Long-term survival trends for primary liver and pancreatic cancers in the Nordic countries

Obstetrics and Gynecology International

et al. 2023

Self Cite

Background. Female cancers cover common breast cancers, relatively common endometrial, ovarian, and cervical cancers and rare vulvar cancer. Survival in these cancers is known to be relatively good compared to all cancers but long-term studies for these cancers are rare, and to fill the gap, here, we generate survival data through 50 years. Materials and Methods. We applied generalized additive models to data from the NORDCAN database and analyzed 1- and 5-year relative survival for these cancers in Denmark (DK), Finland (FI), Norway (NO), and Sweden (SE) over half a century (1971–2020). Conditional 5/1-year survival for patients who survived the 1st year after diagnosis and annual survival changes was also estimated. Results. In 2016–20, 5-year survival was best for breast cancer reaching 92.3% (in SE), followed by endometrial cancer at 86.1% (SE) and cervical cancer at 75.6% (NO). Improvement in 5-year survival over the 50 years was the largest for ovarian cancer (20% units), finally reaching 52.9% (SE). For vulvar cancer, the final survival was between 70 and 73%. The best 5-year survival rate in 2016–20 was recorded for SE in breast, endometrial, and ovarian cancers; NO showed the highest rate for cervical and DK for vulvar cancers. DK had the lowest survival for breast and ovarian cancers, and FI, for the other cancers. Conclusions. The overall survival development appeared to consist of continuous improvements, most likely because of novel treatment and imaging techniques as well as overall organization of patient care. The large survival improvement for ovarian cancer was probably achieved by a surgical focus on tumors spread in the peritoneal cavity. For cervical and vulvar cancers, the high early mortality requires attention and could be helped by raising increasing public awareness of early symptoms in these cancers and developing pathways for fast initiation of treatment.

Section: Discussionmentioning

confidence: 54%

Survival, Incidence, and Mortality Trends in Female Cancers in the Nordic Countries

Tichánek

Försti

Obstetrics and Gynecology International

et al. 2023

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“…Hepatobiliary cancers are fatal cancers with five-year survival ranging from about 10 to 30%, which shows that there is an unmet need to control these cancers through surveillance and risk prevention [ 4 , 16 , 17 , 18 ]. At one level, the focus of improvements may be on avoidance or reduction of exposure to risk factors, such as smoking, alcohol consumption, overweight, physical inactivity, and prevention and treatment of viral hepatitis [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…ICC and ECC also share some risk factors with HCC, but biliary tract infections are the dominant risk factor, while associations with alcohol, HBV, and HCV are weak [ 1 , 8 , 12 , 13 , 14 , 15 ]. Survival in hepatobiliary cancers is poor; five-year survival in HCC, ECC, and GBC is reaching over 20%, is less than 10% for ICC, and over 30% for ampullary cancer [ 4 , 16 , 17 , 18 ]. The only curative treatment for these cancers is surgery, and for HCC, additional liver transplantation; for HCC sorafenib and GBC and bile duct cancers, in addition to chemotherapy, immunotherapies have become available [ 1 , 5 , 17 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Population-Attributable Fractions of Personal Comorbidities for Liver, Gallbladder, and Bile Duct Cancers

Sundquist

et al. 2023

Cancers

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Background: We aim to estimate population-attributable fractions (PAF) for 13 comorbidities potentially predisposing to hepatobiliary cancer of hepatocellular carcinoma (HCC), gallbladder cancer (GBC), cancers of the intrahepatic and extrahepatic bile ducts (ICC and ECC), and ampullary cancer. Methods: Patients were identified from the Swedish Inpatient Register from 1987 to 2018 and cancers from the Swedish Cancer Registry from 1997 through 2018. PAFs were calculated for each comorbidity-associated cancer using a cohort study design. Results: For male HCC, the major individual comorbidities (PAF > 10) were diabetes, alcohol-related liver disease, and hepatitis C virus infection. For female HCC, diabetes and autoimmune diseases were important contributors. For female GBC, gallstone disease was an overwhelming contributor, with a PAF of 30.57%, which was also important for men. The overall PAF for male ICC was almost two times higher than the female one. For ECC and ampullary cancer, infection of bile ducts was associated with the highest PAF. Conclusions: The 13 comorbidities accounted for 50% or more of the potential etiological pathways of each hepatobiliary cancer except female ICC. The underlying convergent mechanism for these cancers may be chronic inflammation lasting for decades and thus offering possibilities for intervention and disease monitoring.

“…FI presented a curious survival paradox for these cancers (bladder cancer at the level of the Nordic partners but kidney cancer well below them), both of which are treated at the urology clinic. While the lower rate of healthcare funding in FI might explain the differences, it is unclear why only kidney cancer shows this pattern [9,30]? In the 1980s, FI urologists established a FinnBladder collaboration to advance clinical research on bladder cancer, which may have offered clinical benefits for bladder over kidney cancer [31].…”

Section: Discussionmentioning

confidence: 99%

Survival in Kidney and Bladder Cancers in Four Nordic Countries through a Half Century

Tichánek

Försti

et al. 2023

Cancers

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Kidney and bladder cancers share etiology and relatively good recent survival, but long-term studies are rare. We analyzed survival for these cancers in Denmark, Finland, Norway (NO), and Sweden (SE) over a 50-year period (1971–2020). Relative 1- and 5-year survival data were obtained from the NORDCAN database, and we additionally calculated conditional 5/1-year survival. In 2016–2020, 5-year survivals for male kidney (79.0%) and bladder (81.6%) cancers were best in SE. For female kidney cancer, NO survival reached 80.0%, and for bladder cancer, SE survival reached 76.1%. The magnitude of 5-year survival improvements during the 50-year period in kidney cancer was over 40% units; for bladder cancer, the improvement was over 20% units. Survival in bladder cancer was worse for women than for men, particularly in year 1. In both cancers, deaths in the first year were approximately as many as in the subsequent 4 years. We could document an impressive development for kidney cancer with tripled male and doubled female 5-year survival in 50 years. Additionally, for bladder cancer, a steady improvement was recorded. The current challenges are to curb early mortality and target treatment to reduce long-term mortality.