Dal Maso L, Guzzinati S, Buzzoni C, Capocaccia R, Serraino D, Caldarella A, Dei Tos A P, Falcini F, Autelitano M, Masanotti G, Ferretti S, Tisano F, Tirelli U, Crocetti E, De Angelis R, Virdone S, Zucchetto A, Gigli A, Francisci S, Baili P, Gatta G, Castaing M, Zanetti R, Contiero P, Bidoli E, Vercelli M, Michiara M, Federico M, Senatore G, Pannozzo F, Vicentini M, Bulatko A, Pirino D R, Gentilini M, Fusco M, Giacomin A, Fanetti A C, Cusimano R
Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute IRCCS, Aviano.
Veneto Tumour Registry, Veneto Region, Padua.
Ann Oncol. 2014 Nov;25(11):2251-2260. doi: 10.1093/annonc/mdu383. Epub 2014 Aug 22.
Persons living after a cancer diagnosis represent 4% of the whole population in high-income countries. The aim of the study was to provide estimates of indicators of long-term survival and cure for 26 cancer types, presently lacking.
Data on 818 902 Italian cancer patients diagnosed at age 15-74 years in 1985-2005 were included. Proportions of patients with the same death rates of the general population (cure fractions) and those of prevalent patients who were not at risk of dying as a result of cancer (cure prevalence) were calculated, using validated mixture cure models, by cancer type, sex, and age group. We also estimated complete prevalence, conditional relative survival (CRS), time to reach 5- and 10-year CRS >95%, and proportion of patients living longer than those thresholds.
The cure fractions ranged from >90% for patients aged <45 years with thyroid and testis cancers to <10% for liver and pancreatic cancers of all ages. Five- or 10-year CRS >95% were both reached in <10 years by patients with cancers of the stomach, colon-rectum, pancreas, corpus and cervix uteri, brain, and Hodgkin lymphoma. For breast cancer patients, 5- and 10-year CRSs reached >95% after 19 and 25 years, respectively, and in 15 and 18 years for prostate cancer patients. Five-year CRS remained <95% for >25 years after cancer diagnosis in patients with liver and larynx cancers, non-Hodgkin lymphoma, myeloma, and leukaemia. Overall, the cure prevalence was 67% for men and 77% for women. Therefore, 21% of male and 31% of female patients had already reached 5-year CRS >95%, whereas 18% and 25% had reached 10-year CRS >95%.
A quarter of Italian cancer patients can be considered cured. This observation has a high potential impact on health planning, clinical practice, and patients' perspective.
在高收入国家，癌症诊断后存活的人群占总人口的4%。本研究的目的是提供目前缺乏的26种癌症类型的长期生存和治愈指标估计值。
纳入了1985 - 2005年期间15 - 74岁被诊断为癌症的818902名意大利患者的数据。使用经过验证的混合治愈模型，按癌症类型、性别和年龄组计算死亡率与普通人群相同的患者比例（治愈比例）以及因癌症无死亡风险的现患患者比例（治愈患病率）。我们还估计了完全患病率、条件相对生存率（CRS）、达到5年和10年CRS>95%的时间，以及存活时间超过这些阈值的患者比例。
治愈比例范围从年龄<45岁的甲状腺癌和睾丸癌患者的>90%到所有年龄段的肝癌和胰腺癌患者的<10%。胃癌、结直肠癌、胰腺癌、子宫体癌、子宫颈癌、脑癌和霍奇金淋巴瘤患者在<10年内达到5年或10年CRS>95%。乳腺癌患者分别在19年和25年后达到5年和10年CRS>95%，前列腺癌患者分别在15年和18年后达到。肝癌、喉癌、非霍奇金淋巴瘤、骨髓瘤和白血病患者在癌症诊断后>25年5年CRS仍<95%。总体而言，男性的治愈患病率为67%，女性为77%。因此，21% 的男性患者和31% 的女性患者已达到5年CRS>95%，而18% 和25% 已达到10年CRS>95%。
四分之一的意大利癌症患者可被视为治愈。这一观察结果对卫生规划、临床实践和患者观念具有很大的潜在影响。
