林州市食管癌和胃癌的发病水平及变化趋势

目的利用林州市人群为基础的食管癌和胃癌发病登记报告资料,描述性分析林州市居民的食管癌和胃癌发生水平及变化趋势,为该地区的癌症防治研究及效果评价提供有效的参考数据。方法从林州市肿瘤登记处抽取1988年至2003年间登记报告的食管癌和胃癌发生的全部记录,按性别、年龄、年份分组后,与相应的人口数据连接。计算食管癌和胃癌各个年份发病率及世界人口年龄调整率。采用Jionpoint模型获得年龄调整发病率的年度变化百分比(APC),以评价林州市食管癌及胃癌发病率的时间变化趋势。结果2003年林州市人群食管癌和胃癌年龄调整发病率分别为81.78/10万和77.08/10万。1988年至2003年间,两种癌症的年龄调整发病率均呈下降趋势,发病率的EAPC分别为-2.6%和-1.8%,EAPC指标均有统计学意义(P<0.05)。同时,男女性胃癌不同解剖部位(贲门、其他胃)和男女性食管癌合并贲门癌的发病率也呈下降趋势。结论观察期间,林州市人群食管癌和胃癌的发病率呈现下降趋势。随着当地社会经济的发展,居民生活水平的逐步提高,居住环境条件及生活习惯的不断改善,这种下降趋势将会延续。     

2003~2012年林州市胃癌发病、生存及患病分析

摘 要：［目的］ 分析2003~2012年林州市不同部位胃癌发病及生存状况,了解当地胃癌发病趋势和疾病负担。［方法］从林州市肿瘤登记处抽取2003~2012年全部胃癌发病个案记录和人口数据,计算不同性别、部位的胃癌发病率。按世界标准人口（Segi’s）年龄构成计算世界人口结构标化发病率（世标率）。采用Joinpoint模型对2003~2012年胃癌的世标率进行回归分析。应用Kaplan-Meier方法计算5年生存率。［结果］ 2003~2012年间,林州市胃癌新发病例7591例,发病率为73.87/10万,其中贲门癌新发病例4948例,占65.18%。2003年林州市胃癌世标率为78.67/10万,2012年世标率为69.83/10万,世标率下降了11.23%。Joinpoint模型回归分析结果显示,胃癌发病率在2003~2012年间每年下降1.2%（95%CI：0.4~2.1）,女性胃癌发病率在2003~2012年间每年下降2.8%（95%CI：0.4~5.1）,不明部位胃癌发病率在2005~2012年间每年下降12.6%（95%CI：5.1~19.4）。胃癌的5年生存率为29.3%(95%CI：28.2~30.3),胃癌5年患病率为196.89/10万。［结论］ 林州市胃癌的发病率呈下降趋势,生存率较以往有所提高,胃癌疾病负担依然较重。胃癌的主要发病部位为贲门。     

食管癌高发区上消化道恶性肿瘤死亡趋势分析

目的分析河北省食管癌高发区磁县、涉县29年（1974-2002年）上消化道恶性肿瘤的死亡情况,为肿瘤防治提供依据。方法对比分析磁县、涉县同时期20世纪70年代（1974-1976年）、90年代（1990-1992年）、21世纪初（2000-2002年）全人群肿瘤登记的食管癌、贲门癌、非贲门胃癌的死亡率。结果自20世纪70年代到21世纪初,磁县、涉县食管癌粗死率均呈现明显下降趋势,磁县食管癌粗死率下降了40.96/10万,下降了32.21%;而同时期涉县下降了65.74/10万,下降了50.06%。磁县贲门癌和非贲门胃癌的粗死率呈现曲线波动,变化不大,20世纪70年代贲门癌死亡占上消化道恶性肿瘤死亡的5.67%,到90年代占4.58%,21世纪初占8.15%。而涉县贲门癌呈现明显上升趋势,非贲门胃癌呈现明显下降趋势,发现贲门癌在上消化道恶性肿瘤死亡中所占比重越来越大,由20世纪70年代的6.28%上升到新世纪的30.17%。磁县、涉县人群中男性贲门癌的死亡率高于女性。磁县山区贲门癌死亡率高于丘陵和平原,年平均死亡率达到11.61/10万,且有上升趋势。结论29年来磁县、涉县食管癌死亡呈显著下降趋势,磁县贲门癌、非贲门胃癌死亡均呈曲线波动;涉县贲门癌死亡率呈明显上升趋势,非贲门胃癌死亡率呈下降趋势。     

