Sant M, Capocaccia R, Coleman M P, Berrino F, Gatta G, Micheli A, Verdecchia A, Faivre J, Hakulinen T, Coebergh J W, Martinez-Garcia C, Forman D, Zappone A
Department of Epidemiology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1, Milan, Italy.
Eur J Cancer. 2001 Sep;37(13):1659-67. doi: 10.1016/s0959-8049(01)00206-4.
The EUROCARE project analysed cancer survival data from 45 population-based cancer registries in 17 European countries, revealing wide international differences in cancer survival. We calculated 5-year relative survival for 1836287 patients diagnosed with one of 13 cancers during the period 1978-1989. The data, from 20 cancer registries in 13 countries, were grouped into four regions: Finland, Sweden, Iceland (Northern Europe); Denmark, England and Scotland (UK and Denmark); France, The Netherlands, Germany, Italy and Switzerland (Western Europe); Estonia and Poland (Eastern Europe), and broken down into four periods (1978-1980, 1981-1983, 1984-1986, 1987-1989). For each cancer, mean European and regional survival was estimated as the weighted mean of 5-year relative survival in each country. Survival increased with time for all tumours, particularly for cancers of testis (12% increase, i.e. from 79.9 to 91.9%), breast, large bowel, skin melanoma (approximately 9-10%), and lymphomas (approximately 7%). For most solid tumours, survival was highest in Northern Europe and lowest in Eastern Europe, and also low in the UK and Denmark. Regional variation was less marked for the lymphomas. Survival improved more in Western than Northern Europe, and the differences between these regions fell for bowel cancer (from 8.0% for those diagnosed in 1978-1980 to 2% for those diagnosed in 1987-1989), breast cancer (from 7.4% to 3.9%), skin melanoma (from 13.4% to 11.0%) and Hodgkin's disease (from 7.2 to 0.6%). For potentially curable malignancies such as Hodgkin's disease, large bowel, breast and testicular cancers, there were substantial increases in survival, suggesting an earlier diagnosis and more effective treatment. The persisting regional differences suggest there are corresponding differences in the availability of diagnostic and therapeutic facilities, and in the effectiveness of healthcare systems.
EUROCARE项目分析了来自17个欧洲国家45个基于人群的癌症登记处的癌症生存数据，揭示了癌症生存率在国际上存在巨大差异。我们计算了1978年至1989年期间被诊断患有13种癌症之一的1836287名患者的5年相对生存率。来自13个国家20个癌症登记处的数据被分为四个区域：芬兰、瑞典、冰岛（北欧）；丹麦、英格兰和苏格兰（英国和丹麦）；法国、荷兰、德国、意大利和瑞士（西欧）；爱沙尼亚和波兰（东欧），并细分为四个时期（1978 - 1980年、1981 - 1983年、1984 - 1986年、1987 - 1989年）。对于每种癌症，欧洲和各区域的平均生存率估计为每个国家5年相对生存率的加权平均值。所有肿瘤的生存率都随时间增加，尤其是睾丸癌（增加12%，即从79.9%增至91.9%）、乳腺癌、大肠癌、皮肤黑色素瘤（约9 - 10%）和淋巴瘤（约7%）。对于大多数实体瘤，北欧的生存率最高，东欧最低，英国和丹麦的生存率也较低。淋巴瘤的区域差异不太明显。西欧的生存率改善幅度大于北欧，这些区域之间在结肠癌（从1978 - 1980年诊断的患者中的8.0%降至1987 - 1989年诊断的患者中的2%）、乳腺癌（从7.4%降至3.9%）、皮肤黑色素瘤（从13.4%降至11.0%）和霍奇金病（从7.2%降至0.6%）方面的差异有所缩小。对于霍奇金病、大肠癌、乳腺癌和睾丸癌等潜在可治愈的恶性肿瘤，生存率有大幅提高，表明诊断更早且治疗更有效。持续存在的区域差异表明，诊断和治疗设施的可及性以及医疗保健系统的有效性存在相应差异。
