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International differences in lung cancer survival by sex, histological type and stage at diagnosis: an ICBP SURVMARK-2 Study.

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journal contribution
posted on 01.09.2021, 09:02 by Marzieh Araghi, Miranda Fidler-Benaoudia, Melina Arnold, Mark Rutherford, Aude Bardot, Jacques Ferlay, Oliver Bucher, Prithwish De, Gerda Engholm, Anna Gavin, Serena Kozie, Alana Little, Bjørn Møller, Nathalie St Jacques, Hanna Tervonen, Paul Walsh, Ryan Woods, Dianne L O'Connell, David Baldwin, Mark Elwood, Sabine Siesling, Freddie Bray, Isabelle Soerjomataram, ICBP SURVMARK-2 Local Leads, ICBP SURVMARK-2 Academic Reference Group, ICBP Clinical Committee–Lung, ICBP SurvMark-2 Academic Reference GroupICBP SurvMark-2 academic reference group, ICBP Clinical Committee – LungICBP clinical Committee – lung

Introduction

Lung cancer has a poor prognosis that varies internationally when assessed by the two major histological subgroups (non-small cell (NSCLC) and small cell (SCLC)).


Method

236 114 NSCLC and 43 167 SCLC cases diagnosed during 2010–2014 in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK were included in the analyses. One-year and 3-year age-standardised net survival (NS) was estimated by sex, histological type, stage and country.


Results

One-year and 3-year NS was consistently higher for Canada and Norway, and lower for the UK, New Zealand and Ireland, irrespective of stage at diagnosis. Three-year NS for NSCLC ranged from 19.7% for the UK to 27.1% for Canada for men and was consistently higher for women (25.3% in the UK; 35.0% in Canada) partly because men were diagnosed at more advanced stages. International differences in survival for NSCLC were largest for regional stage and smallest at the advanced stage. For SCLC, 3-year NS also showed a clear female advantage with the highest being for Canada (13.8% for women; 9.1% for men) and Norway (12.8% for women; 9.7% for men).


Conclusion

Distribution of stage at diagnosis among lung cancer cases differed by sex, histological subtype and country, which may partly explain observed survival differences. Yet, survival differences were also observed within stages, suggesting that quality of treatment, healthcare system factors and prevalence of comorbid conditions may also influence survival. Other possible explanations include differences in data collection practice, as well as differences in histological verification, staging and coding across jurisdictions.

History

Author affiliation

Department of Health Sciences, University of Leicester

Version

AM (Accepted Manuscript)

Published in

Thorax

Publisher

BMJ

issn

0040-6376

eissn

1468-3296

Acceptance date

07/06/2021

Copyright date

2021

Available date

01/09/2021

Spatial coverage

England

Language

eng