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Abstract
Introduction Lung cancer has a poor prognosis that varies internationally when assessed by the two major histological subgroups (non-small cell (NSCLC) and small cell (SCLC)).
Method 236 114 NSCLC and 43 167 SCLC cases diagnosed during 2010–2014 in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK were included in the analyses. One-year and 3-year age-standardised net survival (NS) was estimated by sex, histological type, stage and country.
Results One-year and 3-year NS was consistently higher for Canada and Norway, and lower for the UK, New Zealand and Ireland, irrespective of stage at diagnosis. Three-year NS for NSCLC ranged from 19.7% for the UK to 27.1% for Canada for men and was consistently higher for women (25.3% in the UK; 35.0% in Canada) partly because men were diagnosed at more advanced stages. International differences in survival for NSCLC were largest for regional stage and smallest at the advanced stage. For SCLC, 3-year NS also showed a clear female advantage with the highest being for Canada (13.8% for women; 9.1% for men) and Norway (12.8% for women; 9.7% for men).
Conclusion Distribution of stage at diagnosis among lung cancer cases differed by sex, histological subtype and country, which may partly explain observed survival differences. Yet, survival differences were also observed within stages, suggesting that quality of treatment, healthcare system factors and prevalence of comorbid conditions may also influence survival. Other possible explanations include differences in data collection practice, as well as differences in histological verification, staging and coding across jurisdictions.
- Histology/Cytology
- Lung Cancer
- Non-Small Cell Lung Cancer
- Small Cell Lung Cancer
Data availability statement
Data may be obtained from a third party and are not publicly available. Data contain sensitive and personal information and can be obtained from the cancer registries listed as the local leads in the manuscript.
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Data availability statement
Data may be obtained from a third party and are not publicly available. Data contain sensitive and personal information and can be obtained from the cancer registries listed as the local leads in the manuscript.
Footnotes
MA and MF-B contributed equally.
Collaborators ICBP SURVMARK-2 Local Leads: Alana Little (Cancer Institute NSW, Alexandria, New South Wales, Australia); Angela Eckstrand (Alberta Health Services, Edmonton, Alberta, Canada); Anna Gavin (Northern Ireland Cancer Registry, Queen’s University Belfast, Belfast, Northern Ireland, UK); Bin Zhang (Government of New Brunswick, Fredericton, New Brunswick, Canada); Bjørn Møller (Cancer Registry of Norway (Kreftregisteret), Oslo, Norway); Carol McClure (Government of Prince Edward Island, Charlottetown, Prince Edward Island, Canada); Rebecca Thomas (Welsh Cancer Intelligence and Surveillance Unit, Public Health Wales, Cardiff, Wales, UK); Connie Marano (Cancer Care Ontario, Toronto, Ontario, Canada); Christine Bertrand (Government of Quebec, Montreal, Quebec, Canada); Christopher Jackson (Cancer Society of New Zealand, Wellington, New Zealand); Claire Austin (Ministry of Health, New Zealand); David Gavin (The BC Cancer Research Centre, Vancouver, British Columbia, Canada); David S Morrison (Scottish Cancer Registry, University of Glasgow, Scotland); Deirdre Fitzpatrick (Northern Ireland Cancer Registry, Queen’s University Belfast, Belfast, Northern Ireland, UK); Donna Turner (Cancer Care Manitoba, Winnipeg, Manitoba, Canada); Dyfed Huws (Welsh Cancer Intelligence and Surveillance Unit, Public Health Wales, Cardiff, Wales, UK); Eshwar Kumar (Government of New Brunswick, Fredericton, New Brunswick, Canada); Gail Noonan (Cancer Care Manitoba, Winnipeg, Manitoba, Canada); Geoff Porter (Canadian Partnership Against Canada, Toronto, Ontario, Canada); Gerda Engholm (Surveillance and Pharmacoepidemiology, Danish Cancer Society Research Centre, Copenhagen, Denmark); Gina Lockwood (Canadian Partnership Against Canada, Toronto, Ontario, Canada); Grace Musto (Cancer Care Manitoba, Winnipeg, Manitoba, Canada); Grlica Bolesnikov (Government