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Browsing Publicaciones by Author "Allemani, Claudia"
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- PublicationGlobal surveillance of trends in cancer survival 2000-14 (CONCORD-3)(The Lancet, 2019-03) Allemani, Claudia; Matsuda, Tomohiro; Di Carlo, Veronica; Harewood, Rhea; Matz, Melissa; Nikšić, Maja; Bonaventure, Audrey; Valkov, Mikhail; Johnson, Christopher J; Estève, Jacques; Ogunbiyi, Olufemi J; Chen, Wan-Qing; Eser, Sultan; Engholm, Gerda; Stiller, Charles; Monnereau, Alain; Woods, Ryan; Visser, Otto; Hsiang Lim, Gek; Aitken, Joanne; Weir, Hannah K; Coleman Michel P.; CONCORD Working GroupBackground—In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival, as a metric of the effectiveness of health systems and to inform global policy on cancer control. Methods—CONCORD-3 updates the world-wide surveillance of cancer survival to 2014, with individual data for 37.5 million patients diagnosed with cancer during the 15-year period 2000–2014. Data were provided by 322 population-based cancer registries in 71 countries and territories, of which 47 provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate and melanoma of the skin in adults, and brain tumours, leukaemias and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated five-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights. Findings—For most cancers, five-year net survival remains among the highest in the world in the US and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas and lung. For women diagnosed during 2010–2014, the predicted five-year survival for breast cancer is now close to 90% in the US and in Australia, but international differences remain very wide, with levels as low as 40% in South Africa. For gastrointestinal cancers, the highest levels of five-year survival are seen in South-East Asia, in Korea for cancers of the stomach (69%), colon (72%) and rectum (71%), in Japan for oesophageal cancer (36%) and in Taiwan for liver cancer (28%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (60% in Korea, 52% in Taiwan, 50% in China), and for both lymphoid malignancies (53% in Korea, 51% in Taiwan, 38% in China) and myeloid malignancies (46% in Korea, 33% in Taiwan, 25% in China). For children diagnosed during 2010–2014, five-year survival for acute lymphoblastic leukaemia ranged from 66% in Thailand to 95% in Finland. Five-year survival from brain tumours in children is higher than for adults, and the global range is very wide (from 45% in Thailand to 80% in Sweden and Denmark). Interpretation—The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed world-wide every year. It contributes to the evidence base for global policy on cancer control. From 2017, the Organisation for Economic Co-operation and Development will use findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries world-wide. It is crucial for governments to recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer
- PublicationGlobal survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000–2014 (CONCORD-3)(2022) Girardi, Fabio; Matz, Melissa; Stiller, Charles; You, Hui; Gragera, Rafael Marcos; Valkov, Mikhail Y.; Bulliard, Jean-Luc; De, Prithwish; Morrison, David; Wanner, Miriam; O’Brian, David K.; Saint-Jacques, Nathalie; Coleman, Michel P.; Allemani, Claudia; CONCORD Working GroupAbstract Background. Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. Methods. We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000–2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. Results. The study included 556,237 adults. In 2010–2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%–38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000–2004 and 2005–2009. These improvements were more noticeable among adults diagnosed aged 40–70 years than among younger adults. Conclusions. To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
- PublicationThe histology of brain tumors for 67 331 children and 671 085 adults diagnosed in 60 countries during 2000- 2014: a global, population-based study (CONCORD-3)(Neuro-Oncology, 2021) Girardi, Fabio; Rous, Brian; Stiller, Charles A.; Gatta, Gemma; Fersht Naomi; Storm, Hans H.; Rodrigues, Jessica R.; Herrmann, Christian; Marcos-Gragera, Rafael; Peris-Bonet, Rafael; Valkov, Mikhail; Weir, Hannah K.; Woods, Ryan R.; You, Hui; Cueva, Patricia A.; De, Prithwish; Di Carlo, Veronica; Børge Johannesen, Tom; Lima, Carlos A.; Lynch, Charles F.; Coleman, Michel P.; Allemani, Claudia; CONCORD Working GroupBackground. Global variations in survival for brain tumors are very wide when all histological types are con sidered together. Appraisal of international differences should be informed by the distribution of histology, but little is known beyond Europe and North America. Methods. The source for the analysis was the CONCORD database, a program of global surveillance of cancer sur vival trends, which includes the tumor records of individual patients from more than 300 population-based cancer registries. We considered all patients aged 0-99 years who were diagnosed with a primary brain tumor during 2000-2014, whether malignant or nonmalignant. We presented the histology distribution of these tumors, for pa tients diagnosed during 2000-2004, 2005-2009, and 2010-2014. Results. Records were submitted from 60 countries on 5 continents, 67 331 for children and 671 085 for adults. After exclusion of irrelevant morphology codes, the final study population comprised 60 783 children and 602 112 adults. Only 59 of 60 countries covered in CONCORD-3 were included because none of the Mexican records were eligible. We defined 12 histology groups for children, and 11 for adults. In children (0-14 years), the proportion of low-grade astrocytomas ranged between 6% and 50%. Medulloblastoma was the most common subtype in coun tries where low-grade astrocytoma was less commonly reported. In adults (15-99 years), the proportion of glio blastomas varied between 9% and 69%. International comparisons were made difficult by wide differences in thproportion of tumors with unspecified histology, which accounted for up to 52% of diagnoses in children and up to 65% in adults. Conclusions. To our knowledge, this is the first account of the global histology distribution of brain tumors, in children and adults. Our findings provide insights into the practices and the quality of cancer registration worldwide.
- PublicationWorldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries(Lancet Child Adolesc Health, 2022) Ssenyonga, Naomi; Stiller, Charles; Nakata, Kayo; Shalkow, Jaime; Redmond, Shelagh; Bulliard, Jean-Luc; Girardi, Fabio; Fowler, Christine; Marcos-Gragera, Rafael; Bonaventure, Audrey; Nathalie Saint-Jacques; Minicozzi, Pamela; De, Prithwish; Rodríguez-Barranco, Miguel; Larønningen, Siri; Di Carlo, Veronica; Mägi Margit; Valkov, Mikhail; Seppä, Karri; Wyn Huws, Dyfed; Coleman, Michel P.; Allemani, Claudia; CONCORD Working GroupBackground: Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). Methods: We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings: 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010-14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010-14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000-14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation: This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. Funding: Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.