Isere Cancer Registry, University Hospital of Grenoble, Grenoble, France.
French Network of Cancer Registries (FRANCIM), Toulouse, France.
Cancer. 2022 Oct;128(20):3663-3673. doi: 10.1002/cncr.34413. Epub 2022 Aug 16.
Cancer prevalence is heterogeneous because it includes individuals who are undergoing initial treatment and those who are in remission, experiencing relapse, or cured. The proposed statistical approach describes the health status of this group by estimating the probabilities of death among prevalent cases. The application concerns colorectal, lung, breast, and prostate cancers and melanoma in France in 2017.
Excess mortality was used to estimate the probabilities of death from cancer and other causes.
For the studied cancers, most deaths from cancer occurred during the first 5 years after diagnosis. The probability of death from cancer decreased with increasing time since diagnosis except for breast cancer, for which it remained relatively stable. The time beyond which the probability of death from cancer became lower than that from other causes depended on age and cancer site: for colorectal cancer, it was 6 years after diagnosis for women (7 years for men) aged 75-84 and 20 years for women (18 years for men) aged 45-54 years, whereas cancer was the major cause of death for women younger than 75 years whatever the time since diagnosis for breast and for all patients younger than 75 years for lung cancer. In contrast, deaths from other causes were more frequent in all the patients older than 75 years. Apart from breast cancer in women younger than 55 years and lung cancer in women older than 55 years and men older than 65 years, the probability of death from cancer among prevalent cases fell below 1%, with varying times since diagnosis.
The authors' approach can be used to better describe the burden of cancer by estimating outcomes in prevalent cases.
癌症的患病率存在差异，因为它包括正在接受初始治疗的患者和处于缓解期、复发或治愈的患者。所提出的统计方法通过估计现患病例的死亡概率来描述这一人群的健康状况。该应用涉及法国 2017 年的结直肠癌、肺癌、乳腺癌和前列腺癌以及黑色素瘤。
使用超额死亡率来估计癌症和其他原因导致的死亡概率。
在所研究的癌症中，大多数癌症死亡发生在诊断后 5 年内。除乳腺癌外，随着诊断后时间的延长，死于癌症的概率降低，而乳腺癌的这一概率相对稳定。死于癌症的概率低于其他原因的概率的时间取决于年龄和癌症部位：对于 75-84 岁的女性（男性为 6 年）和 45-54 岁的女性（男性为 20 年），结直肠癌的诊断后 6 年（男性为 7 年），而乳腺癌则是 75 岁以下女性的主要死亡原因，无论诊断后时间如何，对于所有 75 岁以下的患者，肺癌也是如此。相比之下，所有 75 岁以上的患者死于其他原因的概率更高。除了 55 岁以下女性的乳腺癌和 55 岁以上女性和 65 岁以上男性的肺癌之外，现患病例死于癌症的概率随着诊断后时间的不同而下降到 1%以下。
作者的方法可用于通过估计现患病例的结局来更好地描述癌症负担。
