4.6 Article

Survival in gastric and esophageal cancers in the Nordic countries through a half century

期刊

CANCER MEDICINE
卷 12, 期 9, 页码 10212-10221

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WILEY
DOI: 10.1002/cam4.5748

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mortality; relative survival; risk factors; stomach cancer; treatment

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According to Nordic cancer data, the 1-year and 5-year relative survival rates for gastric cancer and esophageal cancer have increased from 1970 to 2019, with the most significant improvement seen in the 1-year survival rates. However, survival rates remain low for elderly patients.
Background: Gastric cancer (GC) and esophageal cancer (EC) are among the most fatal cancers and improving survival in them is a major clinical challenge. Nordic cancer data were recently released up to year 2019. These data are relevant for long- term survival analysis as they originate from high-quality national cancer registries from countries with practically free access to health care, thus documenting real-world' experience for entire populations.Patients/Methods: Data were obtained for Danish (DK), Finnish (FI), Norwegian (NO), and Swedish (SE) patients from the NORDCAN database from years 1970 through 2019. Relative 1-and 5- year survival were analyzed, and additionally the difference between 1-and 5- year survival was calculated as a measure of trends between years 1 and 5 after diagnosis.Results: Relative 1- year survival for Nordic men and women in GC was 30% in period 1970- 74 and it increased close to 60%. Early 5- year survival ranged be-tween 10 and 15% and the last figures were over 30% for all women and NO men while survival for other men remain below 30%. Survival in EC was below that in GC, and it reached over 50% for 1- year survival only for NO patients; 5- year survival reached over 20% only for NO women. For both cancers, the difference between 1-and 5- year survival increased with time. Survival was worst among old patients.Conclusion: GC and EC survival improved over the 50- year period but the in-crease in 5- year survival was entirely explained by gains in 1- year survival, which improved at an accelerated pace in EC. The likely reasons for improvements are changes in diagnosis, treatment, and care. The challenges are to push survival past year 1 with attention to old patients. These cancers have a potential for pri-mary prevention through the avoidance of risk factors.

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