Tichanek Filip, Försti Asta, Hemminki Akseli, Hemminki Otto, Hemminki Kari
Biomedical Center, Faculty of Medicine, Charles University Pilsen, 30605 Pilsen, Czech Republic.
Hopp Children's Cancer Center (KiTZ), 69120 Heidelberg, Germany.
Cancers (Basel). 2023 Aug 25;15(17):4261. doi: 10.3390/cancers15174261.
Survival studies are important tools for cancer control, but long-term survival data on high-quality cancer registries are lacking for all cancers, including prostate (PC), testicular (TC), and penile cancers. Using generalized additive models and data from the NORDCAN database, we analyzed 1- and 5-year relative survival for these cancers in Denmark (DK), Finland (FI), Norway (NO), and Sweden (SE) over a 50-year period (1971-2020). We additionally estimated conditional 5/1-year survival for patients who survived the 1st year after diagnosis. Survival improved early for TC, and 5-year survival reached 90% between 1985 (SE) and 2000 (FI). Towards the end of the follow-up, the TC patients who had survived the 1st year survived the next 4 years with comparable probability to the background population. For PC, the 90% landmark was reached between 2000 (FI) and after 2010 (DK). For penile cancer, 5-year survival never reached the 90% landmark, and the improvements in survival were modest at best. For TC, early mortality requires attention, whereas late mortality should be tackled for PC. For penile cancer, the relatively high early mortality may suggest delays in diagnosis and would require more public awareness and encouragement of patients to seek medical opinion. In FI, TC and penile cancer patients showed roughly double risk of dying compared to the other Nordic countries, which warrants further study and clinical attention.
生存研究是癌症控制的重要工具,但包括前列腺癌(PC)、睾丸癌(TC)和阴茎癌在内的所有癌症,高质量癌症登记处的长期生存数据都很缺乏。利用广义相加模型和来自NORDCAN数据库的数据,我们分析了丹麦(DK)、芬兰(FI)、挪威(NO)和瑞典(SE)在50年期间(1971 - 2020年)这些癌症的1年和5年相对生存率。我们还估计了诊断后存活1年的患者的条件5/1年生存率。TC的生存率早期有所改善,1985年(SE)至2000年(FI)期间5年生存率达到90%。在随访接近尾声时,存活了第1年的TC患者在接下来4年的存活概率与背景人群相当。对于PC,在2000年(FI)至2010年之后(DK)达到了90%的标志性生存率。对于阴茎癌,5年生存率从未达到90%的标志性水平,生存率的改善充其量也很有限。对于TC,早期死亡率需要关注,而对于PC则应解决晚期死亡率问题。对于阴茎癌,相对较高的早期死亡率可能表明诊断存在延迟,这需要提高公众意识,并鼓励患者寻求医疗建议。在FI,TC和阴茎癌患者的死亡风险大约是其他北欧国家的两倍,这值得进一步研究和临床关注。