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Evidence on survival of malignant mesothelioma (MM) and other rare thoracic cancers is limited due to the rarity of these cancer sites. Here, we provide a comprehensive overview of MM incidence and survival after MM and other rare thoracic cancers in Germany and the United States (US). Incidence was estimated from a German National Cancer Database and from the Surveillance, Epidemiology and End Results (SEER) 18 database for 2000–2014. Patients diagnosed in 1997–2013 with malignant epithelial tumors of the trachea (Etra), epithelial tumors of the thymus (Ethy) and MM were extracted from a German cancer survival database and from the SEER 13 database. Period analysis was employed to compute 5‐year relative survival (RS). During 2000–2014, an annual average of 0.9 and 0.6 MM cases per 100,000 person‐years was diagnosed in Germany and the US. Rates decreased in Germany and in the US. Patients with Ethy had highest 5‐year RS with US patients surviving longer (69.1% compared to 63.7%, p = 0.02). Survival after Etra was comparable in both countries (Germany 33.6%, US 34.4%, p = 0.07). Survival in MM patients was poor overall (Germany 11.8%, US 12.1%, p < 0.01). Survival improvements were only observed in MM patients in Germany (10.8% [2002–2007] vs. 13.0% [2008–2013], p < 0.01). The lack of progress in survival for Etra and Ethy patients underlines the need of novel preventive, therapeutic and diagnostic approaches. MM incidence significantly decreased in Germany and in the US. Further monitoring of MM incidence is warranted given that a peak in incidence is expected in 2020–2030 in Western countries. What's new? Certain cancer types that originate from the epithelial or mesothelial tissues of the thoracic cavity are exceedingly rare. As a consequence, little is known about their incidence and survival. Here, utilizing national databases, the authors estimated incidence and survival of malignant mesothelioma (MM) and other rare thoracic cancers in Germany and the United States. Analyses show that between 2000 and 2014, MM incidence declined in both countries, although only MM survival improved in Germany. No improvements were observed in either country for survival of epithelial tumors of the trachea and thymus, highlighting a need for preventive and therapeutic advances. [ABSTRACT FROM AUTHOR]

Background. Rectal cancer (RC) is a common malignancy with a substantial mortality but good survival for patients with optimally treated nonmetastatic disease. Lack of insurance may compromise access to care and therefore compromise survival. Here, we examine RC survival by insurance type. Methods. Data from the Surveillance, Epidemiology, and End Results database were used to determine 1- to 3-year survival for patients with RC by insurance type (Medicaid, uninsured, other insurance). Results. Patients with Medicaid or no insurance presented at later stages and were less likely to receive definitive surgery. Overall 3-year survival was higher for patients with other insurance compared with Medicaid-insured (122.2% units) and uninsured (118.8% units) patients. Major differences in survival were still observed after adjustment for stage. When patients with stage II and III RC were considered, 3-year survival was higher for patients with other insurance versus those with Medicaid (116.2% units) and uninsured patients (112.2% units). However, when the analysis was limited to patients with stage II and III disease who received radiation therapy followed by definitive surgery, the difference decreased to 111.8% units and 17.3% units, respectively, for Medicaid and no insurance. Conclusion. For patients with stage II and III RC, much of the difference in survival between uninsured patients and those with insurance other than Medicaid can be explained by differences in treatment. Further efforts to determine the cause of residual differences as well as efforts to improve access to standard-of-care treatment for uninsured patients may improve population-level survival for RC. [ABSTRACT FROM AUTHOR]

Background: Survival for patients with hematologic malignancies has improved during the early 21st century. However, it is unclear whether older patients have benefited to the same extent as younger patients. This study examines changes in survival for older patients with the 7 most common hematologic malignancies.Methods: Period analysis was used to examine survival for patients who were 65 years old or older and were diagnosed with a common hematologic malignancy between 1992 and 2012 with data from the Surveillance, Epidemiology, and End Results database.Results: Five-year relative survival increased for older patients with hematologic malignancies with the partial exception of acute myelogenous leukemia, for which no change in survival was seen for patients who were 75 years old or older. Patients with chronic lymphocytic leukemia and non-Hodgkin lymphoma, including the oldest patients, had especially strong improvements, with increases in 5-year relative survival for patients who were 85 years old or older of 31.5% and 39.6%, respectively, between 1997-2000 and 2009-2012.Conclusions: Despite these increases, survival rates did not reach those observed for patients aged 50 to 59 years for any hematologic malignancy. Newer therapies and a better understanding of how to treat older patients have led to increased survival expectations for older patients with most hematologic malignancies, but an age-related survival disparity persists. Cancer 2016;122:2031-40. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

