Abstract:
Esophageal cancer (EC) and gastric cancer (GC) are fatal cancers with a relatively late age of onset. Age is a negative risk factor for survival in many cancers and our aim was to analyze age-specific survival in EC and GC using the recently updated NORDCAN database. NORDCAN data originate from the Danish, Finnish, Norwegian, and Swedish nationwide cancer registries covering years 1972 through 2021 inviting for comparison of 50-year survival trends between the countries. Relative 1- and 5-year survival and 5/1-year conditional survival (i.e., survival in those who were alive in Year 1 to survive additional 4 years) were analyzed. Survival in EC showed large gains for patients below age 80 years, 5-year survival in Norwegian men reaching 30% and in women over 30% but for 80-89 year old survival remained at 10%. In contrast, hardly any gain was seen among the 80-89 year patients for 1-year survival and small gains in 5 year and 5/1-year survival. Survival gaps between age-groups increased over time. For GC there was also a clear age-related negative survival gradient but the survival gaps between the age groups did not widen over time; Norwegian male and female 5-year survival for 80-89 year old was about 20%. The age-specific survival difference in GC arose in Year 1 and did not essentially increase in 5-year survival. While there were differences in survival improvements between the countries, poor survival of the 80-89 year old patients was shared by all of them. To conclude, survival has improved steadily in younger GC and EC patients in most Nordic countries. While the 80-89 year old population accounts for nearly a quarter of all patients and their poor survival depressed overall survival, which can therefore be increased further by improving diagnostics, treatment and care of elderly EC and GC patients.
摘要:
食管癌(EC)和胃癌(GC)是致命的癌症,发病年龄相对较晚。年龄是许多癌症生存的负面风险因素,我们的目的是使用最近更新的NORDCAN数据库分析EC和GC的年龄特异性生存。NORDCAN数据来源于丹麦,芬兰语,挪威语,和瑞典全国性癌症登记处,涵盖1972年至2021年,邀请比较各国之间的50年生存趋势。相对1年和5年生存率和5/1年条件生存率(即,分析了在第1年还活着的人的存活率,以再存活4年)。对于80岁以下的患者,EC的生存率有很大的提高,挪威男性的5年生存率达到30%,女性超过30%,但80-89岁的生存率保持在10%。相比之下,在80-89岁的患者中,1年生存率几乎没有任何增加,在5年和5/1年生存率中略有增加。年龄组之间的生存差距随着时间的推移而增加。对于GC,还存在明显的与年龄相关的负生存梯度,但年龄组之间的生存差距并没有随着时间的推移而扩大;挪威男性和女性在80-89岁的5年生存率约为20%。GC的年龄特异性存活差异出现在第1年,并且在5年存活中基本上没有增加。虽然各国在生存改善方面存在差异,所有80-89岁患者的生存率都很低。最后,在大多数北欧国家,年轻GC和EC患者的生存率稳步提高.虽然80-89岁的人群占所有患者的近四分之一,但他们的低生存率降低了总体生存率。因此,可以通过改进诊断来进一步提高,老年EC和GC患者的治疗和护理。