RT Journal Article
SR Electronic
T1 National comparisons of lung cancer survival in England, Norway and Sweden 2001–2004: differences occur early in follow-up
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 436
OP 441
DO 10.1136/thx.2009.124222
VO 65
IS 5
A1 Lars Holmberg
A1 Fredrik Sandin
A1 Freddie Bray
A1 Mike Richards
A1 James Spicer
A1 Mats Lambe
A1 Åsa Klint
A1 Mick Peake
A1 Trond-Eirik Strand
A1 Karen Linklater
A1 David Robinson
A1 Henrik Møller
YR 2010
UL http://thorax.bmj.com/content/65/5/436.abstract
AB Background Countries with a similar expenditure on healthcare within Europe exhibit differences in lung cancer survival. Survival in lung cancer was studied in 2001–2004 in England, Norway and Sweden.Methods Nationwide cancer registries in England, Norway and Sweden were used to identify 250 828 patients with lung cancer from England, 18 386 from Norway and 24 886 from Sweden diagnosed between 1996 and 2004, after exclusion of patients registered through death certificate only or with missing, zero or negative survival times. 5-Year relative survival was calculated by application of the period approach. The excess mortality between the countries was compared using a Poisson regression model.Results In all subcategories of age, sex and follow-up period, the 5-year survival was lower in England than in Norway and Sweden. The age-standardised survival estimates were 6.5%, 9.3% and 11.3% for men and 8.4%, 13.5% and 15.9% for women in the respective countries in 2001–2004. The difference in excess risk of dying between the countries was predominantly confined to the first year of follow-up. The relative excess risk ratio during the first 3 months of follow-up comparing England with Norway 2001–2004 varied between 1.23 and 1.46, depending on sex and age, and between 1.56 and 1.91 comparing England with Sweden.Conclusion Access to healthcare and population awareness are likely to be major reasons for the differences, but it cannot be excluded that diagnostic and therapeutic activity play a role. Future improvements in lung cancer management may be seen early in follow-up.