Sathishkumar Krishnan, Sankarapillai Jayasankar, Mathew Aleyamma, Nair Rekha A, Gangane Nitin, Khuraijam Sushma, Barmon Debabrata, Pandya Shashank, Majumdar Gautam, Deshmane Vinay, Zomawia Eric, Bhutia Tseten Wangyal, Jerang Kaling, George Preethi Sara, Maliye Swapna, Laishram Rajesh, Das Gaurav, Shah Anand, Debbarma Shiromani, Koyande Shravani, Pachuau Lalawmpuii, Sherpa Ashok, Jongkey Gegong, Chaturvedi Meesha, Das Priyanka, Santhappan Stephen, Mathur Prashant
National Center for Disease Informatics and Research, Indian Council of Medical Research, Bangalore, Karnataka, India.
Regional Cancer Center, Thiruvananthapuram, Kerala, India.
Cancer. 2024 May 15;130(10):1816-1825. doi: 10.1002/cncr.35188. Epub 2024 Jan 6.
Population-based cancer survival is a key indicator for assessing the effectiveness of cancer control by a health care system in a specific geographic area. Breast cancer is the most common cancer among women in India, accounting for over one quarter of all female cancers. The objective of this study was to estimate the 5-year survival of female patients who were diagnosed with breast cancer between 2012 and 2015 from the existing Population-Based Cancer Registries (PBCRs) in India.
In total, 17,331 patients who had breast cancer diagnosed between 2012 and 2015 from 11 PBCRs were followed until June 30, 2021. Active methods were used to track the vital status of registered breast cancer cases. The study conducted survival analysis by calculating the difference between the date of first diagnosis and the date of death or censoring to estimate observed survival and relative survival using the actuarial survival approach and the Ederer-II approach, respectively.
The 5-year age-standardized relative survival (95% confidence interval [CI]) of patients with breast cancer was 66.4% (95% CI, 65.5%-67.3%). Mizoram (74.9%; 95% CI, 68.1%-80.8%), Ahmedabad urban (72.7%; 95% CI, 70.3%-74.9%), Kollam (71.5%; 95% CI, 69.2%-73.6%), and Thiruvananthapuram (69.1%; 95% CI, 67.0%-71.2%) had higher survival rates than the national average. Conversely, Pasighat had the lowest survival rate (41.9%; 95% CI, 14.7%-68.6%). The 5-year observed survival rates for localized, regional, and distant metastasis in the pooled PBCRs were 81.0%, 65.5%, and 18.3%, respectively.
The overall disparity in survival rates was observed across 11 PBCRs, with lower survival rates reported in Manipur, Tripura, and Pasighat. Therefore, it is imperative to implement comprehensive cancer control strategies widely throughout the country.
基于人群的癌症生存率是评估特定地理区域医疗保健系统癌症控制效果的关键指标。乳腺癌是印度女性中最常见的癌症，占所有女性癌症的四分之一以上。本研究的目的是根据印度现有的基于人群的癌症登记处（PBCR），估计2012年至2015年间被诊断为乳腺癌的女性患者的5年生存率。
总共对11个PBCR中2012年至2015年间诊断为乳腺癌的17331名患者进行随访，直至2021年6月30日。采用主动方法跟踪登记的乳腺癌病例的生命状态。该研究通过计算首次诊断日期与死亡或审查日期之间的差异进行生存分析，分别使用精算生存方法和埃德勒-II方法估计观察到的生存率和相对生存率。
乳腺癌患者的5年龄标准化相对生存率（95%置信区间[CI]）为66.4%（95%CI，65.5%-67.3%）。米佐拉姆邦（74.9%；95%CI，68.1%-80.8%）、艾哈迈达巴德市区（72.7%；95%CI，70.3%-74.9%）、科拉姆（71.5%；95%CI，69.2%-73.6%）和特里凡得琅（69.1%；95%CI，67.0%-71.2%）的生存率高于全国平均水平。相反，帕西格特的生存率最低（41.9%；95%CI，14.7%-68.6%）。汇总的PBCR中局部、区域和远处转移的5年观察生存率分别为81.0%、65.5%和18.3%。
在11个PBCR中观察到生存率存在总体差异，曼尼普尔邦、特里普拉邦和帕西格特报告的生存率较低。因此，必须在全国广泛实施全面的癌症控制策略。
