Annals of Oncology Advance Access originally published online on April 29, 2007
Annals of Oncology 2007 18(7):1253-1259; doi:10.1093/annonc/mdm126
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© 2007 European Society for Medical Oncology
supportive care |
Trends in population-based cancer survival in Germany: to what extent does progress reach older patients?
1 Division for Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg
2 Saarland Cancer Registry, Saarbrücken, Germany
* Correspondence to: Prof. H. Brenner, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Bergheimer Strasse 20, 69115 Heidelberg, Germany. Tel: +49-6221-548140; Fax: +49-6221-548142; E-mail: h.brenner{at}dkfz.de
Background: The ageing of populations makes outcome monitoring among elderly cancer patients particularly important.
Patients and methods: Using data from the population-based Cancer Registry of Saarland, we examined age-specific trends in 5-year relative survival from 1979 to 2003 for patients with 15 common cancers in Germany. Model-based period analysis was applied to estimate 5-year relative survival for four age groups (15–54, 55–64, 65–74, 75+) in the periods 1979–1983, 1984–1988, 1989–1993, 1994–1998, and 1999–2003.
Results: Overall, 5-year relative survival improved steadily from 42.2% in 1979–1983 to 56.7% in 1999–2003. From the youngest to the oldest age group, 5-year relative survival increased by 14.5, 12.1, 12.5, and 8.4 percent units, respectively, after adjusting for changes in the spectrum of cancer sites, and survival significantly improved for 10, 12, 11, and 5 cancer sites, respectively. The age gradient particularly increased for cancer sites with major progress in chemotherapeutic treatment regimens, such as ovarian cancer, non-Hodgkins lymphoma and leukemia.
Conclusions: Relative survival of cancer patients increased considerably for many forms of cancer in Germany from 1979 to 2003. Increases were much less pronounced among elderly patients, leading to an increasing age gradient in prognosis.
Key words: age-specific survival trends, cancer survival trends, elderly, Germany, modeling
Received for publication October 30, 2006. Revision received March 14, 2007. Accepted for publication March 14, 2007.