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- PublicationGlobal variations in lung cancer incidence by histological subtype in 2020: a population-based study.(Lancet Oncol 2023, 2022) Zhang, Yanting; Vaccarella, Salvatore; Morgan, Eileen; Li, Mengmeng; Etxeberria, Jaione; Chokunonga, Eric; Manraj, Shyam Shunker; Kamate, Bakarou; Omonisi, Abidemi; Bray, FreddieBackground Lung cancer is the second most common cancer worldwide, yet the distribution by histological subtype remains unknown. We aimed to quantify the global, regional, and national burden of lung cancer incidence for the four main subtypes in 185 countries and territories. Methods In this population-based study, we used data from Cancer Incidence in Five Continents Volume XI and the African Cancer Registry Network to assess the proportions of adenocarcinoma, squamous cell carcinoma, small-cell carcinoma, and large-cell carcinoma among all lung cancers by country, sex, and age group and subsequently applied these data to corresponding national (GLOBOCAN) estimates of lung cancer incidence in 2020. Unspecified morphologies were reallocated to specified subtypes. Age-standardised incidence rates were calculated using the world standard population to compare subtype risks worldwide, adjusted for differences in age composition between populations by country. Findings In 2020, there were an estimated 2 206771 new cases of lung cancer, with 1 435943 in males and 770 828 in females worldwide. In males, 560 108 (39%) of all lung cancer cases were adenocarcinoma, 351 807 (25%) were squamous cell carcinoma, 163 862 (11%) were small-cell carcinoma, and 115322 (8%) were large-cell carcinoma cases. In females, 440510 (57%) of all lung cancer cases were adenocarcinoma, 91070 (12%) were squamous cell carcinoma, 68 224 (9%) were small-cell carcinoma, and 49 246 (6%) were large-cell carcinoma cases. Age-standardised incidence rates for adenocarcinoma, squamous cell carcinoma, small-cell carcinoma, and large-cell carcinoma, respectively, were estimated to be 12·4, 7·7, 3·6, and 2·6 per 100000 person-years in males and 8·3, 1·6, 1·3, and 0·9 per 100000 person-years in females worldwide. The incidence rates of adenocarcinoma exceeded those of squamous cell carcinoma in 150 of 185 countries in males and in all 185 countries in females. The highest age-standardised incidence rates per 100 000 person-years for adenocarcinoma, squamous cell carcinoma, small-cell carcinoma, and large-cell carcinoma, respectively, for males occurred in eastern Asia (23·5), central and eastern Europe (17·5), western Asia (7·2), and south-eastern Asia (11·0); and for females occurred in eastern Asia (16·0), northern America (5·4), northern America (4·7), and south-eastern Asia (3·4). The incidence of each subtype showed a clear gradient according to the Human Development Index for male and female individuals, with increased rates in high and very high Human Development Index countries. Interpretation Adenocarcinoma has become the most common subtype of lung cancer globally in 2020, with incidence rates in males exceeding those of squamous cell carcinoma in most countries, and in females in all countries. Our findings provide new insights into the nature of the global lung cancer burden and facilitates tailored national preventive actions within each world region.
- 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.
- 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.
- PublicationTendencias en incidencia y mortalidad por cáncer durante tres decadas en Quito - Ecuador(Colombia Médica, 2018) Corral Cordero, Fabián; Cueva Ayala, Patricia; Yépez Maldonado, José; Tarupi Montenegro, WilmerIntroducción: El Registro Nacional de Tumores ha recolectado, procesado, analizado y divulgado regularmente la información de los casos nuevos de cáncer diagnosticados en la ciudad de Quito, Ecuador durante las últimas tres décadas. Objetivo: Analizar la tendencia de las tasas de incidencia y mortalidad por cáncer durante el periodo 1985-2013. Métodos: Se estimaron las tasas de incidencia y mortalidad estandarizadas por edad a través del método directo, utilizando la población estándar mundial. Para el análisis de la tendencia de las tasas, de localizaciones seleccionadas, se utilizó la regresión joinpoint. Resultados: Se documentó un descenso de las tasas de incidencia y mortalidad de los tipos de cáncer de cuello uterino y estómago. Existe incremento de las tasas de cánceres de mama y colon-recto. Es notorio el crecimiento de la tasa de incidencia de cáncer de tiroides en mujeres. El cáncer de pulmón se incrementó en las mujeres en tanto que en los varones sus valores se mantuvieron estables. Conclusión: Se evidencian importantes variaciones en la evolución del cáncer en Quito, la información presentada constituye un instrumento para el seguimiento y evaluación de las intervenciones que se desarrollen.
- 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.