Fisch T, Pury P, Probst N, Bordoni A, Bouchardy C, Frick H, Jundt G, De Weck D, Perret E, Lutz J-M
Krebsregister des Kantons Zürich (formerly Krebsregister St Gallen-Appenzell), Zurich, Switzerland.
Ann Oncol. 2005 Dec;16(12):1882-8. doi: 10.1093/annonc/mdi404. Epub 2005 Oct 10.
Survival after diagnosis of cancer is a key criterion for cancer control. Major survival differences between time periods and countries have been reported by the EUROCARE studies. We investigated whether similar differences by period and region existed in Switzerland.
Survival of 11,376 cases of primary invasive female breast cancer diagnosed between 1988 and 1997 and registered in seven Swiss cancer registries covering a population of 3.5 million was analysed.
Comparing the two periods 1988-1992 and 1993-1997, age-standardized 5 year relative survival improved globally from 77% to 81%. Furthermore, multivariate analysis adjusting for age, tumour size and nodal involvement identified regional survival differences. Survival was lowest in the rural parts of German-speaking eastern Switzerland and highest in urbanised regions of the Latin- and German-speaking northwestern parts of the country.
This study confirms that survival differences are present even in a small and affluent, but culturally diverse, country like Switzerland, raising the issue of heterogeneity in access to care and quality of treatment.
癌症诊断后的生存率是癌症控制的关键标准。EUROCARE研究报告了不同时期和国家之间存在显著的生存差异。我们调查了瑞士是否也存在类似的时期和地区差异。
分析了1988年至1997年间在瑞士七个癌症登记处登记的11376例原发性浸润性女性乳腺癌病例的生存情况，这些登记处覆盖了350万人口。
比较1988 - 1992年和1993 - 1997年这两个时期，年龄标准化的5年相对生存率从77%提高到了81%。此外，在对年龄、肿瘤大小和淋巴结受累情况进行多变量分析后发现了地区生存差异。生存率在瑞士德语区东部的农村地区最低，在该国拉丁和德语区西北部的城市化地区最高。
本研究证实，即使在像瑞士这样一个小而富裕但文化多样的国家，也存在生存差异，这引发了医疗服务可及性和治疗质量异质性的问题。
