Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy.
National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy.
Int J Epidemiol. 2020 Oct 1;49(5):1517-1525. doi: 10.1093/ije/dyaa128.
Few studies have estimated the probability of being cured for cancer patients. This study aims to estimate population-based indicators of cancer cure in Europe by type, sex, age and period.
7.2 million cancer patients (42 population-based cancer registries in 17 European countries) diagnosed at ages 15-74 years in 1990-2007 with follow-up to 2008 were selected from the EUROCARE-5 dataset. Mixture-cure models were used to estimate: (i) life expectancy of fatal cases (LEF); (ii) cure fraction (CF) as proportion of patients with same death rates as the general population; (iii) time to cure (TTC) as time to reach 5-year conditional relative survival (CRS) >95%.
LEF ranged from 10 years for chronic lymphocytic leukaemia patients to <6 months for those with liver, pancreas, brain, gallbladder and lung cancers. It was 7.7 years for patients with prostate cancer at age 65-74 years and >5 years for women with breast cancer. The CF was 94% for testis, 87% for thyroid cancer in women and 70% in men, 86% for skin melanoma in women and 76% in men, 66% for breast, 63% for prostate and <10% for liver, lung and pancreatic cancers. TTC was <5 years for testis and thyroid cancer patients diagnosed below age 55 years, and <10 years for stomach, colorectal, corpus uteri and melanoma patients of all ages. For breast and prostate cancers, a small excess (CRS < 95%) remained for at least 15 years.
Estimates from this analysis should help to reduce unneeded medicalization and costs. They represent an opportunity to improve patients' quality of life.
很少有研究估计癌症患者治愈的概率。本研究旨在通过类型、性别、年龄和时期来估计欧洲基于人群的癌症治愈指标。
从 EUROCARE-5 数据集中选择了 1990-2007 年间年龄在 15-74 岁之间、随访至 2008 年的 720 万例癌症患者(来自欧洲 17 个国家的 42 个基于人群的癌症登记处)。使用混合治愈模型来估计:(i)致命病例的预期寿命(LEF);(ii)治愈分数(CF),即与普通人群死亡率相同的患者比例;(iii)治愈时间(TTC),即达到 5 年条件相对生存率(CRS)>95%的时间。
LEF 范围从慢性淋巴细胞白血病患者的 10 年到肝癌、胰腺癌、脑癌、胆囊癌和肺癌患者的<6 个月。65-74 岁前列腺癌患者的 LEF 为 7.7 年,乳腺癌女性患者的 LEF 超过 5 年。睾丸癌的 CF 为 94%,女性甲状腺癌的 CF 为 87%,男性甲状腺癌的 CF 为 70%,女性皮肤黑色素瘤的 CF 为 86%,男性皮肤黑色素瘤的 CF 为 76%,乳腺癌的 CF 为 66%,前列腺癌的 CF 为 63%,肝癌、肺癌和胰腺癌的 CF <10%。诊断年龄<55 岁的睾丸癌和甲状腺癌患者的 TTC<5 年,所有年龄段的胃癌、结直肠癌、子宫体癌和黑色素瘤患者的 TTC<10 年。对于乳腺癌和前列腺癌,至少有 15 年的时间仍存在微小的超额(CRS<95%)。
本分析的估计值应该有助于减少不必要的医疗化和成本。它们为改善患者的生活质量提供了机会。