Biomedical Center, Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, 30605 Pilsen, Czech Republic.
Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany; Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany.
Eur J Cancer. 2022 Nov;175:77-85. doi: 10.1016/j.ejca.2022.08.015. Epub 2022 Sep 9.
Global survival studies in cancer have generally shown favourable development, but studies over extended periods on populations for which medical care is essentially free of charge are lacking.
We analyse relative 1- and 5-year survival in all solid cancers in Denmark, Finland, Norway and Sweden through a 50-year period (1970-2019) using the NORDCAN database.
The most recent survival results showed three types of patterns. Cancers of very good survival (5-year survival ∼90%) included common cancers of the breast and prostate, as well as melanoma. The second pattern, which included the largest number of cancers, showed 1-year survival of over 80% and a drop of 10-20 % units in 5-year survival. The third group consisted of eight fatal cancers, sharing poor 5-year survival (around 20%). The 50-year improvement in 1-year survival was largest (30-50 % units) in kidney, brain, gallbladder and liver cancers, and (∼30%) in colon, small intestinal, lung, pleural, pancreas and ovarian cancers. Improvements in 5-year survival were highest (40-50 % units) in prostate and kidney cancers but remained at 10-20 % units for the eight fatal cancers. Survival showed significant sex preferences for a few cancers.
The analysis over a half-century confirms the progress in 'real-world' cancer control, and in 84% of patients 5-year survival was >60%. Metastases remain a challenge, placing the emphasis on early detection before metastasis occurs. Novel therapies, such as immunotherapy which has curative potential even against metastatic disease, are needed.
癌症的全球生存研究通常显示出有利的发展，但缺乏针对基本免费医疗的人群进行长期研究。
我们通过 NORDCAN 数据库分析了丹麦、芬兰、挪威和瑞典所有实体癌的相对 1 年和 5 年生存率，时间跨度为 50 年（1970-2019 年）。
最新的生存结果显示了三种模式。具有良好 5 年生存率（约 90%）的癌症包括常见的乳腺癌和前列腺癌以及黑色素瘤。第二种模式包括最多数量的癌症，1 年生存率超过 80%，5 年生存率下降 10-20%。第三组包括八种致命癌症，5 年生存率较差（约 20%）。1 年生存率的 50 年改善最大（30-50%单位）的是肾癌、脑癌、胆囊癌和肝癌，以及结肠癌、小肠癌、肺癌、胸膜癌、胰腺癌和卵巢癌（约 30%）。前列腺癌和肾癌的 5 年生存率改善最高（40-50%单位），但对于八种致命癌症，仍保持在 10-20%单位。生存情况对一些癌症显示出显著的性别偏好。
半个多世纪的分析证实了“真实世界”癌症控制的进展，84%的患者 5 年生存率>60%。转移仍然是一个挑战，强调在转移发生之前进行早期检测。需要新的治疗方法，如免疫疗法，即使对转移性疾病也具有治愈潜力。
