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七个国家基于人群的国际癌症基准合作 SURVMARK-2 研究:特定分期结肠癌生存的年龄差异。

Age disparities in stage-specific colon cancer survival across seven countries: An International Cancer Benchmarking Partnership SURVMARK-2 population-based study.

机构信息

Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.

Department of Oncology and K.G. Jebsen Colorectal Cancer Research Centre Oslo University Hospital, Oslo, Norway.

出版信息

Int J Cancer. 2021 Apr 1;148(7):1575-1585. doi: 10.1002/ijc.33326. Epub 2020 Oct 14.

Abstract

We sought to understand the role of stage at diagnosis in observed age disparities in colon cancer survival among people aged 50 to 99 years using population-based cancer registry data from seven high-income countries: Australia, Canada, Denmark, Ireland, New Zealand, Norway and the United Kingdom. We used colon cancer incidence data for the period 2010 to 2014. We estimated the 3-year net survival, as well as the 3-year net survival conditional on surviving at least 6 months and 1 year after diagnosis, by country and stage at diagnosis (categorised as localised, regional or distant) using flexible parametric excess hazard regression models. In all countries, increasing age was associated with lower net survival. For example, 3-year net survival (95% confidence interval) was 81% (80-82) for 50 to 64 year olds and 58% (56-60) for 85 to 99 year olds in Australia, and 74% (73-74) and 39% (39-40) in the United Kingdom, respectively. Those with distant stage colon cancer had the largest difference in colon cancer survival between the youngest and the oldest patients. Excess mortality for the oldest patients with localised or regional cancers was observed during the first 6 months after diagnosis. Older patients diagnosed with localised (and in some countries regional) stage colon cancer who survived 6 months after diagnosis experienced the same survival as their younger counterparts. Further studies examining other prognostic clinical factors such as comorbidities and treatment, and socioeconomic factors are warranted to gain further understanding of the age disparities in colon cancer survival.

摘要

我们旨在利用来自澳大利亚、加拿大、丹麦、爱尔兰、新西兰、挪威和英国这七个高收入国家的基于人群的癌症登记数据,了解诊断时的分期在 50 至 99 岁人群中结肠癌生存差异中的作用。我们使用了 2010 年至 2014 年的结肠癌发病数据。我们通过国家和诊断时的分期(分为局部、区域或远处),使用灵活参数超额风险回归模型,估算了 3 年净生存率,以及在至少存活 6 个月和 1 年后诊断的 3 年净生存率。在所有国家,年龄增长与净生存率降低相关。例如,在澳大利亚,50 至 64 岁患者的 3 年净生存率(95%置信区间)为 81%(80-82),85 至 99 岁患者为 58%(56-60);在英国,相应的数字分别为 74%(73-74)和 39%(39-40)。远处期结肠癌患者在最年轻和最年长患者之间的结肠癌生存差异最大。在诊断后最初的 6 个月内,局部或区域癌症的最年长患者存在超额死亡。局部(以及一些国家的区域)期结肠癌且存活 6 个月后的年长患者与年轻患者具有相同的生存率。进一步研究需要检查其他预后临床因素(如合并症和治疗)和社会经济因素,以进一步了解结肠癌生存中的年龄差异。

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