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

Abstract

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.

Survival in Elderly Ovarian Cancer Remains Challenging in the Nordic Countries

“…The median age at onset increased by 6 years. Detailed incidence and mortality trends for all female cancers have been recently published [ 2 ].…”

“…Epithelial ovarian cancer (also called tubo-ovarian carcinoma, here ‘ovarian cancer’) accounts for more than 90% of ovarian malignancies [ 1 ]. It ranks as the third most common female-specific cancer after breast and endometrial cancers in Northern Europe [ 2 ]. Important risk factors for ovarian cancer include obesity, infertility, nulliparity and estrogen hormone treatment, whereas high parity, breastfeeding and oral contraceptive use are protective factors [ 3 ].…”

“…In the Nordic countries, the 5-year relative survival of ovarian cancer was about 50% after 2015, which was the worst survival among the female cancers, in spite of the large improvement in past years [ 2 , 6 ]. Short-term survival improvements have been reported from the Netherlands, but no improvements in long-term survival could be confirmed [ 7 ].…”

Trend and Joinpoint Analysis of Cancer Incidence and 1-Year Mortality in North-East Spain 2005–2020

“…In a study of female cancers in Nordic countries, the incidence of endometrium cancer decreased, but breast cancer incidence trends differed between countries. In addition, the mortality of breast cancer decreased, and it decreased/stabilized for endometrium cancer [9]. In a study of seven high-income countries including Denmark, Ireland, Norway, and UK, incidence and mortality decreased for colorectal, lung (males), ovarian, and stomach cancer [10].…”