Elsevier

European Journal of Cancer

Volume 34, Issue 14, December 1998, Pages 2191-2196
European Journal of Cancer

Original Paper
Variation in survival of patients with lung cancer in Europe, 1985–1989

https://doi.org/10.1016/S0959-8049(98)00312-8Get rights and content

Abstract

In this study, we report on the variation in the prognosis for adult patients with lung cancer within Europe, by age, histology and country from 1985–1989. We considered trends in survival since 1978 for most countries. Survival analysis was carried out on 173 448 lung cancer cases diagnosed between 1985 and 1989 in 44 population-based cancer registries, participating in the EUROCARE study. Relative 1-year survival rates for patients with lung cancer varied from 24 to 40%, being highest in Finland, France, The Netherlands and Switzerland and lowest in Denmark, England, Poland and Scotland. Half of all patients under the age of 45 years died within 1 year of diagnosis, increasing to almost 80% for those aged 75 years or older. Whilst the prognosis for patients with non-small cell carcinoma remained more or less constant between 1978 and 1989 (25% in Denmark and 44% in Finland), that for patients with small cell carcinoma improved slightly, especially in The Netherlands (Eindhoven from 17 to 24%) and Switzerland (Geneva from 24 to 32%). In conclusion, a fairly large variation in lung cancer relative survival rates existed between European countries. The most likely explanation for the differences is the variation in access to specialised care. Except for a slight improvement in short-term survival for patients with small cell lung cancer, survival has remained poor since 1978.

Introduction

Lung cancer is the most frequent or second most frequent type of cancer among European men and ranks third or higher among European women[1]. Prognosis for both men and women is poor, but it has been reported to have improved for patients with small cell carcinoma since the introduction of chemotherapy in the 1970s2, 3, 4, 5, 6. Besides being dependent on age and tumour stage, survival rates for lung cancer differ according to histological subtype, being better for non-small cell carcinoma than for small cell carcinoma7, 8, 9, 10. In the first EUROCARE study[11], relative 5-year survival rates of lung cancer varied from 6 to 14%, being lowest in England and highest in Switzerland. The collaboration across Europe in the EUROCARE study has now been extended to 45 registries in 17 countries that have accumulated data currently on 3.5 million new patients, most diagnosed between 1978 and 1992. We report on variation in the relative survival of adult patients according to age and histology from 1985–1989 and also explore major time trends since 1978 for most countries.

Section snippets

Patients and methods

Survival analysis was carried out on 173 448 lung cancer cases diagnosed between 1985 and 1989 in 17 countries, recorded in 44 population-based cancer registries. Some registries (Finland, Denmark, Estonia, Slovenia, Iceland, Scotland and Slovakia) cover the whole country, others a large proportion (England) and the rest up to 20% (Italy, Spain, France, The Netherlands, Germany and Sweden). Cases discovered at autopsy, first diagnosed with another tumour, or known only on the basis of a death

Results

Overall relative 1-, 3- and 5-year weighted survival rates for European men were 31, 12 and 10%, respectively and for women 29, 13 and 11%, respectively. Age-standardised survival rates varied greatly within Europe. Relative 1-year survival rates were approximately 40% in Finland, France, The Netherlands and Switzerland and approximately 24% in Denmark, England, Poland and Scotland. Age-standardised relative 5-year survival rates were highest in France, Iceland, The Netherlands, Slovakia and

Discussion

Survival for patients with lung cancer varied considerably within Europe, as illustrated by 1-year relative survival rates, which were lowest for patients in Denmark, Poland and the U.K. and highest for those in Finland, France, The Netherlands and Switzerland. Half of all patients under the age of 45 years died within 1 year of diagnosis, increasing to almost 80% for those aged 75 years or older. Whilst the prognosis for patients with non-small cell carcinoma remained relatively constant

Acknowledgements

The EUROCARE study was financed through the BIOMED programme of the European Union.

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    1

    The EUROCARE Working Group for this study is listed in the Appendix A.

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