As reported by Arnold and colleagues in The Lancet Oncology, the International Cancer Benchmarking Partnership Cancer Survival in High-Income Countries (SURVMARK-2) project has found general improvement in cancer survival between 1995 and 2014 in Australia, Canada, Denmark, Ireland, New Zealand, Norway, and the United Kingdom.
Study Details
The study included data on 3,764,543 cases of cancer of the esophagus, stomach, colon, rectum, pancreas, lung, and ovary diagnosed between 1995 and 2014 (with follow-up through 2015) from 19 jurisdictions in the seven countries.
Key Findings
For 1995-2014, 1-year and 5-year net survival increased in each country across almost all cancer types; eg, 5-year rectal cancer survival increased by an absolute > 13% in Denmark, Ireland, and the UK. Relative improvements were greater for cancers associated with poorer prognosis—ie, esophagus, stomach, pancreas, and lung cancers. Improvements were greater among patients aged younger than 75 years old at diagnosis vs older patients.
For 2010–2014, the highest 1-year survival for most cancer sites was in Australia, followed by Canada and Norway. The lowest 1-year survival rates for stomach, colon, rectal, and lung cancer were in the UK, for esophageal cancer in Canada, for pancreatic cancer in New Zealand, and for ovarian cancer in Ireland. Similar patterns were observed for 5-year survival. Survival rates were higher in Australia vs other countries, except for lung cancer in Canada and ovarian cancer in Norway, and survival rates were lower in the UK, except for esophageal cancer in Denmark and ovarian cancer in Ireland.
“The joint evaluation of trends in incidence, mortality, and survival indicated progress in four of the seven studied cancers. Cancer survival continues to increase across high-income countries; however, 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.”— Arnold et al
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Survival gaps between countries were reduced over time for 1-year survival for all cancers except pancreatic cancer. Gaps in 5-year survival were reduced for esophageal and rectal cancers.
Improvement in cancer control—as measured by increased survival and decreased mortality and incidence—was observed over the study period for stomach cancer, colon cancer, lung cancer in males, and ovarian cancer.
The investigators concluded, “The joint evaluation of trends in incidence, mortality, and survival indicated progress in four of the seven studied cancers. Cancer survival continues to increase across high-income countries; however, 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. Future studies are needed to assess the impact of these factors to further our understanding of international disparities in cancer survival.”
Melina Arnold, PhD, of the Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, is the corresponding author for The Lancet Oncology article.
Disclosure: The study was funded by the Canadian Partnership Against Cancer, Cancer Institute New South Wales, Cancer Research UK, Danish Cancer Society, National Cancer Registry Ireland, The Cancer Society of New Zealand, Norwegian Cancer Society, and others. For full disclosures of the study authors, visit thelancet.com.
