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International differences in lung cancer survival by sex, histological type and stage at diagnosis: an ICBP SURVMARK-2 Study
  1. Marzieh Araghi1,
  2. Miranda Fidler-Benaoudia2,
  3. Melina Arnold1,
  4. Mark Rutherford1,3,
  5. Aude Bardot1,
  6. Jacques Ferlay1,
  7. Oliver Bucher4,
  8. Prithwish De5,
  9. Gerda Engholm6,
  10. Anna Gavin7,
  11. Serena Kozie8,
  12. Alana Little9,
  13. Bjørn Møller10,
  14. Nathalie St Jacques11,
  15. Hanna Tervonen9,
  16. Paul Walsh12,
  17. Ryan Woods13,14,
  18. Dianne L O'Connell15,
  19. David Baldwin16,
  20. Mark Elwood17,
  21. Sabine Siesling18,
  22. Freddie Bray1,
  23. Isabelle Soerjomataram1,
  24. ICBP SURVMARK-2 Local Leads,
  25. ICBP SURVMARK-2 Academic Reference Group
  26. ICBP Clinical Committee–Lung
        1. 1Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
        2. 2Cancer Epidemiology and Prevention Research, Holy Cross Centre, Alberta Health Services, Calgary, Alberta, Canada
        3. 3Health Sciences, University of Leicester, Leicester, UK
        4. 4Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
        5. 5Analytics and Informatics, Cancer Care Ontario, Toronto, Ontario, Canada
        6. 6Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Society Research Center, Kobenhavn, Denmark
        7. 7Queen’s University Belfast, Northern Ireland Cancer Registry, Belfast, UK
        8. 8Saskatchewan Cancer Agency, Regina, Saskatchewan, Canada
        9. 9Cancer Institute New South Wales, Eveleigh, New South Wales, Australia
        10. 10Department of Registration, Cancer Registry of Norway, Oslo, Norway
        11. 11Cancer Care Program, Registry and Analytics, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
        12. 12National Cancer Registry, Cork, Ireland
        13. 13BC Cancer, Vancouver, British Columbia, Canada
        14. 14Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
        15. 15The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Cancer Research Division, Sydney, New South Wales, Australia
        16. 16Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
        17. 17School of Population Health, The University of Auckland, Auckland, New Zealand
        18. 18Department of Research and Development, IKNL, Utrecht, The Netherlands
        1. Correspondence to Dr Isabelle Soerjomataram, Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, 69372 CEDEX 08, France; soerjomatarami{at}iarc.fr

        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.

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        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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