cancer diagnosis for eight cancer types (oral cavity, oesophagus, stomach, larynx, lung, liver, non-Hodgkin lymphoma, and leukaemia). There were differences in survival for some cancers by sex: survival was longer for females with stomach or lung cancer than males with stomach or lung cancer, and longer for males with non-Hodgkin lymphomas than females with non-Hodgkin lymphomas. Survival did not differ by country-level HDI for cancers of the oral cavity, oesophagus, liver, thyroid, and for Hodgkin lymphoma.
CONCLUSIONS: For cancers for which population-level prevention strategies exist, and with relatively poor prognosis, these estimates highlight the urgent need to upscale population-level prevention activities in sub-Saharan Africa. These data are vital for providing the knowledge base for advocacy to improve access to prevention, diagnosis, and care for patients with cancers in sub-Saharan Africa.
BACKGROUND: Vital Strategies, the Martin-Luther-University Halle-Wittenberg, and the International Agency for Research on Cancer.
UNASSIGNED: For the French and Portuguese translations of the abstract see Supplementary Materials section.
METHODS: We included data on patients diagnosed with 18 cancer types between Jan 1, 2005, and Dec 31, 2014, from 13 population-based cancer registries in Cotonou (Benin), Abidjan (CÔte d\'Ivoire), Addis Ababa (Ethiopia), Eldoret and Nairobi (Kenya), Bamako (Mali), Mauritius, Namibia, Seychelles, Eastern Cape (South Africa), Kampala (Uganda), and Bulawayo and Harare (Zimbabwe). Patients were followed up until Dec 31, 2018. Patient-level data including cancer topography and morphology, age and date at diagnosis, vital status, and date of death (if applicable) were collected. The follow-up (survival) time was measured from the date of incidence until the date of last contact, the date of death, or until the end of the study, whichever occurred first. We estimated the 1-year, 3-year, and 5-year survival (observed, net, and age-standardised net survival) by sex, cancer type, registry, country, and human development index (HDI). 1-year and 3-year survival data were available for all registries and all cancer sites, whereas availability of 5-year survival data was slightly more variable; thus to provide medium-term survival prospects, we have focused on 3-year survival in the Results section.
RESULTS: 10 500 individuals from 13 population-based cancer registries in 11 countries were included in the survival analyses. 9177 (87·4%) of 10 500 cases were morphologically verified. Survival from cancers with a high burden and amenable to prevention was poor: the 3-year age-standardised net survival was 52·3% (95% CI 49·4-55·0) for cervical cancer, 18·1% (11·5-25·9) for liver cancer, and 32·4% (27·5-37·3) for lung cancer. Less than half of the included patients were alive 3 years after a cancer diagnosis for eight cancer types (oral cavity, oesophagus, stomach, larynx, lung, liver, non-Hodgkin lymphoma, and leukaemia). There were differences in survival for some cancers by sex: survival was longer for females with stomach or lung cancer than males with stomach or lung cancer, and longer for males with non-Hodgkin lymphomas than females with non-Hodgkin lymphomas. Survival did not differ by country-level HDI for cancers of the oral cavity, oesophagus, liver, thyroid, and for Hodgkin lymphoma.
CONCLUSIONS: For cancers for which population-level prevention strategies exist, and with relatively poor prognosis, these estimates highlight the urgent need to upscale population-level prevention activities in sub-Saharan Africa. These data are vital for providing the knowledge base for advocacy to improve access to prevention, diagnosis, and care for patients with cancers in sub-Saharan Africa.
BACKGROUND: Vital Strategies, the Martin-Luther-University Halle-Wittenberg, and the International Agency for Research on Cancer.
UNASSIGNED: For the French and Portuguese translations of the abstract see Supplementary Materials section.
摘要：
背景：非洲的癌症生存，亚洲,国际癌症研究机构的南美项目（SURVCAN-3）旨在填补这些地区国家的人口水平癌症生存率估计的空白。这里,我们使用来自撒哈拉以南非洲11个国家的非洲癌症登记网络成员登记处的数据,分析了18种癌症的生存率.
