Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Acta Oncol. 2020 Nov;59(11):1266-1274. doi: 10.1080/0284186X.2020.1822544. Epub 2020 Oct 19.
Differences in cancer survival between the Nordic countries have previously been reported. The aim of this study was to examine whether these differences in outcome remain, based on updated information from five national cancer registers.
The data used for the analysis was from the NORDCAN database focusing on nine common cancers diagnosed 1990-2016 in Denmark, Finland, Iceland, Norway and Sweden with maximum follow-up through 2017. Relative survival (RS) was estimated at 1 and 5 years using flexible parametric RS models, and percentage point differences between the earliest and latest years available were calculated.
A consistent improvement in both 1- and 5-year RS was found for most studied sites across all countries. Previously observed differences between the countries have been attenuated. The improvements were particularly pronounced in Denmark that now has cancer survival similar to the other Nordic countries.
The reasons for the observed improvements in cancer survival are likely multifactorial, including earlier diagnosis, improved treatment options, implementation of national cancer plans, uniform national cancer care guidelines and standardized patient pathways. The previous survival disadvantage in Denmark is no longer present for most sites. Continuous monitoring of cancer survival is of importance to assess the impact of changes in policies and the effectiveness of health care systems.
北欧国家之间的癌症存活率存在差异，此前已有报道。本研究旨在根据来自五个国家癌症登记处的最新信息，检验这些结果差异是否仍然存在。
本分析使用的是 NORDCAN 数据库的数据，该数据库主要关注丹麦、芬兰、冰岛、挪威和瑞典五个国家 1990 年至 2016 年间诊断出的九种常见癌症，随访时间最长可达 2017 年。使用灵活参数相对生存率模型估算了 1 年和 5 年的相对生存率，并计算了最早和最晚年份之间的百分点差异。
在所有国家的大多数研究部位，1 年和 5 年的相对生存率均有持续改善。之前观察到的国家间差异已减弱。丹麦的改善尤为显著，其癌症生存率现在与其他北欧国家相似。
癌症生存率提高的原因可能是多方面的，包括早期诊断、治疗选择的改善、国家癌症计划的实施、全国统一的癌症护理指南和标准化的患者路径。丹麦在大多数部位的先前生存劣势已不复存在。持续监测癌症生存率对于评估政策变化的影响和卫生保健系统的有效性非常重要。