食管癌高发区1.5万队列人群内镜筛查与食管癌胃癌死亡研究

目的:磁县是我国北方食管癌高发区.河北医科大学第四医院肿瘤研究所自2001年开展40～69岁为目标人群的内镜碘染色队列筛查,以期降低食管癌高发区的发病率和死亡率.方法:2001年10月～2002年10月选择磁县4个乡,干预人群22016例,对照人群33410例,总覆盖人群5.5万,其中干预人群40～69岁中男性3 257例,女性3 339例,对照人群中男性4 299例,女性4 430例.干预人群采用内镜碘染色筛查,筛查率53.2%.内镜碘染色筛查食管鳞状上皮和贲门腺上皮原位癌及黏膜内癌97例,食管和贲门重度不典型增生102例;对照人群观察肿瘤自然发病率和死亡率.肿瘤发病死亡登记编码应用ICD-0-2.2008年6月～9月根据全县肿瘤发病死亡登记数据库,对该队列人群进行随访核实.结果:干预人群食管癌死亡133例,胃癌48例,对照组人群分别为259例和37例.男性食管癌死亡相对危险度RR=0.76,95%CI(0.59～0.98),P=0.038;女性RR=0.51,95%CI(0.35～0.75),P=0.000.男性胃癌死亡相对危险度RR=2.45,95%CI(1.4～4.29).P=0.010;女性RR=0.99,95%CI(0.47～1.99),P=0.906.结论:食管癌高发区内镜碘染色大人群队列筛查历经6年时间演变,男性和女性食管癌死亡危险度下降,有显著性差异,但内镜筛查对胃癌死亡危险未见到保护作用.     

我国5个高发区非贲门胃癌危险因素的病例对照研究

[目的]探讨我国食管癌胃癌高发区非贲门胃癌的危险因素.[方法]选择河北省磁县和涉县、河南省林州市、山东省肥城市和辽宁省庄河市,按照统一的研究方案,随机抽取2009年1月1日以后新发生的非贲门胃癌各50例(林州市51例),采用1:3人群配对选取对照组.用统一的调查表对251例患者和753例对照进行调查.数据的录入和分析分...     

胃癌内镜筛查对统计治愈比例的影响

[目的]评估胃癌统计治愈比例现状及其与胃癌内镜筛查之间的关系。[方法]提取2005—2012年林州市以人群为基础的肿瘤登记数据库中ICD-10为C16.0～C16.9范围的胃癌病例数据(共6 172例)，通过链接胃癌人群筛查数据库与肿瘤登记数据库以获取患者是否参加筛查信息，利用混合统计治愈模型建模并估计统计治愈比例及相对生存率，计算比值比（OR）值以及95%可信区间（CI）以评估胃癌内镜筛查和统计治愈之间的关系。[结果]曾参加内镜筛查和从未参加内镜筛查胃癌患者的统计治愈比例分别为75.51%(95%CI:69.18%～81.85%)和31.69%(95%CI:30.30%～33.07%)，估计治愈比例两者差值为38.76%(32.35%～45.00%)。参加内镜筛查患者与未参加筛查患者相比，受益于统计治愈的OR为5.84 (95%CI:4.10～8.31)，参加内镜筛查患者受益于贲门胃统计治愈（OR=6.10,95%CI:3.96～9.39）要高于非贲门胃(OR=5.34,95%CI:2.54～11.23)。[结论]参加胃癌内窥镜筛查可以提高胃癌患者统计治愈比例。     

单纯被动随访评估人群肿瘤生存率偏倚分析

目的评估单纯被动随访在人群肿瘤生存率研究中对5年生存率估计造成的偏倚。方法从沈阳、鞍山和本溪3个城市2000-2002年肿瘤登记报告数据库中随机抽取21种主要肿瘤8 334例,通过与三市2000-2005年全死因数据库联动进行被动随访,然后再通过医院病案和公安局人口信息库核对,电话、入户、社区与工作单位回访进行主动随访。生存期起始时间是首次确诊日期,根据被动和主动随访结果对患者2005-12-31的生存状态进行不同的假设,采用寿命表法计算观察生存率。结果单纯被动随访共确认2 572例(30.9%)5年内死亡,主动随访确认2 142例(25.7%)死亡。单纯被动随访将只能确认总死亡病例的54.6%,对21种癌瘤的5年生存率高估9.0%~52.6%,高估幅度各癌间存在很大差异,高估率与生存率呈显著负相关(r=-0.474 7,P<0.01)。单纯被动随访对甲状腺癌、乳腺癌和子宫体癌等恶性度较低癌症的生存率高估10%~20%,对肝癌、肺癌、胃癌和胰腺癌等恶性度较高癌症的生存率高估30%~50%。结论对于目前我国肿瘤发病报告和死亡报告人口标识信息填写和(或)录入准确性较差的地区,单纯采用被动随访将严重高估肿瘤的5年生存率,需采用主动与被动随访结合的方式进行人群肿瘤生存率研究。     