Background. New treatment options and supportive care measures have greatly improved survival of patients with non-Hodgkin lymphoma (NHL) but may not be affordable for those with no insurance or inadequate insurance. Methods. Using data from the Surveillance, Epidemiology, and End Results database, we estimated overall and cause-specific survival according to insurance status within 3 years after diagnosis of patients diagnosed with NHL in the U.S. in the period 2007-2011. Because NHL is a heterogeneous condition, we also examined survival in diffuse large B-cell lymphoma (DLBCL). Results. Survival was higher for patients with non-Medicaid insurance compared with either uninsured patients or patients with Medicaid. For patients with any NHL, the 3-year survival estimates were 68.0% for uninsured patients, 60.7% for patients with Medicaid, and 84.9% for patients with non-Medicaid insurance. Hazard ratios (HRs) for uninsured and Medicaid-only patients compared with insured patients were 1.92 (95% confidence interval [CI]: 1.76-2.10) and 2.51 (95% CI: 2.36-2.68), respectively. Results were similar for patients with DLBCL, with survival estimates of 68.5% for uninsured patients (HR: 1.78; 95% CI: 1.57-2.02), 58%, for patients with Medicaid (HR: 2.42; 95% CI: 2.22-2.64), and 83.3% for patients with non-Medicaid insurance. Cause-specific analysis showed survival estimates of 80.3% for uninsured patients (HR: 1.83; 95%CI: 1.62-2.05),77.7%for patients with Medicaid (HR: 2.23; 95% CI: 2.05-2.42), and 90.5% for patients with non-Medicaid insurance. Conclusion. Lack of insurance and Medicaid only were associated with significantly lower survival for patients with NHL. Further evaluation of the reasons for this disparity and implementation of comprehensive coverage for medical care are urgently needed. [ABSTRACT FROM AUTHOR]

Treatment for Hodgkin lymphoma ( HL) is more aggressive in Germany than in the United States ( US) and differences in treatment may lead to differences in population level survival. Patients diagnosed with HL in 11 German states in 1997-2006 were included in the analyses and were compared to similar analyses from patients in the Surveillance, Epidemiology, and End Results database in the US. Period analysis was used to calculate 5-year relative survival for the time period of 2002-2006 overall and by gender, age and histology. Overall 5-year relative survival for patients with HL in Germany was 84·3%, compared to 80·6% for the US. Survival was highest in patients aged 15-29 years at 97·9% and decreased with age to 57·5% at age 60 + Survival for men and women, respectively, was 84·7% and 84·1% in Germany and 78·2% and 83·6% in the US. 5-year relative survival for patients diagnosed with HL in Germany was close to 100% for younger patients. Survival of HL patients in the US was lower than in Germany overall, but was comparable in older patients and in women. Population-based studies with longer follow-up are still needed to examine effects of late toxicity on long term survival. [ABSTRACT FROM AUTHOR]

Introduction: The advent of tyrosine kinase inhibitors has produced 5-year survival of 90 + % for chronic myelocytic leukemia (CML) patients in clinical trials. However, population level survival has been lower, especially in older patients. Here, we examine survival of patients with CML in Germany and compare it to survival of patients in the United States (US). Methods: Data were extracted from the Surveillance, Epidemiology, and End Results database in the US and 11 cancer registries in Germany. Patients 15-69 years old diagnosed with CML were included in the analysis. Period analysis for 2002-2006 was used to provide the most up-to-date possible estimates of five-year relative survival. Results: Five-year relative survival was 68.7% overall in Germany and 72.7% in the US. Survival was higher in the US for all age groups except for ages 15-39 years, but the difference was only statistically significant for ages 50- 59 years (at 67.5% vs 77.7% in Germany and the US, respectively). Survival decreased with age, ranging from 83.1% and 81.9%, respectively, in Germany and the US for patients 15-39 years old to 54.2% and 54.5%, respectively, in patients 65-69 years old. Survival increased between 2002 and 2006 by 12.0% points in Germany and 17.1% points in the US. Conclusions: Five-year survival estimates were higher in the US than in Germany overall, but the difference was only significant for ages 50-59 years. Survival did not equal that seen in clinical trials for either country, but strong improvement in survival was seen between 2002 and 2006. [ABSTRACT FROM AUTHOR]

Abstract: Within the past 10–15 years, major advances in therapy have strongly improved prognosis of patients with chronic myelocytic leukaemia (CML). We estimated trends in 5- and 10-year relative survival of patients developing CML after a previous malignancy in the United States from 1990–1994 to 2000–2004. Period analysis was employed to disclose recent developments with minimum delay. Overall, 5- and 10-year relative survival increased from 17.6% to 37.7% (p <0.0001) and from 7.6% to 23.8% (p <0.0001), respectively. Improvements were particularly strong in younger age groups. Prognosis of CML patients with previous malignancy no longer lags behind prognosis of patients with primary CML. [Copyright &y& Elsevier]

The article presents the study on the trends of survival of adolescence or young adults after having diagnosed with hematologic malignancy in the U.S. from 1981-2005. The study showed improved survival expectations for adolescents and young adults with hematologic malignancies, however, survival rates have not reached the levels observed for children diagnosed with these malignancies. The study also indicated that survival expectations for acute leukemia remains at low levels.

