Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Cancer Med. 2024 Aug;13(15):e7365. doi: 10.1002/cam4.7365.
Esophageal cancer (EC) and gastric cancer (GC) are fatal cancers with a relatively late age of onset. Age is a negative risk factor for survival in many cancers and our aim was to analyze age-specific survival in EC and GC using the recently updated NORDCAN database. NORDCAN data originate from the Danish, Finnish, Norwegian, and Swedish nationwide cancer registries covering years 1972 through 2021 inviting for comparison of 50-year survival trends between the countries. Relative 1- and 5-year survival and 5/1-year conditional survival (i.e., survival in those who were alive in Year 1 to survive additional 4 years) were analyzed. Survival in EC showed large gains for patients below age 80 years, 5-year survival in Norwegian men reaching 30% and in women over 30% but for 80-89 year old survival remained at 10%. In contrast, hardly any gain was seen among the 80-89 year patients for 1-year survival and small gains in 5 year and 5/1-year survival. Survival gaps between age-groups increased over time. For GC there was also a clear age-related negative survival gradient but the survival gaps between the age groups did not widen over time; Norwegian male and female 5-year survival for 80-89 year old was about 20%. The age-specific survival difference in GC arose in Year 1 and did not essentially increase in 5-year survival. While there were differences in survival improvements between the countries, poor survival of the 80-89 year old patients was shared by all of them. To conclude, survival has improved steadily in younger GC and EC patients in most Nordic countries. While the 80-89 year old population accounts for nearly a quarter of all patients and their poor survival depressed overall survival, which can therefore be increased further by improving diagnostics, treatment and care of elderly EC and GC patients.
食管癌 (EC) 和胃癌 (GC) 是致命的癌症，发病年龄相对较晚。年龄是许多癌症的负生存风险因素，我们的目的是使用最近更新的 NORDCAN 数据库分析 EC 和 GC 的年龄特异性生存。NORDCAN 数据来自丹麦、芬兰、挪威和瑞典的全国癌症登记处，涵盖了 1972 年至 2021 年的年份，邀请比较这些国家的 50 年生存趋势。分析了相对 1 年和 5 年生存率以及 5/1 年条件生存率（即，在第 1 年存活的人中，再存活额外 4 年的生存率）。EC 患者年龄低于 80 岁的生存率显著提高，挪威男性 5 年生存率达到 30%以上，女性超过 30%，但 80-89 岁的生存率仍为 10%。相比之下，80-89 岁患者的 1 年生存率几乎没有提高，5 年和 5/1 年生存率略有提高。各年龄段之间的生存差距随时间推移而增加。对于 GC，也存在明显的与年龄相关的负生存梯度，但各年龄组之间的生存差距随时间推移没有扩大；挪威男性和女性 80-89 岁的 5 年生存率约为 20%。GC 的年龄特异性生存率差异出现在第 1 年，5 年生存率没有显著增加。尽管各国之间的生存率改善存在差异，但所有国家的 80-89 岁老年患者的生存率都很差。总之，在大多数北欧国家，年轻的 GC 和 EC 患者的生存率稳步提高。虽然 80-89 岁的人群占所有患者的近四分之一，并且他们的生存状况不佳降低了总体生存率，但通过改善老年 EC 和 GC 患者的诊断、治疗和护理，可以进一步提高总体生存率。
