|Título : ||Colorectal cancer survival in the USA and Europe: a CONCORD high-resolution study.|
|Autor : ||Allemani, Claudia|
Weir, Hannah K.
Richardson, Lisa C.
Fulton, John P.
Diba, Chakameh Safaei
Schymura, Maria J.
Wolf, Holly J.
Coleman, Michel P.
|Filiación: ||[Allemani,C; Rachet,B; Coleman,MP] Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. [Weir,HK; Richardson,LC] Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. [Lepage,C; Faivre,J] Côte-d’Or Digestive Cancer Registry, Faculté de Médecine, Dijon Cédex, France. [Gatta,G] Evaluative Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Capocaccia,R] National Center of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy. [Sant,M; Baili,P] Descriptive Studies and Health Planning Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Lombardo,C] Alleanza Contro il Cancro, Rome, Italy. [Aareleid,T] Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia. [Ardanaz,E] Navarra Cancer Registry, Navarra Public Health Institute, Navarra, Spain. CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain. [Bielska-Lasota,M] National Institute of Public Health, National Institute of Hygiene, Warszawa, Poland. [Bolick,S] SC Department of Health and Environmental Control, South Carolina Central Cancer Registry, Office of Public Health Statistics and Information Systems, Columbia, South Carolina, USA. [Cress,R] Public Health Institute, Cancer Registry of Greater California, Sacramento, California, USA. [Elferink,M] Comprehensive Cancer Centre the Netherlands, Utrecht, The Netherlands. [Fulton,JP] Rhode Island Department of Health, Rhode Island Cancer Registry,Providence, Rhode Island, USA. [Galceran,J] Tarragona Cancer Registry, Foundation Society for Cancer Research and Prevention, Pere Virgili Health Research Institute, Tarragona, Spain. [Gózdz,S] Swietokrzyskie Centrum Onkologii (Holycross Cancer Centre), Kielce, Poland. Faculty of Health Sciences, Jan Kochanowski University of Humanities and Sciences in Kielce, Kielce, Poland. [Hakulinen,T] Finnish Cancer Registry, Helsinki, Finland. [Primic-Zakelj,M] Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia. [Rachtan,J] Cracow Cancer Registry, Centre of Oncology, M Sklodowska-Curie Memorial Cancer Institute, Krakow, Poland. [Diba,CS] National Cancer Registry of Slovakia, National Health Information Center, Bratislava, Slovakia. [Sánchez,MJ] Andalusian School of Public Health, Granada, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Schymura,MJ] New York State Department of Health, New York State Cancer Registry, Albany, New York, USA. [Shen,T] Illinois Department of Public Health, Illinois State Cancer Registry, Springfield, Illinois, USA. [Tagliabue,G] Cancer Registry and Environmental Epidemiology Division, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, Civile-MP Arezzo Hospital, ASP Ragusa, Ragusa, Italy. [Vercelli,M] UOS Epidemiologia Descrittiva, USM-IST (IRCCS Azienda Ospedaliera Universitaria San Martino—IST Istituto Nazionale per la Ricerca sul Cancro), Largo R Benzi, Genova, Italy. Sez. Epidemiologia Descrittiva, Dipartimento di Scienze della Salute, Università di Genova, Genova, Italy. [Wolf,HJ] Cancer Prevention and Control Division, University of Colorado Cancer Center, Colorado School of Public Health, Aurora, Colorado, USA. [Wu,XC] Louisiana Tumor Registry, LSU Health Sciences Center School of Public Health, New Orleans, Louisiana, USA.|
|Palabras clave : ||Epidemiología|
|MeSH: ||Medical Subject Headings::Disciplines and Occupations::Health Occupations::Medicine::Public Health::Epidemiology|
Medical Subject Headings::Disciplines and Occupations::Health Occupations::Medicine::Public Health
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms
|Fecha de publicación : ||10-Sep-2013|
|Editorial : ||BMJ Publishing Group|
|Cita Bibliográfica: ||Allemani C, Rachet B, Weir HK, Richardson LC, Lepage C, Faivre J, et al. Colorectal cancer survival in the USA and Europe: a CONCORD high-resolution study. BMJ Open. 2013; 3(9):e003055|
|Abstract: ||OBJECTIVES: To assess the extent to which stage at diagnosis and adherence to treatment guidelines may explain the persistent differences in colorectal cancer survival between the USA and Europe.
DESIGN: A high-resolution study using detailed clinical data on Dukes' stage, diagnostic procedures, treatment and follow-up, collected directly from medical records by trained abstractors under a single protocol, with standardised quality control and central statistical analysis.
SETTING AND PARTICIPANTS: 21 population-based registries in seven US states and nine European countries provided data for random samples comprising 12 523 adults (15-99 years) diagnosed with colorectal cancer during 1996-1998.
OUTCOME MEASURES: Logistic regression models were used to compare adherence to 'standard care' in the USA and Europe. Net survival and excess risk of death were estimated with flexible parametric models.
RESULTS: The proportion of Dukes' A and B tumours was similar in the USA and Europe, while that of Dukes' C was more frequent in the USA (38% vs 21%) and of Dukes' D more frequent in Europe (22% vs 10%). Resection with curative intent was more frequent in the USA (85% vs 75%). Elderly patients (75-99 years) were 70-90% less likely to receive radiotherapy and chemotherapy. Age-standardised 5-year net survival was similar in the USA (58%) and Northern and Western Europe (54-56%) and lowest in Eastern Europe (42%). The mean excess hazard up to 5 years after diagnosis was highest in Eastern Europe, especially among elderly patients and those with Dukes' D tumours.
CONCLUSIONS: The wide differences in colorectal cancer survival between Europe and the USA in the late 1990s are probably attributable to earlier stage and more extensive use of surgery and adjuvant treatment in the USA. Elderly patients with colorectal cancer received surgery, chemotherapy or radiotherapy less often than younger patients, despite evidence that they could also have benefited.|
|Descripción : ||Journal Article;|
|Versión del editor : ||http://bmjopen.bmj.com/content/3/9/e003055.abstract|
|ISSN : ||2044-6055 (Online)|
|Appears in Collections:||01- Artículos - EASP. Escuela Andaluza de Salud Pública|