Keller D M, Peterson E A, Silberman G
Health Education, and Human Services Division, US General Accounting Office, Washington, DC 20548, USA.
Am J Public Health. 1997 Jul;87(7):1164-7. doi: 10.2105/ajph.87.7.1164.
In this study, cancer survival rates for patients diagnosed in Ontario and selected areas within the United States were compared.
Relative survival rates were computed for patients aged 15 through 84 years diagnosed with any of four forms of cancer (breast, colon, lung, and Hodgkin's disease). The cohorts represented those diagnosed over the years 1978 through 1986 in the Canadian province of Ontario and in nine regions covered by the US National Cancer Institute's Surveillance Epidemiology and End Results program. Patients were followed through the end of 1990.
The cumulative relative survival rates were similar for American and Canadian patients. The largest difference was observed for breast cancer, where patients in the United States enjoyed a survival advantage throughout the follow-up period.
Patients in the United States and Ontario with the diseases studied, except for breast cancer, experience very similar survival. The greater use of mammographic screening in the United States could account for that country's higher breast cancer survival rate by promoting earlier and therefore more efficacious treatment, by introducing bias, or by a combination of both treatment and bias factors.
本研究比较了安大略省以及美国部分地区确诊癌症患者的生存率。
计算了15至84岁被诊断患有四种癌症(乳腺癌、结肠癌、肺癌和霍奇金病)中任何一种的患者的相对生存率。这些队列代表了1978年至1986年期间在加拿大安大略省以及美国国家癌症研究所监测流行病学和最终结果计划覆盖的九个地区被诊断出的患者。对患者进行随访直至1990年底。
美国和加拿大患者的累积相对生存率相似。乳腺癌的差异最大,美国患者在整个随访期间具有生存优势。
美国和安大略省患有所研究疾病(乳腺癌除外)的患者生存率非常相似。美国更广泛地使用乳房X线筛查,可能通过促进更早且更有效的治疗、引入偏差或治疗与偏差因素的综合作用,导致该国乳腺癌生存率更高。