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Annals of Oncology Advance Access published online on October 10, 2005
Annals of Oncology, doi:10.1093/annonc/mdi404
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© 2005 European Society for Medical Oncology
Received March 14, 2005
Revised June 24, 2005
Accepted August 2, 2005

Original article

Variation in survival after diagnosis of breast cancer in Switzerland

T. Fisch 1, P. Pury 2, N. Probst 1, A. Bordoni 3, C. Bouchardy 4, H. Frick 5, G. Jundt 6, D. De Weck 7, E. Perret 8, and J.-M. Lutz 9*

1 Krebsregister des Kantons Zürich (formerly Krebsregister St Gallen-Appenzell), Zurich, Switzerland
2 Centre de Coordination ASRT (Association Suisse des Registres des Tumeurs), Switzerland
3 Registro Ticinese dei Tumori, Locarno, Switzerland
4 Registre Genevois des Tumeurs, Geneva, Switzerland
5 Kantonales Krebsregister Graubünden, Choir, Switzerland
6 Krebsregister beider Basel, Switzerland
7 Registre Valaisan des Tumeurs, Sion, Switzerland
8 Zentrale Informatikdienststelle Basel Stadt, Basel, Switzerland
9 Centre de Coordination ASRT (Association Suisse des Registres des Tumeurs), Switzerland; Registre Genevois des Tumeurs, Geneva, Switzerland

* To whom correspondence should be addressed.
J.-M. Lutz, E-mail: jean-michel.lutz{at}imsp.unige.ch


  Abstract

Background: Survival after diagnosis of cancer is a key criterion for cancer control. Major survival differences between time periods and countries have been reported by the EUROCARE studies. We investigated whether similar differences by period and region existed in Switzerland.

Methods: Survival of 11 376 cases of primary invasive female breast cancer diagnosed between 1988 and 1997 and registered in seven Swiss cancer registries covering a population of 3.5 million was analysed.

Results: Comparing the two periods 1988-1992 and 1993-1997, age-standardized 5 year relative survival improved globally from 77% to 81%. Furthermore, multivariate analysis adjusting for age, tumour size and nodal involvement identified regional survival differences. Survival was lowest in the rural parts of German-speaking eastern Switzerland and highest in urbanised regions of the Latin- and German-speaking northwestern parts of the country.

Conclusions: This study confirms that survival differences are present even in a small and affluent, but culturally diverse, country like Switzerland, raising the issue of heterogeneity in access to care and quality of treatment.

Keywords: breast cancer; cancer registry; population-based; survival differences; Switzerland.
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