Progress in cancer control: survival, mortality and incidence in seven high-income countries 1995-2014 (the ICBP SURVMARK-2 project)
The file associated with this record is under embargo until 6 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above. ; Introduction: Population-based cancer survival estimates provide valuable insights into the effectiveness of cancer services, and can reflect the prospects of cure. This first study of the ICBP SURVMARK2 project aims to provide a comprehensive overview of cancer survival across high-income countries and a comparative assessment of corresponding incidence and mortality trends. Methods: Data on 3·9 million cancer cases were collected from populationbased cancer registries in 21 jurisdictions in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK) for seven cancer sites (oesophagus, stomach, colon, rectum, pancreas, lung and ovary) diagnosed 1995-2014 and followed up until 31 December 2015. Age-standardized net survival at 1 and 5 years after diagnosis were calculated by site, age group and period of diagnosis. Changes in incidence and mortality rates were mapped to changes in survival to assess progress in cancer control. Results: Over the 1995-2014 period, 1- and 5-year net survival increased in each country across cancer types, with, for example, 5-year rectal cancer survival rising more than 14 percentage points in Denmark, Ireland and the UK. Overall, survival was consistently higher in Australia, Canada and Norway, followed by New Zealand, Denmark, Ireland and the UK. Larger survival improvements were observed for patients aged less than 75 years at diagnosis, most notably for poorer prognosis sites. Progress in cancer control was evident for stomach, colon, lung (in males) and ovarian cancer. Interpretation: The joint evaluation of trends in incidence, mortality and survival indicated progress in four of the seven studied cancers. While cancer survival continues to increase across high-income countries, international disparities persist. While truly valid comparisons require differences in registration practice, classification and coding to be minimal, stage of disease at diagnosis, timely access to effective treatment, and the extent of comorbidity are likely the main determinants of patient outcomes. Funding: Canadian Partnership Against Cancer; Cancer Council Victoria; Cancer Institute New South Wales; Cancer Research UK; Danish Cancer Society; National Cancer Registry Ireland; The Cancer Society of New Zealand; NHS England; Norwegian Cancer Society; Public Health Agency Northern Ireland, on behalf of the Northern Ireland Cancer Registry; The Scottish Government; Western Australia Department of Health; Wales Cancer Network. ; This study was funded by: Canadian Partnership Against Cancer; Cancer Council Victoria; Cancer Institute New South Wales; Cancer Research UK; Danish Cancer Society; National Cancer Registry Ireland; The Cancer Society of New Zealand; NHS England; Norwegian Cancer Society; Public Health Agency Northern Ireland, on behalf of the Northern Ireland Cancer Registry; The Scottish Government; Western Australia Department of Health; Wales Cancer Network. ; Peer-reviewed ; Post-print