Understanding variations in survival for colorectal cancer in Europe: a EUROCARE high resolution study

Abstract

Results-Three year observed survival rates ranged from 25% (Cracow) to 59% (Modena), and were low in the Thames area (UK) (38%). Survival rates between registries for "resected" patients varied less than those for all patients. When age, sex, and site were considered, RRs ranged from 0.7 (95% confidence intervals (CI) 0.6-0.9) (Modena) to 2.3 (95% CI 1.9-2.9) (Cracow). After further adjustment by stage, between registry RR variation was between 0.8 (95% CI 0.6-0.9) and 1.8 (95% CI 1.5-2.2). Inter-registry RR diVerences were slightly reduced when the determinants of stage (number of nodes examined and liver imaging) were included in the model. The reduction was marked for the UK registries. Conclusions-The wide diVerences across Europe in colorectal cancer survival depend to a large extent on diVerences in stage at diagnosis. There are wide variations in diagnostic and surgical practices. There was a twofold range in the risk of death from colorectal cancer even after adjustment for surgery and disease stage. (Gut 2000;47:533-538)

Cancer survival in China, 2003–2005: A population‐based study

“…Differences in health awareness and early detection, and the availability, development of and accessibility to cancer treatment within the population should also be considered. 24,25 In our study, the age-standardized 5-year survival for all cancers combined in China was 30.9%, much lower than has been reported for developed countries. In the United States, for example, five-year relative survival for all cancers combined was 67.2% for adults in 2004, 23 and the corresponding Australian estimate (2006-2010) was 66%.…”

EURECCA colorectal: Multidisciplinary Mission statement on better care for patients with colon and rectal cancer in Europe

“…While Iater reports of EUROCARE showed that although survival was improving, inter-country variation is still r_rsisting, suggesting room for further improvement. 5 • 1 Even in high-income countries with well established guidelines and a similar healthcare structure, the difference in outcome is unexplained and vast. 11 Highly relevan!…”

Cancer survival differences between European populations: the UK uneasiness

“…It is right that such inconsistencies should be pointed out; in fact they were not unexpected given that the study periods differ, and survival rates are changing. These authors highlighted in particular that in the HR study (Gatta et al, 2000) the population of the Modena registry did not perfectly coincide with that presented in the EUROCARE II monograph. * Clearly further HR studies on larger samples are required to clarify how much intercountry survival differences are due to differential delay in diagnosis and how much to differences in treatment.…”

“…As a consequence, the results are uncertain and the conclusions preliminary. The paper by Woodman et al draws attention to several inconsistencies between survival rates estimated from a few hundred cases included in the recent HR study (Gatta et al, 2000) and those obtained from many thousands of cases diagnosed in a previous period and included in the main EUROCARE II study. It is right that such inconsistencies should be pointed out; in fact they were not unexpected given that the study periods differ, and survival rates are changing.…”