Alawadhi E, Al-Awadi A, Elbasmi A, Coleman M P, Allemani C
Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK.
Kuwait Cancer Control Center, Ministry of Kuwait, Kuwait City, Kuwait.
J Oncol. 2019 Sep 9;2019:8463195. doi: 10.1155/2019/8463195. eCollection 2019.
To examine the distribution of stage at diagnosis for 12 cancers in Kuwait, to estimate stage-specific net survival at 1 and 5 years after diagnosis, and to assess differences in stage-specific survival between Kuwait and the United States.
Data were obtained from the Kuwait Cancer Registry, for Kuwaiti patients diagnosed during 2000-2013, with follow-up to 31 December 2015. The distribution of Surveillance Epidemiology and End Results (SEER) Summary Stage for 12 malignancies was examined. We estimated net survival by stage up to 5 years after diagnosis, controlling for background mortality with life tables of all-cause mortality in the general population by single year of age, sex, and calendar period. Survival estimates were age-standardised using the International Cancer Survival Standard (ICSS) weights.
Only 14.2% of patients were diagnosed at a localised stage and 38.9% at the regional stage. The proportion of patients with known stage was 88.9% during 2000-2004 but fell to 59.4% during 2010-2013. During 2005-2009, 1- and 5-year survival for colon, rectal, breast, cervical, and prostate cancer was about 90% or higher for patients diagnosed at the localised stage. During 2004-2009, the proportion of patients diagnosed at a localised stage was lower in Kuwait than in the US for colon, breast, and lung cancer. Age-standardised 5-year net survival for all stages combined was lower in Kuwait than the US for colon, lung, and breast cancer, but stage-specific survival was similar.
Since stage-specific survival is similar in Kuwait and the US, late stage at diagnosis is likely to be a major contributing factor to the overall lower survival in Kuwait than in the US. Increasing public awareness of cancer risk factors and symptoms and investment in early detection will be vital to reduce the proportion of patients diagnosed at a late stage and to improve survival.
研究科威特12种癌症确诊时的分期分布情况，估计确诊后1年和5年的各分期净生存率，并评估科威特与美国在各分期生存率上的差异。
数据取自科威特癌症登记处，涵盖2000年至2013年期间确诊的科威特患者，随访至2015年12月31日。研究了12种恶性肿瘤的监测、流行病学和最终结果（SEER）总结分期分布情况。我们通过确诊后长达5年的分期来估计净生存率，使用按年龄、性别和日历期划分的普通人群全因死亡率生命表来控制背景死亡率。生存估计值采用国际癌症生存标准（ICSS）权重进行年龄标准化。
仅14.2%的患者在局部阶段被确诊，38.9%在区域阶段被确诊。2000年至2004年期间已知分期的患者比例为88.9%，但在2010年至2013年期间降至59.4%。在2005年至2009年期间，结肠癌、直肠癌、乳腺癌、宫颈癌和前列腺癌在局部阶段确诊的患者1年和5年生存率约为90%或更高。在2004年至2009年期间，科威特结肠癌、乳腺癌和肺癌在局部阶段确诊的患者比例低于美国。科威特结肠癌、肺癌和乳腺癌所有分期合并的年龄标准化5年净生存率低于美国，但各分期生存率相似。
由于科威特和美国各分期生存率相似，确诊时的晚期阶段可能是科威特总体生存率低于美国的主要因素。提高公众对癌症风险因素和症状的认识以及对早期检测的投入对于降低晚期确诊患者比例和提高生存率至关重要。
