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Background: Survival trends help to evaluate the progress made to reduce the burden of cancer. The aim was to estimate the trends in 5‐year relative survival of patients diagnosed with breast, prostate, lung, colorectal cancer and skin melanoma in the time periods 1980–1989, 1990–1999, 2000–2009 and 2010–2015 in the Canton of Zurich, Switzerland. Furthermore, we investigated relative survival differences by TNM stage and age group. Methods: Data from the Cancer Registry of Zurich was used from 1980 to and including 2015, including incident cases of breast (N = 26,060), prostate (N= 23,858), colorectal (N= 19,305), lung cancer (N= 16,858) and skin melanoma (N= 9780) with follow‐up until 31 December 2020. The cohort approach was used to estimate 5‐year relative survival. Results: The 5‐year relative survival increased significantly between 1980 and 1989, and 2010 and2015: from 0.70 to 0.89 for breast, from 0.60 to 0.92 for prostate, from 0.09 to 0.23 (men) and from 0.10 to 0.27 (women) for lung, from 0.46 to 0.66 (men) and from 0.48 to 0.68 (women) for colorectal cancer, and from 0.74 to 0.94 (men) and from 0.86 to 0.96 (women) for skin melanoma. Survival for stage IV tumors was considerably lower compared to lower‐staged tumors for all cancer types. Furthermore, relative survival was similar for the age groups <80 years but lower for patients aged 80 years and older. Conclusion: The observed increasing trends in survival are encouraging and likely reflect raised awareness around cancer, improved diagnostic methods, and improved treatments. The fact that stage I tumor patients have generally high relative survival reflects the efforts made regarding early detection. [ABSTRACT FROM AUTHOR]

In Switzerland, there is a large seasonal variation in sunlight, and vitamin D deficiency is relatively common during winter. The season of diagnosis may be linked to cancer survival via vitamin D status. Using data from the Cancer Registry of Zurich, Zug, Schaffhausen, and Schwyz with more than 171,000 cancer cases registered since 1980, we examined the association of the season of diagnosis with survival for cancers including prostate (ICD10 code C61; International Categorization of Diseases, version 10), breast (C50), colorectal (C18-21), lung (C34), melanoma (C43), and all sites combined. Cox proportional hazards regression models were used to assess the differences in the all-cause mortality by the season of the diagnosis. Winter was used as the reference season. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for all the cancers combined (excluding nonmelanoma skin cancer) and for prostate (in men), breast (in women), colorectal, lung cancer, and melanomas, separately. A diagnosis in summer and/or autumn was associated with improved survival in all the sites combined for both sexes (men: HR 0.97 [95% CI 0.96–0.99]; women: HR 0.97 [95% CI 0.94–0.99]) and in colorectal (HR 0.91 [95% CI 0.84–0.99]), melanoma (HR 0.81 [95% CI 0.65–1.00]), and breast cancer (HR 0.91 [95% CI 0.94–0.99]) in women. Our study results suggest that a cancer diagnosis in summer and/or autumn is associated with a better prognosis. The improved seasonal survival coincides with the seasonal variation of sun-induced vitamin D, and vitamin D may play a protective and beneficial role in cancer survival. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is among the three most common incident cancers and causes of cancer death in Switzerland for both men and women. To promote aspects of gender medicine, we examined differences in treatment decision and survival by sex in CRC patients diagnosed 2000 and 2001 in the canton of Zurich, Switzerland. Methods: Characteristics assessed of 1076 CRC patients were sex, tumor subsite, age at diagnosis, tumor stage, primary treatment option and comorbidity rated by the Charlson Comorbidity Index (CCI). Missing data for stage and comorbidities were completed using multivariate imputation by chained equations. We estimated the probability of receiving surgery versus another primary treatment using multivariable binomial logistic regression models. Univariable and multivariable Cox proportional hazards regression models were used for survival analysis. Results: Females were older at diagnosis and had less comorbidities than men. There was no difference with respect to treatment decisions between men and women. The probability of receiving a primary treatment other than surgery was nearly twice as high in patients with the highest comorbidity index, CCI 2+, compared with patients without comorbidities. This effect was significantly stronger in women than in men (p-interaction = 0.010). Survival decreased with higher CCI, tumor stage and age in all CRC patients. Sex had no impact on survival. Conclusion: The probability of receiving any primary treatment and survival were independent of sex. However, female CRC patients with the highest CCI appeared more likely to receive other therapy than surgery compared to their male counterparts. [ABSTRACT FROM AUTHOR]