启东市2001-2007年胃癌生存率分析

目的:分析启东市2001年-2007年全人群胃癌患者的观察生存率和相对生存率。方法:2839例胃癌登记病例的生存(死亡)情况随访截止于2009年12月31日;剔除DCO(death certificate only)病例,实际纳入分析2824例。用SURV3.01软件计算观察生存率(OS)及相对生存率(RS)。结果:启东胃癌1、3、5年OS分别为41.86%、27.59%和24.41%,1、3、5年RS分别为43.82%、31.68%和30.88%。其中男性1、3、5年OS分别为44.04%、31.00%、29.99%,女性1、3、5年RS分别为43.45%、32.86%、32.42%,男女性生存率差别无显著意义(P>0.05)。15-34岁、35-44岁、45-54岁、55-64岁、65-74岁及75岁以上各年龄组的5年RS分别为27.79%、37.91%、34.18%、29.41%、29.61%及29.85%,年龄组生存率差异有显著意义(P<0.001)。5年相对生存率与启东20世纪70年代相比,有了显著的提高。结论:启东市全人群胃癌生存率呈上升趋势,应当继续重视胃癌的生存率研究,为人群综合防治服务。     

上海市区泌尿系统恶性肿瘤相对生存率分析

目的:分析1988～1995年上海市区泌尿系统恶性肿瘤的生存情况,观察其趋势.方法:根据上海市肿瘤登记处积累的肿瘤登记病例和随访资料,采用寿命表法和Hakulinen氏法计算相对生存率,并比较前后两个时期(4年)结果.结果:上海市区1988～1995年男性膀胱癌、肾癌、前列腺癌5年相对生存率分别为57.4%、49.9%、36.5%,女性膀胱癌、肾癌5年相对生存率分别为47.6%、53.5%;其中男性膀胱癌的生存率高于女性,但肾癌相反.不同时间段分析结果显示:1988～1991年男性膀胱癌、肾癌、前列腺癌5年相对生存率分别从53.7%、41.6%、38.0%上升至1992～1995年的57.2%、50.6%、39.1%;女性膀胱癌5年相对生存率从41.8%上升至44.7%,而女性肾癌5年相对生存率从48.0%降至47.3%.结论:上海市区泌尿系统恶性肿瘤生存率基本呈现上升趋势,但仅男性肾癌和前列腺癌的变化有统计学意义.     

北方食管癌高发区磁县1988年至2011年胃癌死亡趋势分析

目的:分析北方食管癌高发区磁县1988-2011年胃癌死亡趋势.方法:选取磁县肿瘤登记处同年度ICD编码为C16死亡数据.结果:1988-2011年胃癌总死亡4 677人.男性1988-1999年平均粗死亡率40.5/105,2000-2011年为45.5/105;女性同期死亡率分别为19.7/105、22.7/105.1988-2011年胃癌死亡年度变化百分比(APC)总体呈现上升趋势,APC为0.43％.1988-1999年与2000-2011年两个时间段APC变化,1988-1999年胃癌死亡表现下降趋势,其中男性APC为-2.65％,P=0.042,女性-0.92％,P=0.439.2000-2011年胃癌死亡则表现整体上升趋势,男性和女性APC分别是3.13％、2.82％,均无统计学差异.结论:磁县1988-1999年胃癌死亡呈下降趋势,2000-2011年则明显上升,虽然尚无统计学差异,但上升趋势表明,在食管癌高发区对胃癌的防治研究是不能忽视的重要课题.     

