A wide difference in cancer survival between middle aged and elderly patients in Europe

被引:32
作者
Quaglia, Alberto
Capocaccia, Riccardo
Micheli, Andrea
Carrani, Eugenio
Vercelli, Marina
机构
[1] Natl Inst Canc Res, Liguria Canc Registry, Descript Epidemiol Unit, I-16132 Genoa, Italy
[2] Natl Ctr Epidemiol Surveillance & Promot Hlth, Natl Inst Hlth, Rome, Italy
[3] Natl Canc Inst, Descript Epidemiol & Publ Hlth Planning Unit, I-20133 Milan, Italy
[4] Univ Genoa, Dept Hlth Sci, Genoa, Italy
关键词
cancer; conditional and cumulative relative survival; health care inequalities; elderly;
D O I
10.1002/ijc.22515
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Nowadays the burden of cancer in elderly people has reached an alarming extent. The purpose of this study is comparing cumulative and conditional relative survival in elderly patients between 65 and 84 years and younger adults aged from 55 to 64. Fifty-three cancer registries of 22 European countries, participating in the EUROCARE-3 programme, collected information on the cases diagnosed over the period 1990-1994. We computed cumulative and conditional relative survival for 16 cancer sites. Middle aged patients experienced a better prognosis than the elderly for all cancer sites, in both sexes and the differences were more marked at 1 than 5 years since diagnosis. The very large differences noted in the first period after cancer detection declined in the subsequent years and, when 5-years conditional survival was considered, for several cancers the elderly and younger adults had the same probabilities of surviving. The death relative excess risks (RERs) in the elderly with respect younger individuals were really very high and markedly larger at I than 5 years, and in women than men. Genitourinary and gynaecological cancers showed the highest RERs, around 2.0 and between 1.5 and 2.5 respectively. This very high early mortality could be due not only to clinical aspects: the barriers to health care access and a consequent late diagnosis might represent for elderly patients the main determinant of this very large prognostic disadvantage. In conclusion, clinical management of cancer in the elderly remains a major issue to be faced with complex social and health care policies. (c) 2007 Wiley-Liss, Inc.
引用
收藏
页码:2196 / 2201
页数:6
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