Teppo L, Dickman P W, Hakulinen T, Luostarinen T, Pukkala E, Sankila R, Söderman B
Finnish Cancer Registry, Helsinki.
Acta Oncol. 1999;38(3):283-94. doi: 10.1080/028418699431348.
The effects of primary site, sex, age, stage and histological type on cancer patient survival were analysed on the basis of the population-based material of the Finnish Cancer Registry from 1985 to 1994. In addition, trends in survival were constructed for the period 1955-1994. Detailed site-specific data are published as Supplement 12 to Vol. 38 of Acta Oncologica. Within a given site, the survival differences by gender were not large. However, because of different site distributions, the average prognosis for female patients, all sites taken together, was superior to that of males: the 5-year relative survival rates (RSR) were 58% and 43%, respectively. In general, older patients had a poorer outcome compared with younger patients (partly because of different stage and histology distributions). Stage was a strong determinant of patient survival. In some cancers with a poor average prognosis the 5-year RSR for localized tumours was reasonable, e.g. 61% for stomach cancer, males, 34% for gallbladder cancer, females, and 29% for lung cancer, males. Most of the survival rates clearly increased over time. In addition to improvements in cancer treatment, changes over time in several other factors affect the trends, such as changes in the stage distribution (early diagnosis as a result of health education, improved diagnostic methods, screening, etc.) and in the composition of the patient material because of changing definitions of cancer (e.g. papilloma versus papillary carcinoma of the bladder, occult carcinoma of the thyroid, and early prostate cancer). The large Cancer Registry material (466,000 patients) enabled accurate estimates of the survival rates of cancer patients in Finland. These rates reflect the effectiveness of the healthcare system as a whole and are useful for planning and evaluation purposes. However, the estimated survival rates are based on grouped data, and cannot be directly applied for predicting the prognoses of individual patients, although they can be used as guidelines.
基于芬兰癌症登记处1985年至1994年的人群数据，分析了原发部位、性别、年龄、分期和组织学类型对癌症患者生存的影响。此外，还构建了1955年至1994年期间的生存趋势。详细的特定部位数据作为《肿瘤学学报》第38卷增刊12发表。在给定的部位内，性别之间的生存差异不大。然而，由于部位分布不同，所有部位综合起来，女性患者的平均预后优于男性：5年相对生存率（RSR）分别为58%和43%。一般来说，老年患者的预后比年轻患者差（部分原因是分期和组织学分布不同）。分期是患者生存的一个重要决定因素。在一些平均预后较差的癌症中，局限性肿瘤的5年RSR是合理的，例如男性胃癌为61%，女性胆囊癌为34%，男性肺癌为29%。大多数生存率随时间明显提高。除了癌症治疗的改善外，其他几个因素随时间的变化也影响了这些趋势，如分期分布的变化（由于健康教育、诊断方法改进、筛查等导致的早期诊断）以及由于癌症定义的变化（如膀胱乳头状瘤与乳头状癌、甲状腺隐匿性癌和早期前列腺癌）导致的患者材料组成的变化。大型癌症登记处的数据（466,000名患者）使我们能够准确估计芬兰癌症患者的生存率。这些率反映了整个医疗系统的有效性，对规划和评估目的很有用。然而，估计的生存率是基于分组数据的，虽然可以用作指导，但不能直接用于预测个体患者的预后。
