Cancer Research UK, Statistical Information Team, 61 Lincoln's Inn Fields, London, UK.
Br J Cancer. 2009 Dec 3;101 Suppl 2(Suppl 2):S102-9. doi: 10.1038/sj.bjc.6605399.
This review of the EUROCARE-4 results attempts to separate out the early and late mortality effects contributing to the widely reported poorer 5-year survival rates for cancer patients in the United Kingdom compared with other European countries for 26 cancer sites.
Patients diagnosed with cancer in 1996-1999 in 23 European countries were included in the analyses. Comparison of 1-year, 5-year and 5|1-year (i.e. only including those patients who had survived to 1 year) survival estimates between data for England and the 'European average' was undertaken. This analysis was to highlight the relative contribution of early diagnosis, using 1-year survival as a proxy measure, on 5-year survival for the different sites of cancer. Three groups of cancer sites were identified according to whether the survival differences at 1, 5 and 5|1-years were statistically significant.
Breast cancer showed significantly poorer 1- and 5-year survival estimates in England, but the 5|1-year survival figure was not significantly different. Thus, successful initiatives around awareness and early detection could eradicate the survival gap. In contrast, the 5|1-year survival estimates remained significantly worse for lung, colorectal and prostate cancers, showing that although early detection could make some difference, late effects such as treatment and management of the patients were also influencing long-term outcome differences between England and Europe.
本项对 EUROCARE-4 研究结果的综述试图区分导致英国与其他欧洲国家相比，26 个癌症部位的癌症患者五年生存率普遍较低的早期和晚期死亡效应。
对 23 个欧洲国家 1996-1999 年诊断为癌症的患者进行了分析。对英格兰与“欧洲平均水平”的数据进行了一年、五年和五年生存（即仅包括那些存活至一年的患者）的生存估计值的比较。此分析旨在突出使用一年生存率作为五年生存率的替代指标，早期诊断对不同癌症部位的五年生存率的相对贡献。根据一年、五年和五年生存率的差异在统计学上是否显著，将癌症部位分为三组。
英格兰的乳腺癌在一年和五年时的生存率明显较差，但五年生存率无显著差异。因此，围绕意识和早期发现的成功举措可能消除生存差距。相比之下，肺癌、结直肠癌和前列腺癌的五年生存率仍显著较差，表明尽管早期发现可能有所不同，但患者的治疗和管理等晚期效应也影响了英国和欧洲之间的长期预后差异。