of New Brunswick, Fredericton, New Brunswick, Canada); Guillaume Ruel (Government of Quebec, Montreal, Quebec, Canada); Hanna Tervonen (Cancer Institute NSW, Alexandria, New South Wales, Australia); Hazem Abd Elkader (Cancer Society of New Zealand, Wellington, New Zealand); Heather Stuart-Panko (Saskatchewan Cancer Agency, Regina, Saskatchewan, Canada); Janet Warlow (Welsh Cancer Intelligence and Surveillance Unit, Public Health Wales, Cardiff, Wales, UK); Jason Poole (Public Health England, London, England, UK); John Spinelli (The BC Cancer Research Centre, Vancouver, British Columbia, Canada); Lorraine Shack (Alberta Health Services, Edmonton, Alberta, Canada); Louise Sandford (Cancer Society of New Zealand, Wellington, New Zealand); Marianne Brenn Jerm (Cancer Registry of Norway (Kreftregisteret), Oslo, Norway); Maureen MacIntyre (Nova Scotia Health Authority, Halifax, Nova Scotia, Canada); Nathalie St-Jacques (Nova Scotia Health Authority Cancer Care Program, Halifax, Nova Scotia, Canada); Oliver Bucher (Cancer Care Manitoba, Winnipeg, Manitoba, Canada); Paul Walsh (National Cancer Registry Ireland, Cork, Ireland); Prithwish De (Cancer Care Ontario, Toronto, Ontario, Canada); Raman Agnihotram (Research-Institude, McGill University Health Centre, Montreal, Quebec, Canada); Richard Trevithick (Department of Health, Perth, Western Australia, Australia); Rory Carle (Department of Health, Perth, Western Australia, Australia); Ryan Woods (Cancer Control Research, BC Cancer, Vancouver, British Columbia, Canada); Sally Vernon (Public Health England, London, England, UK); Serena Kozie (Saskatchewan Cancer Agency, Regina, Saskatchewan, Canada); Susan Ryan (Eastern Health, St. John’s, Newfoundland and Labrador, Canada); Sue Evans (Cancer Council Victoria, Melbourne, Victoria, Australia). ICBP SURVMARK-2 Academic Reference Group: Dianne O'Connell (Cancer Council New South Wales, Sydney, New South Wales, Australia); Michael Eden (Public Health England, London, UK); Mark Elwood (University of Auckland, New Zealand); Sabine Siesling (Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht Amsterdam, The Netherlands; and University of Twente, Enschede, The Netherlands). ICBP Clinical Committee–Lung: Anur Guhan (The Ayr Hospital, Scotland, UK); Christian Finley (McMaster University, Canadian Association of Thoracic Surgeons, Canada); Brian McCaughan (University of Sydney, Australia); David Baldwin (University of Nottingham, UK); Erik Jakobsen (Odense University Hospital, Denmark); Ian Williamson (Aneurin Bevan University Hospital, Wales, UK); Jason Lester (Velindre Cancer Centre, Wales, UK); Jonathan McAleese (Belfast City Hospital, Northern Ireland, UK); Karl Kolbeck (Karolinska University Hospital, Sweden); Mick Peake (Public Health England, UK); Odd Terje Brustugun (Oslo University Hospital, Norway); Paul Dawkins (Middlemore Hospital, New Zealand); Wendy Anderson (Northern Health and Social Care Trust, Northern Ireland, UK).
Contributors MAr and MF-B analysed the data and drafted and revised the paper. MA, MR and AB wrote the statistical analysis plan, monitored data collection for the study and revised the draft paper. JF prepared the study protocol, monitored data collection and data harmonisation for the study, and revised the draft paper. OB, PD, GE, AG, SK, AL, BM, NSJ, HT, PW and RW prepared the study protocol, collected the data, contributed to the analytical plan and revised the draft of the paper. DLOC, DB, ME and SS commented on the analytical plan, study results and revised the draft of the paper. FB and IS designed the study, data collection tools, monitored data collection for the study, wrote the statistical analysis plan, and drafted and revised the paper. IS is the guarantor of the study.
Funding The project is funded by the International Cancer Benchmarking Partnership which is funded by the 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; and Wales Cancer Network.
Disclaimer Where authors are identified as personnel of the International Agency for Research on Cancer/WHO, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer/WHO.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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