Survival of stomach and esophagus cancer patients in Germany in the early 21st century

Abstract Background. Esophagus and stomach cancers are associated with poor prognosis. But most published population-based cancer survival estimates for stomach and esophagus cancer refer to survival experience of patients diagnosed in the 1990s or earlier years. The aim of this study was to provide up-to-date survival estimates and trends for patients with stomach and esophagus cancer in Germany. Material and methods. Our analysis is based on data from 11 population-based cancer registries, covering 33 million inhabitants. Patients diagnosed with stomach and esophagus cancer in 1997-2006 were included. Period analysis was used to derive five-year relative survival estimates and trends by age, sex, cancer subsite, and stage for the time period of 2002-2006. German and US survival estimates were compared utilizing the SEER 13 database. Results. Overall age-standardized five-year relative survival was 31.8% and 18.3% for stomach and esophagus cancer, respectively, compared to 27.2% and 17.4% in the US. Survival was somewhat higher among female than among male patients for both cancer sites (33.6% vs. 30.6% and 21.5% vs. 17.5%, respectively) and much higher for non-cardia stomach cancer (40.4%) than for cardia cancer (23.4%). From 2002 to 2006, a moderate increase in five-year relative survival by 2.7 percent units was observed for non-cardia stomach cancer patients in Germany (p 相似文献   

Parity and risk of stomach cancer by sub-site: a national Swedish study

We investigated stomach cancer risk by anatomic sub-site in relation to parity, as a marker for higher exposure to sex hormones, in a case-control study, nested within a cohort of 2,406,439 Swedish women born in 1925 or later and followed from 1970 or age 30 until emigration, death, any cancer diagnosis, or through 2004, whichever occurred first. We identified 286 cardia and 2498 non-cardia stomach cancer cases with five matched controls for each case. Cross-linkage with the Multi-Generation Register provided information about reproductive history. Using conditional logistic regression models for estimating odds ratios (ORs) and corresponding 95% confidence intervals (CIs), adjusted for education level and occupation, we found no association between any aspect of parity and non-cardia stomach cancer (OR=1.01, 95% CI 0.89-1.15, comparing parous with nulliparous women). However, a 30% risk reduction for postmenopausal cardia cancer (OR=0.7, 95% CI 0.4-1.0) was noted among parous relative to nulliparous women and the risk for premenopausal cardia cancer fell with increasing number of children (P for trend=0.04). Our results indicate that exposure to female sex hormones does not protect against non-cardia stomach cancer and does not explain male predominance. The observed moderate inverse relationship between parity and cardia cancer may be mediated by non-hormonal factors and warrants further study.     

Primary central nervous system lymphoma in Japan: changes in clinical features, treatment, and prognosis during 1985-2004

We have conducted nationwide surveys of primary central nervous system lymphoma (PCNSL) treated since 1985. In the present study, we newly collected data between 2000 and 2004 and investigated changes in clinical features and outcome over time. A total of 739 patients with histologically proven PCNSL under going radiotherapy were analyzed. Seventeen institutions were surveyed, and data on 131 patients were collected. These data were compared with updated data that were previously obtained for 466 patients treated during 1985-1994 and 142 patients treated during 1995-1999. Recent trends toward decrease in male/female ratio, increase in aged patients, and increase in patients with multiple lesions were seen. Regarding treatment, decrease in attempts at surgical tumor removal and increases in use of systemic chemotherapy and methotrexate (MTX)-containing regimens were observed. The median survival time was 18, 29, and 24 months for patients seen during 1985-1994, 1995-1999, and 2000-2004, respectively, and the respective 5-year survival rates were 15%, 30%, and 30%. In groups seen during 1995-1999 and during 2000-2004, patients who received systemic or MTX-containing chemotherapy had better prognosis than those who did not. Multivariate analysis of all patients seen during 1985-2004 suggested the usefulness of MTX-containing chemotherapy as well as the importance of age, lactate dehydrogenase level, and tumor multiplicity as prognostic factors. Thus, this study revealed several notable changes in clinical features of PCNSL patients. The prognosis improved during the last 10 years. Advantage of radiation plus chemotherapy, especially MTX-containing chemotherapy, over radiation alone was suggested.     

