Survival of solid cancer patients in France, 1989-2013: a population-based study

Our plain-English summary of Survival of solid cancer patients in France, 1989-2013: a population-based study, by A. Cowppli-Bony, Z. Uhry, L. Remontet, et al (European Journal of Cancer Prevention, 2017).

The study

• Authors: A. Cowppli-Bony, Z. Uhry, L. Remontet, N. Voirin, A.V. Guizard, B. Trétarre, A.M. Bouvier, M. Colonna, N. Bossard, A.S. Woronoff, P. Grosclaude, French Network of Cancer Registries (FRANCIM)
• Journal: European Journal of Cancer Prevention
• Published: 2017;26(6):461-468
• Cited by: 44 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This study provides updates of net survival (NS) estimates at 5, 10, and 15 years as well as survival trends for 35 solid cancers in France using data from 19 population-based cancer registries. The study considered all cases of solid cancer diagnosed between 1989 and 2010 in patients older than 15 years of age who were actively followed up until 30 June 2013. NS was estimated using the Pohar-Perme method. The age-standardized NS used the international cancer survival standard weights. The 5-year age-standardized NSs ranged from 4% (pleural mesothelioma) to 93% (prostate) in men and from 10% (pancreas) to 97% (thyroid) in women. The 10-year age-standardized NSs ranged from 2% (pleural mesothelioma) in both sexes to 95% (testis) in men and 91% (thyroid) in women. The most frequent cancers (namely, breast and prostate cancers) had the highest NSs: 87 and 93% at 5 years and 78 and 84% at 10 years, respectively. Several cancers (especially lung, pancreas, and liver cancer) had very poor prognoses (5-year NSs under 20%). Fifteen-year NSs remained high for testis cancer. In most cancers, 5- and 10-year age-standardized NSs increased between 1989 and 2010. Advanced age was associated with a poor prognosis and little improvement in survival. The increases in cancer survival are probably related to earlier diagnosis and therapeutic advances over the last decade. However, poor prognoses are still found in some alcohol-related and tobacco-related cancers and in elderly patients, highlighting the need for more prevention, diagnosis, and treatment efforts.

In plain English

This French registry study estimated net survival (survival if cancer were the only cause of death) for 35 solid cancers. Patients older than 15 diagnosed from 1989 to 2010 came from 19 registries and were followed to 30 June 2013. Long-term and trend analyses used 12 registries with complete data, though Loire-Atlantique breast and colorectal data began in 1991. For 2005 to 2010 diagnoses, five-year net survival ranged from 4% (pleural mesothelioma) to 93% (prostate) in men and 10% (pancreas) to 97% (thyroid) in women. Among 946 pleural mesothelioma cases, it was 4% (95% CI 2 to 6) in men and 11% (7 to 17) in women. Ten-year survival (317 cases, diagnosed 1999 to 2004) was 2% (1 to 5), both sexes combined. These mesothelioma figures were not age-standardized. Survival rose for most common cancers and was lower in older patients. Cervical and bladder cancer survival fell, which the authors said occurred only in women over 65. The authors concluded poor prognoses persisted for some cancers and the elderly. They lacked stage and treatment data. Asbestos was not examined.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: population-based cancer registry study of net survival and survival trends
• Who was studied: All cases of 35 invasive solid cancers diagnosed from 1 January 1989 to 31 December 2010 in patients older than 15, from 19 French population-based registries. One dataset held 307 449 cases diagnosed from 2005 to 2010 and was used for recent five-year survival. A second held 502 063 cases from only 12 registries with complete data over 1989 to 2010. The exception was the Loire-Atlantique registry, whose breast and colorectal cancer data covered 1991 to 2010. The second dataset was used for long-term survival and trends. Vital status was checked to 30 June 2013.
• Main results:
  • For patients diagnosed from 2005 to 2010, five-year net survival ranged from 4% (pleural mesothelioma) to 93% (prostate) in men, and from 10% (pancreas) to 97% (thyroid) in women.
  • Pleural mesothelioma, 946 cases (both sexes, diagnosed 2005 to 2010): five-year net survival was 4% (95% CI 2 to 6) in men and 11% (7 to 17) in women. For patients diagnosed from 1999 to 2004 (317 cases), ten-year net survival was 2% (1 to 5) for both sexes combined. The table marks these mesothelioma figures as nonstandardized.
  • Ten-year net survival ranged from 2% (pleural mesothelioma) in both sexes to 95% (testis) in men and 91% (thyroid) in women.
  • Breast and prostate cancers had net survival of 87% and 93% at 5 years, and 78% and 84% at 10 years, respectively.
  • Several cancers had poor prognoses (5-year net survival of 33% or less): lung, pancreas, liver, stomach, esophagus, central nervous system and biliary tract cancers, and pleural mesothelioma in both sexes, plus hypopharynx cancers in men.
  • For all cancers affecting both sexes except bladder, 5- and 10-year net survival was higher in women than in men.
  • Survival increased over the diagnosis periods for most common cancers. The largest rise was for prostate cancer: 5-year net survival went from 72% in 1989 to 1993 to 94% in 2005 to 2010.
  • Five-year net survival fell by 6 percentage points for cervical cancer. Five- and ten-year net survival fell by 4 to 6 percentage points for bladder cancer. The authors stated that these declines occurred only in women older than 65.
  • Net survival decreased with age. For prostate and colorectal cancers, improvements were smaller in elderly patients than in young patients.
• The authors' conclusion: The authors concluded that despite an overall improvement in survival, poor prognoses remained for some cancer sites and among the elderly. In their view, this pointed to a need for more prevention, diagnosis and treatment efforts.
• Limitations the authors state:
  • There was no information on stage at diagnosis or type of treatment, which limited interpretation of the results.
  • Fifteen-year estimates were given only for patients younger than 75, because of possible errors in estimating net survival in elderly groups.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Prognosis.

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