Biomedical Center, Faculty of Medicine, Charles University, Pilsen, Czech Republic.
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Cancer Med. 2023 May;12(9):10212-10221. doi: 10.1002/cam4.5748. Epub 2023 Feb 27.
Gastric cancer (GC) and esophageal cancer (EC) are among the most fatal cancers and improving survival in them is a major clinical challenge. Nordic cancer data were recently released up to year 2019. These data are relevant for long-term survival analysis as they originate from high-quality national cancer registries from countries with practically free access to health care, thus documenting 'real-world' experience for entire populations.
PATIENTS/METHODS: Data were obtained for Danish (DK), Finnish (FI), Norwegian (NO), and Swedish (SE) patients from the NORDCAN database from years 1970 through 2019. Relative 1- and 5-year survival were analyzed, and additionally the difference between 1- and 5-year survival was calculated as a measure of trends between years 1 and 5 after diagnosis.
Relative 1-year survival for Nordic men and women in GC was 30% in period 1970-74 and it increased close to 60%. Early 5-year survival ranged between 10 and 15% and the last figures were over 30% for all women and NO men while survival for other men remain below 30%. Survival in EC was below that in GC, and it reached over 50% for 1-year survival only for NO patients; 5-year survival reached over 20% only for NO women. For both cancers, the difference between 1- and 5-year survival increased with time. Survival was worst among old patients.
GC and EC survival improved over the 50-year period but the increase in 5-year survival was entirely explained by gains in 1-year survival, which improved at an accelerated pace in EC. The likely reasons for improvements are changes in diagnosis, treatment, and care. The challenges are to push survival past year 1 with attention to old patients. These cancers have a potential for primary prevention through the avoidance of risk factors.
胃癌（GC）和食管癌（EC）是最致命的癌症之一，提高它们的生存率是一个主要的临床挑战。北欧癌症数据最近公布至 2019 年。这些数据与长期生存分析相关，因为它们来自癌症发病率登记处，这些登记处来自医疗保健几乎免费的高质量国家，因此为整个人群记录了“真实世界”的经验。
患者/方法：从 1970 年至 2019 年，从 NORDCAN 数据库中获取了丹麦（DK）、芬兰（FI）、挪威（NO）和瑞典（SE）患者的数据。分析了相对 1 年和 5 年生存率，并计算了 1 年和 5 年生存率之间的差异，作为诊断后 1 年至 5 年趋势的衡量标准。
1970-74 年期间，北欧男性和女性的 GC 1 年相对生存率为 30%，接近 60%。早期 5 年生存率在 10%至 15%之间，最后一组数据显示所有女性和 NO 男性的生存率超过 30%，而其他男性的生存率仍低于 30%。EC 的生存率低于 GC，只有 NO 患者的 1 年生存率超过 50%；只有 NO 女性的 5 年生存率超过 20%。对于这两种癌症，1 年和 5 年生存率之间的差异随时间增加。老年患者的生存率最差。
在过去的 50 年中，GC 和 EC 的生存率有所提高，但 5 年生存率的提高完全是由 1 年生存率的提高所解释的，EC 的 1 年生存率提高速度加快。改善的可能原因是诊断、治疗和护理的变化。挑战在于通过避免危险因素，使生存率超过 1 年，并关注老年患者。这些癌症具有通过避免危险因素进行一级预防的潜力。