Trends in incidence,treatment and survival of gastric adenocarcinoma between 1990 and 2007: A population-based study in the Netherlands

BackgroundSurvival of gastric cancer in the Western world remains poor. We conducted a retrospective population-based study to evaluate trends in incidence, treatment and outcome of gastric adenocarcinoma.MethodsAll patients diagnosed with gastric adenocarcinoma during 1990–2007 in the Dutch Eindhoven Cancer Registry area were included (n = 4797). Trend analyses were conducted for incidence, mortality, tumour and patient characteristics, treatment and crude overall survival, according to tumour location (cardia versus non-cardia). Temporal changes in the odds of undergoing surgery and the risk of death were analysed by means of multivariable regression methods.ResultsAge-standardised incidence decreased among males (24–12 per 100,000 inhabitants) and females (10–6); mortality rates decreased at a similar pace. The proportion of cardia tumours remained stable. Stage distribution worsened over time among patients with cardia (stages I and II: 32% in 1990–1993 and 22% in 2006–2007, p = 0.005) and non-cardia (stage IV: 33% in 1990–1993 and 40% in 2006–2007, p = 0.0003) cancer. Chemotherapy rates increased in all settings. Five-year survival worsened over time for patients with non-cardia tumours. Age and stage had significant influence on survival after stratification for tumour localisation. After adjustments for relevant factors (i.e. stage), the risk of death decreased since the late 90s for patients with a cardia tumour (hazard ratio 0.8, p = 0.01).ConclusionThe absence of improvement in survival rates indicates the need for earlier detection and prospective studies to evaluate new therapy regimens with standardised surgery and pathology.     

EPIDEMIC STRENGTH OF CARDIA AND DISTANT STOMACH CANCER IN THE HIGH RISK REGION OF ESOPHAGEAL CANCER AND THEIR IMPLICATION TO EDOSCOPIC SCREENING

Objective： To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to clarify the tasks for the control of upper gastrointestinal tract cancer as a whole in the region. Methods： Comparisons of incidence and mortality rates of esophageal, cardia and stomach cancers were made between Cixian, Linxian and Shexian Counties with reference to detection rates of cancer in situ and precancerous lesions of the three upper gastrointestinal cancers by endoscopic screening. The screening was performed from 1999 through 2004 in the three adjacent counties including a total of 6233 local residents aged 40 to 69 years old. Results： The incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9 and 41.5, and the mortality rates were 54.3 and 33.2 respectively in Shexian County. Esophageal, cardia, and stomach cancers constitute about 70～80 percent of all malignant disease by incidence or mortality rates. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but the method is inadequate for the detection of adeno precancerous lesions of the cardia and stomach. Conclusion： The south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia and stomach cancers. To control upper gastrointestinal tract cancers as a whole in the region, special attention should be paid to the control of cardia and stomach cancers. Presently, to find effective screening methods for detecting cardia and stomach precancerous lesions is especially important.     

Long-term crude probabilities of death among breast cancer patients by age and stage: a population-based survival study in Northeastern Spain (Girona–Tarragona 1985–2004)

Background

We provide population-based long-term survival indicators of breast cancer patients by quantifying the observed survival, and the probabilities of death due to breast cancer and to other causes by age and tumor stage at diagnosis.

Methods

We included a total of 10,195 female patients diagnosed before 85 years with invasive primary breast cancer in Girona and Tarragona during the periods 1985–1994 and 1995–2004 and followed-up until December 31st 2014. The survival indicators were estimated at 5, 10, 15 and 20 years of follow-up comparing diagnostic periods.

Results

Comparing diagnostic periods: I) the probability of death due to other causes did not change; II) the 20-year survival for women diagnosed ≤ 49 years increased 13% (1995–2004 = 68%; 1985–1994:55%), whereas their probability of death due to breast cancer decreased at the same pace (1995–2004 = 29%; 1985–1994 = 42%); III) at 10 years of follow-up, decreases in the probabilities of death due to breast cancer across age groups switched from 11 to 17% resulting in a risk of death reduction of 19% after adjusting by stage. During 1995–2004, the stage-specific 10-year probabilities of death due to breast cancer switched from: 3–6% in stage I, 18–20% in stage II, 34–46% in stage III and surpassed 70% in stage IV beyond 5 years after diagnosis.

Conclusions

In our study, women diagnosed with breast cancer had higher long-term probability to die from breast cancer than from other causes. The improvements in treatment and the lead-time bias in detecting cancer in an early stage resulted in a reduction of 19% in the risk of death between diagnostic periods.

