Sant M, Aareleid T, Berrino F, Bielska Lasota M, Carli P M, Faivre J, Grosclaude P, Hédelin G, Matsuda T, Møller H, Möller T, Verdecchia A, Capocaccia R, Gatta G, Micheli A, Santaquilani M, Roazzi P, Lisi D
Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
Ann Oncol. 2003;14 Suppl 5:v61-118. doi: 10.1093/annonc/mdg754.
EUROCARE-3 analysed the survival of 1815584 adult cancer patients diagnosed from 1990 to 1994 in 22 European countries. The results are reported in tables, one per cancer site, coded according to the International Classification of Diseases (ICD)-9 classification. The main findings of the tables are summarised and commented on in this article. For most solid cancers, wide differences in survival between different European populations were found, as also reported by EUROCARE-1 and EUROCARE-2, despite a remarkable (10%) overall increase in cancer survival from 1985 to 1994. Survival was highest in northern Europe (Sweden, Norway, Finland and Iceland), and fairly good in central-southern Europe (France, Switzerland, Austria and Spain). Survival was particularly low in eastern Europe, low in Denmark and the UK, and fairly low in Portugal and Malta. The mix of tumour stage at diagnosis explains much of the survival differences for cancers of the digestive tract, female reproductive system, breast, thyroid, and also skin melanoma. For tumours of the urinary tract and prostate, the differences were explained mainly by differences in diagnostic criteria and procedures. The case mix by anatomic subsite largely explains differences in survival for head and neck cancers. For oesophagus, pancreas, liver and brain cancer, with poor prognoses, survival differences were limited. Tumours, for which highly effective treatments are available, such as testicular cancer, Hodgkin's lymphoma and some haematological malignancies, had fairly uniform survival across Europe. Survival for all tumours combined (an indicator of the overall cancer care performance of a nation's health system) was better in young than old patients, and better in women than men. The affluence of countries influenced overall cancer survival through the availability of adequate diagnostic and treatment procedures, and screening programmes.
欧洲癌症患者队列研究（EUROCARE-3）分析了1990年至1994年期间在22个欧洲国家确诊的1815584例成年癌症患者的生存情况。结果以表格形式呈现，每个癌症部位一个表格，按照国际疾病分类（ICD）-9分类进行编码。本文对表格的主要发现进行了总结和评论。尽管从1985年到1994年癌症生存率总体显著提高（10%），但正如EUROCARE-1和EUROCARE-2所报告的那样，对于大多数实体癌，不同欧洲人群之间的生存差异很大。北欧（瑞典、挪威、芬兰和冰岛）的生存率最高，中南部欧洲（法国、瑞士、奥地利和西班牙）的生存率相当不错。东欧的生存率特别低，丹麦和英国的生存率较低，葡萄牙和马耳他的生存率相当低。诊断时肿瘤分期的差异在很大程度上解释了消化道、女性生殖系统、乳腺、甲状腺以及皮肤黑色素瘤癌症生存差异的原因。对于泌尿系统和前列腺肿瘤，差异主要由诊断标准和程序的不同所解释。按解剖亚部位划分的病例组合在很大程度上解释了头颈癌生存差异的原因。对于预后较差的食管癌、胰腺癌、肝癌和脑癌，生存差异有限。对于有高效治疗方法的肿瘤，如睾丸癌、霍奇金淋巴瘤和一些血液系统恶性肿瘤，欧洲各地的生存率相当一致。所有肿瘤合并后的生存率（一个国家卫生系统整体癌症护理表现的指标）在年轻患者中比老年患者更好，在女性中比男性更好。国家的富裕程度通过提供适当的诊断和治疗程序以及筛查计划影响了总体癌症生存率。