Available long-term survival figures for patients with Hodgkin's lymphoma (HL) from population-based cancer registries mostly refer to patients diagnosed in the 1980s and 1990s, and do not reflect recent progress in and spread of effective therapy at the population level. Using data from the Surveillance, Epidemiology, and End Results program, we employed a novel model-based projection method to estimate 5- and 10-year relative survival expectations of HL patients in the U.S. diagnosed in 2006-2010. Preliminary empirical evaluation of the method using historical data indicates excellent performance. Projections of 10-year relative survival percentages and their standard errors by age groups are as follows: 15-24 y: 94.7 (1.1), 25-34 years, 89.4 (1.5); 35-44 years, 90.1 (1.6); 45-54 years, 83.6 (2.7); 55-64 years, 70.5 (4.7); 65-74 years, 48.5 (5.9); and 75+ years, 24.0 (5.7). These estimates are 2.5-11.1 percentage points higher than those obtained by standard cohort analysis from the same database (pertaining to patients diagnosed in 1991-1995). Patients diagnosed with HL in 2006-2010 have higher long-term survival expectations than suggested by conventional survival statistics from population-based cancer registries. The 10-year survival expectations are now close to or exceed 90% in all age groups up to age 45, and exceed 80% and 70% in the 45-54 and 55-64 age groups, respectively. [ABSTRACT FROM AUTHOR]

Abstract: Up-to-date monitoring of long-term survival is an important task of population-based cancer registries. Period analysis, a new method of survival analysis introduced a few years ago, has been shown to be particularly useful for that purpose. The “classical” period analysis uses a life-table approach which requires both the year and month of diagnosis for implementation in pertinent software programs. However, an increasing number of cancer registries remove the month of diagnosis from their datasets, mainly to ensure the highest possible protection against re-identification of patients. In this paper, we present modifications of period analysis that allow the application of this technique, while almost completely preserving its advantages, in datasets without the month of diagnosis. The modified techniques are illustrated and evaluated using examples from the Surveillance, Epidemiology, and End Results (SEER) programme of the United States (US) National Cancer Institute (NCI), which also has removed month of diagnosis from its most recently released public use database. [Copyright &y& Elsevier]

Up-to-date monitoring of long-term survival is an important task of population-based and clinical cancer registries. A few years ago, a new method of survival analysis, denoted period analysis, was introduced to provide more up-to-date estimates of long-term survival. However, a prototypical period analysis may not be applicable in situations with delayed recording of incident cases. We introduce herein a hybrid type of analysis that combines elements of both traditional and period analyses which may still be feasible in such settings. The performance of the hybrid type of analysis compared with other design options is empirically evaluated and illustrated for children diagnosed with cancer in the United States. The empirical evaluation indicates that hybrid analysis may be useful to derive more up-to-date estimates of long-term survival compared with traditional design options if there is a strong improvement of survival over time, even in situations with a substantial delay in recording of incident cases. [Copyright &y& Elsevier]

Background: Breast cancer treatment has changed tremendously over the last decades. In addition, the use of mammography screening for early detection has increased strongly. To evaluate the impact of these developments, long-term trends in incidence, mortality, stage distribution and survival were investigated for Germany and the United States (US). Methods: Using population-based cancer registry data, long-term incidence and mortality trends (1975–2015), shifts in stage distributions (1998–2015), and trends in five-year relative survival (1979–2015) were estimated. Additionally, trends in five-year relative survival after standardization for stage were explored (2004–2015). Results: Age-standardized breast cancer incidence rates were much higher in the US than in Germany in all periods, whereas age-standardized mortality began to lower in the US from the 1990s on. The largest and increasing differences were observed for patients aged 70+ years with a 19% lower incidence but 45% higher mortality in Germany in 2015. For this age group, large differences in stage distributions were observed, with 29% (Germany) compared to 15% (US) stage III and IV patients. Age-standardized five-year relative survival increased strongly between 1979–1983 and 2013–2015 in Germany (+17% units) and the US (+19% units) but was 9% units lower in German patients aged 70+ years in 2013–2015. This difference was entirely explained by differences in stage distributions. Conclusions: Overall, our results are in line with a later uptake and less extensive utilization of mammography screening in Germany. Further studies and efforts are highly needed to further explore and overcome the increased breast cancer mortality among elderly women in Germany. [ABSTRACT FROM AUTHOR]

Harmonized European NSCLC incidence, treatment approach, and survival based on national tumor registries are unclear. Surgery has the potential to cure NSCLC and significantly prolong survival. This large-scale international study aimed to investigate treatment variations in Europe and the USA, as well as the determinants for its utilization. The retrospective cohort study analyzed data from six European national population-based cancer registries (Belgium, