Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Int J Cancer. 2012 Jun 15;130(12):2981-9. doi: 10.1002/ijc.26315. Epub 2011 Sep 9.
Progress against cancer through prevention and treatment is often measured by survival statistics only instead of analyzing trends in incidence, survival and mortality simultaneously because of interactive influences. This study combines these parameters of major cancers to provide an overview of the progress achieved in the Netherlands since 1989 and to establish in which areas action is needed. The population-based Netherlands Cancer Registry and Statistics Netherlands provided incidence, 5-year relative survival and mortality of 23 major cancer types. Incidence, survival and mortality changes were calculated as the estimated annual percentage change. Optimal progress was defined as decreasing incidence and/or improving survival accompanied by declining mortality, and deterioration as increasing incidence and/or deteriorating survival accompanied by increasing mortality rates. Optimal progress was observed in 12 of 19 cancer types among males: laryngeal, lung, stomach, gallbladder, colon, rectal, bladder, prostate and thyroid cancer, leukemia, Hodgkin and non-Hodgkin lymphoma. Among females, optimal progress was observed in 12 of 21 cancers: stomach, gallbladder, colon, rectal, breast, cervical, uterus, ovarian and thyroid cancer, leukemia, Hodgkin and non-Hodgkin lymphoma. Deterioration occurred in three cancer types among males: skin melanoma, esophageal and kidney cancer, and among females six cancer types: skin melanoma, oral cavity, pharyngeal, esophageal, pancreatic and lung cancer. Our conceptual framework limits misinterpretations from separate trends and generates a more balanced discussion on progress.
通过预防和治疗来对抗癌症的进展通常仅通过生存统计数据来衡量，而不是同时分析发病率、生存率和死亡率的趋势，因为这些因素会相互影响。本研究结合了这些主要癌症的参数，提供了自 1989 年以来荷兰在癌症防治方面取得的进展概述，并确定了需要采取行动的领域。基于人群的荷兰癌症登记处和荷兰统计局提供了 23 种主要癌症的发病率、5 年相对生存率和死亡率数据。发病率、生存率和死亡率的变化是通过估计的年百分比变化来计算的。最佳进展被定义为发病率下降和/或生存率提高，同时死亡率下降，而恶化则定义为发病率上升和/或生存率恶化，同时死亡率上升。在男性的 19 种癌症类型中，有 12 种观察到了最佳进展：喉癌、肺癌、胃癌、胆囊癌、结肠癌、直肠癌、膀胱癌、前列腺癌和甲状腺癌、白血病、霍奇金淋巴瘤和非霍奇金淋巴瘤。在女性中，21 种癌症中有 12 种观察到了最佳进展：胃癌、胆囊癌、结肠癌、直肠癌、乳腺癌、宫颈癌、子宫癌、卵巢癌和甲状腺癌、白血病、霍奇金淋巴瘤和非霍奇金淋巴瘤。在男性中，有三种癌症出现恶化：皮肤黑色素瘤、食管癌和肾癌，在女性中，有六种癌症出现恶化：皮肤黑色素瘤、口腔癌、咽癌、食管癌、胰腺癌和肺癌。我们的概念框架限制了对单独趋势的误解，并就进展情况展开了更平衡的讨论。
