1964-2003 年间北欧国家乳腺癌患者的生存趋势，随访至 2006 年底。

Trends in the survival of patients diagnosed with breast cancer in the Nordic countries 1964-2003 followed up to the end of 2006.

机构信息

Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland.

出版信息

Acta Oncol. 2010 Jun;49(5):624-31. doi: 10.3109/02841860903575323.

DOI:10.3109/02841860903575323

PMID:20429724

Abstract

BACKGROUND

Breast cancer is the leading cancer among women worldwide in terms of both incidence and mortality. European patients have generally high 5-year relative survival ratios, and the Nordic countries, except for Denmark, have ratios among the highest.

MATERIAL AND METHODS

Based on the NORDCAN database we present trends in age-standardised incidence and mortality rates of invasive breast cancer in the Nordic countries, alongside 5- and 10-year relative survival for the period of diagnosis 1964-2003 followed up to the end of 2006. Excess mortality rates are also provided for varying follow-up intervals after diagnosis. The analysis is confined to invasive breast cancer in Nordic women.

RESULTS

Incidence increased rapidly in all five countries, whereas mortality remained almost unchanged. Both incidence and mortality rates were highest in Denmark. Between 1964 and 2003 both 5- and 10-year relative survival increased by 20-30 percentage points in all countries, and 10-year survival remained around 10 percentage points lower than 5-year survival. Relative survival was lowest in Denmark throughout the period, with a 5-year survival of 79% for years 1999-2003, but 83-87% in the other countries. From 1964 the youngest women had the highest survival ratios up until the introduction of screening, when a shift occurred towards higher survival among age groups 50-59 and 60-69 in each country, except for Denmark. Excess death rates during the first months after diagnosis were highest in Denmark.

CONCLUSION

Breast cancer survival is high and rising in the Nordic countries, and probably relates to the early implementation of organised mammography screening in each country except Denmark and a high and relatively uniform standard of living, diagnosis and treatment. Denmark stands out with higher mortality and poorer survival. The major determinants may include a failure to instigate national breast screening and a greater co-morbidity resulting from a higher prevalence of both tobacco smoking and alcohol consumption.

摘要

背景

乳腺癌是全球范围内女性发病率和死亡率最高的癌症。欧洲患者的 5 年相对生存率普遍较高，北欧国家的生存率除丹麦外均处于较高水平。

材料和方法

我们根据 NORDCAN 数据库，展示了北欧国家浸润性乳腺癌的年龄标准化发病率和死亡率趋势，以及 1964-2003 年期间诊断后 5 年和 10 年的相对生存率，随访至 2006 年底。还提供了不同随访时间后诊断的超额死亡率。分析仅限于北欧女性的浸润性乳腺癌。

结果

所有五个国家的发病率均迅速上升，而死亡率几乎保持不变。丹麦的发病率和死亡率均最高。1964 年至 2003 年期间，所有国家的 5 年和 10 年相对生存率均提高了 20-30 个百分点，而 10 年生存率仍比 5 年生存率低 10 个百分点左右。整个期间，丹麦的相对生存率最低，1999-2003 年的 5 年生存率为 79%，而其他国家为 83-87%。自 1964 年以来，最年轻的女性的生存率最高，直到每个国家引入筛查时，生存率才发生变化，除丹麦外，每个国家的年龄组 50-59 岁和 60-69 岁的生存率均有所提高。诊断后最初几个月的超额死亡率在丹麦最高。