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预测未来肺癌的生存率:基于人群的癌症生存模型研究。

Predicting Lung Cancer Survival to the Future: Population-Based Cancer Survival Modeling Study.

机构信息

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Parexel International Company Limited, Taipei, Taiwan.

出版信息

JMIR Public Health Surveill. 2024 May 31;10:e46737. doi: 10.2196/46737.

Abstract

BACKGROUND

Lung cancer remains the leading cause of cancer-related mortality globally, with late diagnoses often resulting in poor prognosis. In response, the Lung Ambition Alliance aims to double the 5-year survival rate by 2025.

OBJECTIVE

Using the Taiwan Cancer Registry, this study uses the survivorship-period-cohort model to assess the feasibility of achieving this goal by predicting future survival rates of patients with lung cancer in Taiwan.

METHODS

This retrospective study analyzed data from 205,104 patients with lung cancer registered between 1997 and 2018. Survival rates were calculated using the survivorship-period-cohort model, focusing on 1-year interval survival rates and extrapolating to predict 5-year outcomes for diagnoses up to 2020, as viewed from 2025. Model validation involved comparing predicted rates with actual data using symmetric mean absolute percentage error.

RESULTS

The study identified notable improvements in survival rates beginning in 2004, with the predicted 5-year survival rate for 2020 reaching 38.7%, marking a considerable increase from the most recent available data of 23.8% for patients diagnosed in 2013. Subgroup analysis revealed varied survival improvements across different demographics and histological types. Predictions based on current trends indicate that achieving the Lung Ambition Alliance's goal could be within reach.

CONCLUSIONS

The analysis demonstrates notable improvements in lung cancer survival rates in Taiwan, driven by the adoption of low-dose computed tomography screening, alongside advances in diagnostic technologies and treatment strategies. While the ambitious target set by the Lung Ambition Alliance appears achievable, ongoing advancements in medical technology and health policies will be crucial. The study underscores the potential impact of continued enhancements in lung cancer management and the importance of strategic health interventions to further improve survival outcomes.

摘要

背景

肺癌仍然是全球癌症相关死亡的主要原因,晚期诊断通常导致预后不良。为此,肺癌雄心联盟旨在到 2025 年将 5 年生存率提高一倍。

目的

本研究利用台湾癌症登记数据,采用生存期间队列模型,通过预测台湾肺癌患者未来生存率,评估实现这一目标的可行性。

方法

本回顾性研究分析了 1997 年至 2018 年间登记的 205104 例肺癌患者的数据。使用生存期间队列模型计算生存率,重点关注 1 年间隔生存率,并进行外推预测,从 2025 年的角度预测 2020 年之前诊断的患者的 5 年结局。通过对称平均绝对百分比误差,将预测率与实际数据进行比较,对模型进行验证。

结果

研究发现,自 2004 年以来,生存率显著提高,预计 2020 年的 5 年生存率为 38.7%,与最近可获得的 2013 年诊断患者的 23.8%相比有了显著提高。亚组分析显示,不同人群和组织学类型的生存率改善情况各不相同。基于当前趋势的预测表明,实现肺癌雄心联盟的目标是可行的。

结论

分析表明,台湾的肺癌生存率显著提高,这得益于低剂量计算机断层扫描筛查的采用,以及诊断技术和治疗策略的进步。虽然肺癌雄心联盟设定的目标雄心勃勃,但医疗技术和卫生政策的持续进步至关重要。该研究强调了持续加强肺癌管理的潜力,以及战略卫生干预措施对进一步改善生存结果的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29f2/11179019/a91b477c2e21/publichealth_v10i1e46737_fig1.jpg

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