CONCORD-3: Global Surveillance of Cancer Survival Trends, 2000–2014
In an article in The Lancet, Allemani et al reported findings from the CONCORD program for global surveillance of cancer survival trends updated through 2014 (CONCORD-3).
Study Details
CONCORD-3 includes data on 37.5 million patients diagnosed with cancer between 2000 and 2014 from 322 population-based cancer registries in 71 countries and territories, of which 47 provided data with 100% population coverage. The program covers 18 cancers or groups of cancers, including cancers of the esophagus; stomach; colon; rectum; liver; pancreas; lung; breast (women); cervix; ovary; prostate; melanoma of the skin in adult; and brain tumors, leukemias, and lymphomas in both adults and children.
Findings for 5-year net survival rates included the following:
- For most cancers, 5-year net survival remains among the highest in the world in the United States and Canada; in Australia and New Zealand; and in Finland, Iceland, Norway, and Sweden, with the gap between Denmark and other Nordic countries closing.
- In general, trends indicate increasing cancer survival rates worldwide, including rates for some of the more lethal cancers; in some countries, 5-year survival has increased by up to 5% for liver, pancreas, and lung cancers.
- For women diagnosed between 2010 and 2014, 5-year survival for breast cancer is now 89.5% in Australia and 90.2% in the United States; however, global rates differ substantially, with rates as low as 66.1% being observed in India.
- For gastrointestinal cancers, the highest 5-year survival rates were observed in southeast Asia, including rates of 68.9%, 71.8%, and 71.1% for stomach, colon, and rectal cancers in South Korea, 36.0% for esophageal cancer in Japan, and 27.9% for liver cancer in Taiwan. In contrast, in the same region, survival was generally lower than elsewhere for melanoma of the skin (59.9% in South Korea, 52.1% in Taiwan, and 49.6% in China), lymphoid malignancies (52.5%, 50.5%, and 38.3%) and myeloid malignancies (45.9%, 33.4%, and 24.8%).
- For children diagnosed with cancers between 2010 and 2014, 5-year survival for acute lymphoblastic leukemia ranged from 49.8% in Ecuador to 95.2% in Finland. Rates of 5-year survival from brain tumors are higher in children vs adults, but differ substantially throughout the world, ranging from 28.9% in Brazil to nearly 80% in Sweden and Denmark.
The investigators concluded, “The CONCORD program enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed worldwide every year. It contributes to the evidence base for global policy on cancer control. Since 2017, the Organisation for Economic Co-operation and Development has used findings from the CONCORD program as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries worldwide. Governments must recognize population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer.”
The study was funded by the American Cancer Society, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research Foundation, Swiss Cancer League, Institut National du Cancer, La Ligue Contre le Cancer, Rossy Family Foundation, National Cancer Institute, and Susan G. Komen Foundation.
Claudia Allemani, PhD, of the Cancer Survival Group, London School of Hygiene & Tropical Medicine, is the corresponding author for The Lancet article.
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