Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia; Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Brisbane, QLD 4059, Australia.
Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia.
Cancer Epidemiol. 2020 Apr;65:101686. doi: 10.1016/j.canep.2020.101686. Epub 2020 Feb 13.
Loss of life expectancy (LOLE) provides valuable insights into the impact of cancer. We evaluated the temporal trends in LOLE for Australian cancer patients and the gain in life years for recently diagnosed patients due to survival improvements.
Analysis was conducted using an Australian population-based cohort (n = 1,865,154) aged 50-89 years, who were primarily diagnosed with one of 19 leading cancers between 1982-2015. Flexible parametric survival models were used to estimate LOLE and the proportion of life lost (POLL) by year, age group, sex, and, for New South Wales only, spread of disease. The total years of LOLE and gain in life years due to survival improvements were estimated for those diagnosed in 2014.
For 19 cancers combined, LOLE and POLL were significantly lower for more recent diagnoses. Cancer-specific temporal trends were consistent by age, sex, and spread of disease (where relevant) although the magnitude varied. Prostate, kidney, or non-Hodgkin lymphoma experienced the largest decreases in POLL over time. For the 2014 diagnoses, an estimation of 403,094 life years lost will be caused by the 19 cancers. With the increase in cancer survival over time, the 2014 cohort will gain an extra 432,588 life years (52 %) compared to that experienced by the 1982 cohort.
While reduced impact of a cancer diagnosis on LOLE over time is encouraging, the growing number of cancer survivors in Australia is likely to pose complex challenges for cancer patients, their care givers, and health-care systems.
预期寿命损失（LOLE）提供了有关癌症影响的宝贵见解。我们评估了澳大利亚癌症患者的 LOLE 随时间的变化趋势，以及由于生存改善而使最近诊断出的患者增加的生命年数。
使用澳大利亚人群为基础的队列（n = 1,865,154）进行分析，该队列年龄在 50-89 岁之间，主要在 1982-2015 年间被诊断出患有 19 种主要癌症之一。使用灵活的参数生存模型来估计 LOLE 和每年按年龄组、性别以及新南威尔士州仅按疾病扩散程度损失的生命比例（POLL）。对于 2014 年被诊断出的患者，估计了由于生存改善而导致的 LOLE 总年数和增加的生命年数。
对于 19 种癌症的总和，最近诊断的 LOLE 和 POLL 显著降低。癌症特异性时间趋势在年龄、性别和疾病扩散程度（如适用）方面一致，尽管幅度有所不同。前列腺癌、肾癌或非霍奇金淋巴瘤随时间推移，POLL 的下降幅度最大。对于 2014 年的诊断，19 种癌症将导致 403,094 个生命年数的损失。随着癌症生存时间的延长，与 1982 年队列相比，2014 年队列将额外增加 432,588 个生命年数（52%）。
尽管随着时间的推移，癌症诊断对 LOLE 的影响有所降低，但澳大利亚癌症幸存者人数的增加可能会给癌症患者、他们的护理人员和医疗保健系统带来复杂的挑战。
