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Breast cancer survival in the US and Europe: a CONCORD high-resolution study

Allemani, Claudia; Sant, Milena; Weir, Hannah K.; Richardson, Lisa C.; Baili, Paolo; Storm, Hans; Siesling, Sabine; Torrella-Ramos, Ana; Voogd, Adri C. and Aareleid, Tiiu, et al. (2013) In International Journal of Cancer 132(5). p.1170-1181
Abstract
Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe.... (More)
Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5-6%). Net survival in Northern, Western and Southern Europe (81-84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70-99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment. (Less)
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publication status
published
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keywords
CONCORD, net survival, excess hazard, cancer registries
in
International Journal of Cancer
volume
132
issue
5
pages
1170 - 1181
publisher
John Wiley & Sons
external identifiers
  • wos:000314071300020
  • scopus:84872849005
ISSN
0020-7136
DOI
10.1002/ijc.27725
language
English
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yes
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ff2017f7-d5e2-4d64-a5c2-64e232bc1044 (old id 3577102)
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2013-04-02 07:43:23
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@article{ff2017f7-d5e2-4d64-a5c2-64e232bc1044,
  abstract     = {Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5-6%). Net survival in Northern, Western and Southern Europe (81-84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70-99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment.},
  author       = {Allemani, Claudia and Sant, Milena and Weir, Hannah K. and Richardson, Lisa C. and Baili, Paolo and Storm, Hans and Siesling, Sabine and Torrella-Ramos, Ana and Voogd, Adri C. and Aareleid, Tiiu and Ardanaz, Eva and Berrino, Franco and Bielska-Lasota, Magdalena and Bolick, Susan and Cirilli, Claudia and Colonna, Marc and Contiero, Paolo and Cress, Rosemary and Crocetti, Emanuele and Fulton, John P. and Grosclaude, Pascale and Hakulinen, Timo and Isabel Izarzugaza, M. and Malmström, Per and Peignaux, Karin and Primic-Zakelj, Maja and Rachtan, Jadwiga and Diba, Chakameh Safaei and Sanchez, Maria-Jose and Schymura, Maria J. and Shen, Tiefu and Traina, Adele and Tryggvadottir, Laufey and Tumino, Rosario and Velten, Michel and Vercelli, Marina and Wolf, Holly J. and Woronoff, Anne-Sophie and Wu, Xiaocheng and Coleman, Michel P.},
  issn         = {0020-7136},
  keyword      = {CONCORD,net survival,excess hazard,cancer registries},
  language     = {eng},
  number       = {5},
  pages        = {1170--1181},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Breast cancer survival in the US and Europe: a CONCORD high-resolution study},
  url          = {http://dx.doi.org/10.1002/ijc.27725},
  volume       = {132},
  year         = {2013},
}