方法：我们纳入了2005年1月1日至2014年12月31日之间诊断为18种癌症类型的患者的数据，来自科托努（贝宁）的13个基于人群的癌症登记处，阿比让(科特迪瓦)，亚的斯亚贝巴(埃塞俄比亚)，埃尔多雷特和内罗毕(肯尼亚)，巴马科(马里),毛里求斯,纳米比亚,塞舌尔,东开普省(南非),坎帕拉(乌干达)，布拉瓦约和哈拉雷(津巴布韦)。患者随访至2018年12月31日。患者级数据，包括癌症地形和形态学，诊断时的年龄和日期，生命状态,并收集死亡日期（如适用）。随访（生存）时间从发病日期到最后一次接触日期，死亡日期,或者直到研究结束，以先发生者为准。我们估计了一年，3年,和5年生存率（观察，net,和年龄标准化的净存活率)按性别划分，癌症类型,注册表，国家,人类发展指数（HDI）。1年和3年的生存数据可用于所有注册和所有癌症地点，而5年生存数据的可得性稍有变化；因此，为了提供中期生存前景，我们在结果部分重点关注了3年生存率.
结果：来自11个国家的13个基于人群的癌症登记处的10500名个体被纳入生存分析。10500例中的9177例（87·4%）进行了形态学验证。高负担且易于预防的癌症生存率较差：宫颈癌的3岁标准化净生存率为52·3％（95％CI49·4-55·0），18·1%（11·5-25·9）用于肝癌，32·4%(27·5-37·3)为肺癌。不到一半的纳入患者在癌症诊断为八种癌症类型（口腔，食管,胃,喉部,肺，肝脏,非霍奇金淋巴瘤,和白血病)。某些癌症的生存率因性别而异：患有胃癌或肺癌的女性比患有胃癌或肺癌的男性更长，非霍奇金淋巴瘤的男性比非霍奇金淋巴瘤的女性更长。口腔癌的国家/地区HDI生存率没有差异，食管,肝脏,甲状腺，还有霍奇金淋巴瘤.
结论：对于存在人群水平预防策略的癌症，预后相对较差，这些估计突出表明，迫切需要在撒哈拉以南非洲扩大人口一级的预防活动。这些数据对于为宣传提供知识库以改善获得预防的机会至关重要，诊断,并为撒哈拉以南非洲的癌症患者提供护理。
背景：重要策略，马丁-路德大学哈雷-维滕贝格，和国际癌症研究机构。
■有关摘要的法语和葡萄牙语翻译，请参见补充材料部分。
方法：我们纳入了2005年1月1日至2014年12月31日之间诊断为18种癌症类型的患者的数据，来自科托努（贝宁）的13个基于人群的癌症登记处，阿比让(科特迪瓦)，亚的斯亚贝巴(埃塞俄比亚)，埃尔多雷特和内罗毕(肯尼亚)，巴马科(马里),毛里求斯,纳米比亚,塞舌尔,东开普省(南非),坎帕拉(乌干达)，布拉瓦约和哈拉雷(津巴布韦)。患者随访至2018年12月31日。患者级数据，包括癌症地形和形态学，诊断时的年龄和日期，生命状态,并收集死亡日期（如适用）。随访（生存）时间从发病日期到最后一次接触日期，死亡日期,或者直到研究结束，以先发生者为准。我们估计了一年，3年,和5年生存率（观察，net,和年龄标准化的净存活率)按性别划分，癌症类型,注册表，国家,人类发展指数（HDI）。1年和3年的生存数据可用于所有注册和所有癌症地点，而5年生存数据的可得性稍有变化；因此，为了提供中期生存前景，我们在结果部分重点关注了3年生存率.
结果：来自11个国家的13个基于人群的癌症登记处的10500名个体被纳入生存分析。10500例中的9177例（87·4%）进行了形态学验证。高负担且易于预防的癌症生存率较差：宫颈癌的3岁标准化净生存率为52·3％（95％CI49·4-55·0），18·1%（11·5-25·9）用于肝癌，32·4%(27·5-37·3)为肺癌。不到一半的纳入患者在癌症诊断为八种癌症类型（口腔，食管,胃,喉部,肺，肝脏,非霍奇金淋巴瘤,和白血病)。某些癌症的生存率因性别而异：患有胃癌或肺癌的女性比患有胃癌或肺癌的男性更长，非霍奇金淋巴瘤的男性比非霍奇金淋巴瘤的女性更长。口腔癌的国家/地区HDI生存率没有差异，食管,肝脏,甲状腺，还有霍奇金淋巴瘤.
结论：对于存在人群水平预防策略的癌症，预后相对较差，这些估计突出表明，迫切需要在撒哈拉以南非洲扩大人口一级的预防活动。这些数据对于为宣传提供知识库以改善获得预防的机会至关重要，诊断,并为撒哈拉以南非洲的癌症患者提供护理。
背景：重要策略，马丁-路德大学哈雷-维滕贝格，和国际癌症研究机构。
■有关摘要的法语和葡萄牙语翻译，请参见补充材料部分。
