背景:基于人群的癌症生存率是与诊断和治疗相关的癌症控制性能的关键指标,但是,包括低收入环境并将结果与卫生系统和人类发展联系起来的基准研究很少。SURVCAN-3是一项基于人群的癌症登记处的国际合作,旨在对非洲的及时和可比的癌症生存率估计进行基准测试。中美洲和南美洲,和亚洲。
方法:在SURVCAN-3中,来自非洲的基于人群的癌症登记处,中美洲和南美洲,亚洲应邀提供数据。与基于人群的癌症登记处合作进行质量控制和数据检查,如果适用,在注册表中进行了积极的随访.患者级别的数据(性别,诊断时的年龄,诊断日期,形态学和形貌,舞台,生命状态,以及死亡日期或最后一次接触)被包括在内,包括2008年1月1日至2012年12月31日之间诊断的患者,并随访至少2年(至2014年12月31日)。年龄标准化的净生存率(癌症是唯一可能的死亡原因的生存率),95%CI,在1年,3年,诊断后5年,使用Pohar-Perme估计器计算15种主要癌症。1年,3年,和5年净生存估计按大陆内的国家分层(非洲,中美洲和南美洲,和亚洲),和国家根据四级人类发展指数(HDI;低,中等,高,并且非常高)。
结果:纳入了32个国家68个人群癌症登记处的1400435例癌症病例。各国和世界区域的净生存差异很大,随着人类发展指数水平的提高,估计数稳步上升。在包括的癌症类型中,属于最低人类发展指数类别的国家(例如,科特迪瓦)的3年最大净生存率为54·6%(95%CI33·3-71·6;前列腺癌),而那些属于最高人类发展指数类别的人(例如,以色列)的最大生存率为96·8%(96·1-97·3;前列腺癌)。确定了三个不同的组,根据国家和HDI不同,结果不同,取决于癌症类型:3年中位净生存率较低(<30%)和HDI类别差异很小的癌症(例如,肺和胃),具有中等中位3年净生存率(30-79%)和中等HDI差异的癌症(例如,子宫颈和结肠直肠),和具有较高的3年净生存率(≥80%)和HDI差异较大的癌症(例如,乳房和前列腺)。
结论:各国癌症生存率的差异与一个国家的发展地位有关,以及卫生服务的可用性和效率。这些数据可以告知政策制定者癌症控制的优先事项,以减少癌症结果中的明显不平等。
背景:塔塔纪念医院,马丁-路德大学哈雷-维滕贝格,和国际癌症研究机构。
Population-based cancer survival is a key measurement of cancer control performance linked to diagnosis and treatment, but benchmarking studies that include lower-income settings and that link results to health systems and human development are scarce. SURVCAN-3 is an international collaboration of population-based cancer registries that aims to benchmark timely and comparable cancer survival estimates in Africa, central and south America, and Asia.
In SURVCAN-3, population-based cancer registries from Africa, central and south America, and Asia were invited to contribute data. Quality control and data checks were carried out in collaboration with population-based cancer registries and, where applicable, active follow-up was performed at the registry. Patient-level data (sex, age at diagnosis, date of diagnosis, morphology and topography, stage, vital status, and date of death or last contact) were included, comprising patients diagnosed between Jan 1, 2008, and Dec 31, 2012, and followed up for at least 2 years (until Dec 31, 2014). Age-standardised net survival (survival where cancer was the only possible cause of death), with 95% CIs, at 1 year, 3 years, and 5 years after diagnosis were calculated using Pohar-Perme estimators for 15 major cancers. 1-year, 3-year, and 5-year net survival estimates were stratified by countries within continents (Africa, central and south America, and Asia), and countries according to the four-tier Human Development Index (HDI; low, medium, high, and very high).
1 400 435 cancer cases from 68 population-based cancer registries in 32 countries were included. Net survival varied substantially between countries and world regions, with estimates steadily rising with increasing levels of the HDI. Across the included cancer types, countries within the lowest HDI category (eg, CÔte d\'Ivoire) had a maximum 3-year net survival of 54·6% (95% CI 33·3-71·6; prostate cancer), whereas those within the highest HDI categories (eg, Israel) had a maximum survival of 96·8% (96·1-97·3; prostate cancer). Three distinct groups with varying outcomes by country and HDI dependant on cancer type were identified: cancers with low median 3-year net survival (<30%) and small differences by HDI category (eg, lung and stomach), cancers with intermediate median 3-year net survival (30-79%) and moderate difference by HDI (eg, cervix and colorectum), and cancers with high median 3-year net survival (≥80%) and large difference by HDI (eg, breast and prostate).
Disparities in cancer survival across countries were linked to a country\'s developmental position, and the availability and efficiency of health services. These data can inform policy makers on priorities in cancer control to reduce apparent inequality in cancer outcome.
Tata Memorial Hospital, the Martin-Luther-University Halle-Wittenberg, and the International Agency for Research on Cancer.