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探讨年龄和分期对卵巢癌生存的影响(ICBP SurvMark-2):一项基于人群的研究。

Exploring variations in ovarian cancer survival by age and stage (ICBP SurvMark-2): A population-based study.

机构信息

Section of Cancer Surveillance, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, Lyon 69372 CEDEX 08, France.

Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England, UK.

出版信息

Gynecol Oncol. 2020 Apr;157(1):234-244. doi: 10.1016/j.ygyno.2019.12.047. Epub 2020 Jan 28.

Abstract

OBJECTIVE

The study aims to evaluate the differences in ovarian cancer survival by age and stage at diagnosis within and across seven high-income countries.

METHODS

We analyzed data from 58,161 women diagnosed with ovarian cancer during 2010-2014, followed until 31 December 2015, from 21 population-based cancer registries in Australia, Canada, Denmark, Ireland, New Zealand, Norway, and United Kingdom. Comparisons of 1-year and 3-year age- and stage-specific net survival (NS) between countries were performed using the period analysis approach.

RESULTS

Minor variation in the stage distribution was observed between countries, with most women being diagnosed with 'distant' stage (ranging between 64% in Canada and 71% in Norway). The 3-year all-ages NS ranged from 45 to 57% with Australia (56%) and Norway (57%) demonstrating the highest survival. The proportion of women with 'distant' stage was highest for those aged 65-74 and 75-99 years and varied markedly between countries (range:72-80% and 77-87%, respectively). The oldest age group had the lowest 3-year age-specific survival (20-34%), and women aged 65-74 exhibited the widest variation across countries (3-year NS range: 40-60%). Differences in survival between countries were particularly stark for the oldest age group with 'distant' stage (3-year NS range: 12% in Ireland to 24% in Norway).

CONCLUSIONS

International variations in ovarian cancer survival by stage exist with the largest differences observed in the oldest age group with advanced disease. This finding endorses further research investigating international differences in access to and quality of treatment, and prevalence of comorbid conditions particularly in older women with advanced disease.

摘要

目的

本研究旨在评估在 7 个高收入国家内和国家间,按诊断时年龄和分期评估卵巢癌生存情况的差异。

方法

我们分析了 2010 年至 2014 年期间,21 个基于人群的癌症登记处来自澳大利亚、加拿大、丹麦、爱尔兰、新西兰、挪威和英国的 58161 名卵巢癌诊断女性的数据,随访至 2015 年 12 月 31 日。使用时期分析方法比较各国之间年龄和分期特异性净生存率(NS)的 1 年和 3 年差异。

结果

各国之间的分期分布略有差异,大多数女性被诊断为“远处”期(加拿大为 64%,挪威为 71%)。所有年龄段的 3 年总生存率(NS)范围为 45%至 57%,澳大利亚(56%)和挪威(57%)的生存率最高。65-74 岁和 75-99 岁的女性“远处”期比例最高,且各国之间差异显著(分别为 72%-80%和 77%-87%)。最年长的年龄组 3 年年龄特异性生存率最低(20-34%),且各国之间差异最大(3 年 NS 范围:40%-60%)。在最年长的年龄组中,“远处”期的生存率在国家之间存在显著差异(爱尔兰为 3 年 NS 范围为 12%,挪威为 24%)。

结论

按分期评估,卵巢癌生存情况存在国际差异,在患有晚期疾病的最年长年龄组中差异最大。这一发现支持进一步研究国际间在治疗机会和质量以及在患有晚期疾病的老年妇女中合并症的流行情况方面的差异。

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