Survival patterns in lung and pleural cancer in Europe 1999-2007: Results from the EUROCARE-5 study

Our plain-English summary of Survival patterns in lung and pleural cancer in Europe 1999-2007: Results from the EUROCARE-5 study, by S. Francisci, P. Minicozzi, D. Pierannunzio, et al (European Journal of Cancer, 2015).

The study

• Authors: S. Francisci, P. Minicozzi, D. Pierannunzio, E. Ardanaz, A. Eberle, T.K. Grimsrud, A. Knijn, U. Pastorino, D. Salmerón, A. Trama, M. Sant, EUROCARE-5 Working Group:
• Journal: European Journal of Cancer
• Published: 2015;51(15):2242-2253
• Cited by: 74 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Survival of patients diagnosed with lung and pleura cancer is a relevant health care indicator which is related to the availability and access to early diagnosis and treatment facilities. Aim of this paper is to update lung and pleural cancer survival patterns and time trends in Europe using the EUROCARE-5 database.

Methods: Data on adults diagnosed with lung and pleural cancer from 87 European cancer registries in 28 countries were analysed. Relative survival (RS) in 2000-2007 by country/region, age and gender, and over time trends in 1999-2007 were estimated.

Results: Lung cancer survival is poor everywhere in Europe, with a RS of 39% and 13% at 1 and 5years since diagnosis, respectively. A geographical variability is present across European areas with a maximum regional difference of 12 and 5 percentage points in 1-year and 5-year RS respectively. Pleural cancer represents 4% of cases included in the present study with 7% 5-year RS overall in Europe. Most pleural cancers (83%) are microscopically verified mesotheliomas. Survival for both cancers decreases with advancing age at diagnosis for both cancers. Slight increasing trends are described for lung cancer. Survival over time is higher for squamous cell carcinoma and adenocarcinomas than for small and large cell carcinoma; and better among women than men.

Conclusions: Despite the generalised although slight increase, survival of lung and pleural cancer patients still remains poor in European countries. Priority should be given to prevention, with tobacco control policies across Europe for lung cancer and banning asbestos exposure for pleural cancer, and in early diagnosis and better treatment. The management of mesothelioma needs a multidisciplinary team and standardised health care strategies.

Copyright © 2015 Elsevier Ltd. All rights reserved.

In plain English

This study used the EUROCARE-5 database of 87 cancer registries in 28 European countries. It described survival of adults with lung cancer or with cancer of the pleura, the lining around the lungs. It covered 917,568 lung and 34,146 pleural cancer patients diagnosed in 2000–2007, followed to the end of 2008. Relative survival compares patients with the general population. For lung cancer, relative survival was 39% at 1 year and 13% at 5 years. Regions differed by up to 12 percentage points at 1 year, 6 at 5 years. In 31 registries, survival by tumor type and region mostly rose slightly in 1999–2007; only 25% of period-to-period differences were statistically significant. Pleural cancers were about 4% of cases; 83% were microscopically verified mesotheliomas. Their relative survival was 43% at 1 year, 7% at 5 years. Survival fell with older age. The study did not measure asbestos exposure. The authors concluded that prognosis remained very poor, with only limited improvement. They noted that the quality of checking whether patients were alive seemed to vary between countries, so regional comparisons, especially for the elderly, need caution.

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 survival study (relative survival analysis, with period-approach time trends for lung cancer)
• Who was studied: Adults (aged 15+) diagnosed in 2000–2007 with lung cancer (917,568 patients) or pleural cancer (34,146 patients), recorded by 87 cancer registries in 28 European countries and followed up to 31 December 2008
• Exposure: No exposure was studied. The study measured survival after diagnosis. Asbestos is mentioned only in the introduction and discussion as the main cause of malignant pleural mesothelioma, not as something measured in this study.
• Main results:
  • Lung cancer patients in Europe: relative survival of 39% at 1 year and 13% at 5 years after diagnosis
  • Lung cancer: maximum regional difference of 12 percentage points in 1-year and 6 percentage points in 5-year relative survival, with Ireland/UK lowest and Central Europe highest
  • In the restricted analysis of 31 registries by lung cancer morphology group and region, 1-year and conditional relative survival trends rose slightly for all morphology groups, with some exceptions; only 25% of the between-period differences were statistically significant
  • Lung cancer: women had higher 5-year relative survival than men in all age groups during 1999–2007
  • Pleural cancer patients in Europe: 1-year relative survival 43%, 5-year 7%, and 5-year survival conditional on surviving the first year 17%
  • 83% of pleural cancers were microscopically verified mesotheliomas
  • Pleural cancer: 5-year relative survival ranged from 3% in Spain to 13% in Croatia
  • Pleural cancer: 1-year relative survival was 26 percentage points lower for patients aged 75+ than for those aged 15–44
• The authors' conclusion: The authors concluded that lung and pleural cancer patients across Europe had very poor prognosis, with only limited improvement in 1999–2007. They said priorities should be prevention through tobacco and asbestos exposure control policies, and early diagnosis.
• Limitations the authors state:
  • The quality of checking whether patients were still alive seemed not to be uniform across European countries, a potential limit for geographic comparisons. The authors said results, especially those for the elderly, should be interpreted with caution.
  • The highest 5-year lung cancer survival, seen in women aged 75+ in Eastern Europe, was likely due to incomplete follow-up
  • The relatively high mesothelioma survival in Eastern Europe had previously been attributed to difficulty reaching a correct diagnosis and the resulting inclusion of non-cancerous lesions

Topics

Medical terms in this study, explained in our Lexicon: Pleura, Lung Cancer, Mesothelioma, Squamous Cell Carcinoma, Adenocarcinoma, Carcinoma, Asbestos Exposure, Multidisciplinary Team.

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