     

Suicide mortality is decreasing among cancer patients in Central Italy

The objective of this study was to discover whether suicide mortality among patients diagnosed with cancer during the period 1985-1999 had decreased with calendar time in comparison to the rate in the general population. 90?197 cancer patients resident in Tuscany, Central Italy and incident during the period 1985-1999 were followed up for life status to 31 December 2000. The mortality codes for suicide were considered (E950-E959). Time trends for suicide rates were assessed by using Kernel smoothing estimators, standardised mortality ratios and Poisson analysis of the observed/expected ratios. The standardised mortality ratios were 324, 224, and 185 for cancer patients diagnosed during the periods 1985-1989, 1990-1994, and 1995-1999, respectively. Tests for linear trends were borderline significant (P=0.053). Suicide mortality among cancer patients in central Italy had decreased with calendar time relative to the suicide trend in the general population. Improved treatment options and better communication of diagnosis are possible explanations of this finding.     

Cancer survival in Chennai (Madras), India, 1990-1999

The Madras metropolitan tumour registry was established in 1981, and registration of incident cancer cases is entirely done by active method. Data on survival for 20 cancer sites or types registered during 1990-1999 are reported. Follow-up has been carried out predominantly by active methods with a median follow-up time ranging between 2-28 months for different cancers. The proportion of histologically verified diagnosis for various cancers ranged between 45-100%; death certificates only (DCOs) comprised 0-5%; 68-95% of total registered cases were included for survival analysis. Complete follow-up at five years ranged between 83-96%. The 5-year age-standardized relative survival rates for common cancers were cervix (60%), breast (47%), stomach (8%), oesophagus (9%), lung (6%) and mouth (36%). The 5-year relative survival by age group portrayed either an inverse relationship or fluctuated. A majority of cases were diagnosed with regional spread of disease, and survival decreased with increasing extent of disease. The absolute difference in 5-year relative survival of most cancers diagnosed in 1984-1989 and1990-1999 ranged between 2-3%, with lesser survival in the latest period in most instances.     

Significant improvement in survival of patients presenting with metastatic colon cancer in the south of The Netherlands from 1990 to 2004

BackgroundIn randomised controlled trials, the median overall survival (OS) for patients with metastatic colon cancer has improved. However, the results of randomised controlled trials should be interpreted with caution and cannot simply be extrapolated to the general practice. We retrospectively analysed population-based survival data of patients who presented with metastatic colon cancer at diagnosis.Patients and methodsAll patients diagnosed with primary metastatic colon cancer from 1990 to 2004 in the registration area of the Eindhoven Cancer Registry were included. Date of diagnosis was divided into four periods (1990–1994, 1995–1999, 2000–2002, and 2003–2004) according to the availability of chemotherapy for metastatic colon cancer. We assessed OS according to chemotherapy use and period.ResultsOf the 1769 patients, 30.6% received chemotherapy. Chemotherapy use over time increased from 24% in 1990–1994 to 55% in 2000–2004 for patients aged <70 years and from 2% to 22% in patients aged 70 years and older. Median survival for patients diagnosed in 1990–1994 was 26 [95% confidence interval (CI) 22–32] weeks, while patients diagnosed in 2003–2004 had a median survival of 39 (95% CI 31–48) weeks. Patients who did not receive chemotherapy had a survival of 22 (95% CI 20–25) weeks, while the survival for patients who did receive chemotherapy was 57 (95% CI 51–65) weeks. OS decreased with increasing age (P < 0.0001). In the multivariate survival analysis, chemotherapy use, increasing age, having multiple comorbid conditions, and having more than one tumour site significantly affect survival, with the strongest effect of chemotherapy use.ConclusionPalliative chemotherapy significantly improved OS in unselected patients with metastatic colon cancer.     

Childhood cancer survival in France, 1990-1999

The aim of this study was to describe the overall survival after childhood cancer in France using follow-up data from regional population-based registries. The survival of children (aged under 15 years) diagnosed with a cancer during 1990-1999 was analysed. For all cancers, the survivals were, respectively, 90.3% [89.4-91.3] at 1-year, 75.2% [73.8-76.6] at 5 years and 72.2% [70.7-73.7] at 10 years. During the 1990s, the average improvement in the 5-year survival was +1.2% per year. Adjusted for gender, age, area of residence and stage, children with cancer diagnosed between 1995 and 1999 had a 0.80 reduced risk of dying compared with those whose cancer had been diagnosed between 1990 and 1994. The increase of survival at the population level reflects a global improvement in childhood cancer care. The Paediatric Registries, in association with the French Society of Childhood Cancer, are now collecting data to quantify on a national basis the other events, at least relapse and second cancers.