CONCORD-2 Study Reveals Wide Variability in Global Cancer Survival Rates
As reported in The Lancet by Allemani et al, the CONCORD-2 study of global cancer survival indicates improvements in survival in many countries in colorectal, breast, and prostate cancers, persistent poor outcomes in lung and liver cancers, and wide variability in survival in many cancers.
The study involved individual tumor records on 25.7 million adults and 75,000 children diagnosed with cancer between 1995 and 2009 and followed through at least December 2009. Records were submitted by 279 population-based cancer registries in 67 countries. Some of the major findings are:
- 5-year survival in colon, rectal, and breast cancers has increased steadily in most developed countries, reaching ≥ 60% for colon and rectal cancer in 22 countries among patients diagnosed during 2005 to 2009 and reaching ≥ 85% for breast cancer in 17 countries among patients diagnosed during this period.
- Liver and lung cancer remain lethal everywhere, with 5-year survival for both at < 20% everywhere in Europe, 15% to 19% in North America, and as low as 7% to 9% in Mongolia and Thailand.
- 5-year survival in prostate cancer increased by 10% to 20% between 1995 to 1999 and 2005 to 2009 in 22 countries in South America, Asia, and Europe. However, survival still varies widely, from < 60% in Bulgaria and Thailand to ≥ 95% in Brazil, Puerto Rico, and the United States.
- 5-year survival in cervical cancer ranges from < 50% to > 70% with very wide regional variations and only slight improvements between 1995 to 1999 and 2005 to 2009.
- For women diagnosed with ovarian cancer in 2005 to 2009, 5-year survival was ≥ 40% only in Ecuador, the United States, and 17 countries in Asia and Europe.
- 5-year survival for stomach cancer in 2005 to 2009 was 54% to 58% in Japan and South Korea and < 40% in other countries.
- 5-year survival in adult leukemia is 18% to 23% in Japan and South Korea, with survival rates in most other countries being higher.
- 5-year survival in childhood acute lymphoblastic leukemia is < 60% in several countries, but as high as 90% in Canada and four European countries.
The investigators concluded: “International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems.”
M. P. Coleman, FFPH, of the London School of Hygiene & Tropical Medicine, is the corresponding author for The Lancet article.
The study was funded by Canadian Partnership Against Cancer, Cancer Focus Northern Ireland, Cancer Institute New South Wales, Cancer Research UK, US Centers for Disease Control and Prevention, Swiss Cancer Research Foundation, Swiss Cancer League, and University of Kentucky, Lexington.
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