Background: Even though breast cancer in situ (BCIS) incidence has been increasing, the prognosis of BCIS patients has not been extensively investigated. According to the literature, women with BCIS have a higher risk of developing subsequent invasive breast cancer; conflicting information has been reported regarding their potential risk for a subsequent invasive non-breast cancer. Methods: Data from 1,082 women, whose first-ever cancer diagnosis was primary BCIS between 2003 and 2015 and were living in the canton of Zurich, were used. Standardized incidence ratios (SIRs) were calculated to compare the risk of an invasive breast or non-breast cancer among women with a primary BCIS with the corresponding risk of the adult female population. SIRs were calculated overall and by patient and tumor characteristics. To investigate potential risk factors (e.g., age at diagnosis, treatment) for a subsequent invasive breast or non-breast cancer we used Cox proportional hazards regression models. Results: BCIS patients had 6.85 times [95% confidence interval (CI): 5.52–8.41] higher risk of being diagnosed with invasive breast cancer compared to the general population. They additionally faced 1.57 times (95% CI: 1.12–2.12) higher risk of an invasive non-breast cancer. The SIRs were higher for women < 50-years old for both invasive breast and non-breast cancer at BCIS diagnosis. Age ≥ 70-years old at BCIS diagnosis was statistically significantly associated with a subsequent invasive non-breast cancer diagnosis. Conclusions: BCIS patients had a higher risk of being diagnosed with invasive breast and non-breast cancer compared to the general population. Age 70 years or older at BCIS diagnosis was the only risk factor statistically significantly associated with a subsequent invasive non-breast cancer. Our results support the increased risk for subsequent cancers in BCIS patients reported in the literature. Future studies should establish the risk factors for subsequent cancers, highlight the need for intensive monitoring in this population, and help distinguish BCIS patients who could benefit from systemic therapy to prevent distant cancers. [ABSTRACT FROM AUTHOR]

Purpose: Increase in in situ breast cancer (BCIS) incidence has been reported across Europe and the USA. However, little is known about the trends in BCIS incidence in regions without population-based mammographic screening programs. We set out to investigate these trends in Zurich, Switzerland, where only opportunistic mammographic screening exists.Methods: Data from 989 women diagnosed with a primary BCIS between 2003 and 2014 were used in our analyses. Age-standardized incidence rates per 100,000 person-years (ASR) were computed per year. Additional analyses by BCIS subtype, by age group at diagnosis and by incidence period were conducted. Incidence trends over time were assessed using joinpoint regression analysis.Results: The overall BCIS ASR was 10.7 cases per 100,000 person-years with an increasing trend over the study period. A similar trend was observed for the ductal carcinoma in situ (DCIS) ASR, while the lobular carcinoma in situ (LCIS) ASR decreased. Age-specific analyses revealed that the 50-59 year age group had the highest BCIS ASR. The highest increase in BCIS ASR, even though not statistically significant, was observed for the < 40 year age group.Conclusions: BCIS ASR increased linearly over a 12-year period. The increase was reflected by an increase in DCIS ASR, whereas LCIS ASR decreased over time. The highest increase in BCIS ASR over the study period was observed for the < 40 year age group, even though not statistically significant. Patient and tumor characteristics of this group that may be associated with BCIS development warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess the associations of comorbidities with primary treatment of prostate cancer (PCa) patients and of comorbidities with PCa-specific mortality (PCSM) compared to other-cause mortality (OCM) in Switzerland.Patients and methods: We included 1527 men diagnosed with PCa in 2000 and 2001 in the canton of Zurich. Multiple imputation methods were applied to missing data for stage, grade and comorbidities. Multinomial logistic regression analyses were used to explore the associations of comorbidities with treatment. Cox regression models were used to estimate all-cause mortality, and Fine and Gray competing risk regression models to estimate sub-distribution hazard ratios for the outcomes PCSM and OCM.Results: Increasing age was associated with a decreasing probability of receiving curative treatment, whereas an increasing Charlson Comorbidity Index (CCI) did not influence the treatment decision as strongly as age. The probability of OCM was higher for patients with comorbidities compared to those without comorbidities [CCI 1: hazard ratio 2.07 (95% confidence interval 1.51-2.85), CCI 2+: 2.34 (1.59-3.44)]; this was not observed for PCSM [CCI 1: 0.79 (0.50-1.23), CCI 2+: 0.97 (0.59-1.59)]. In addition, comorbidities had a greater impact on the patients’ mortality than age.Conclusions: The results of the current study suggest that chronological age is a stronger predictor of treatment choices than comorbidities, although comorbidities have a larger influence on patients’ mortality. Hence, inclusion of comorbidities in treatment choices may provide more appropriate treatment for PCa patients to counteract over- or undertreatment. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess associations of stage, grade, and age with the primary treatment of prostate cancer (PCa) patients comparing the incidence years 2000/2001 and 2012/2013, and to estimate the relative survival (RS) for patients diagnosed in 2000/2001. Methods: We included 1,541 men diagnosed in 2000/2001 and 1,605 men diagnosed in 2012/2013. Multiple imputation methods were applied to missing data for stage and grade. Multinomial logistic regression analyses were used to explore the associations of stage, grade, and age with treatment. RS was estimated using the Ederer II approach. Results: In 2000/2001, older patients were more likely to choose active surveillance (AS)/watchful waiting (WW) or to receive androgen deprivation therapy (ADT) compared to surgery; in 2012/2013, this association was only observed for ADT but not for AS/WW. In 2000/2001, the overall 1-, 5-, and 10-year RS was approximately 99, 94, and 92%, respectively. RS was highest for patients who underwent surgical procedures or radiotherapy and considerably lower for patients with ADT. Conclusion: Our data show that today AS/WW is an option not only for patients with a life expectancy of < 10 years but also for younger men with localized PCa. PCa patients have a good RS if the cancer is diagnosed at an early stage. [ABSTRACT FROM AUTHOR]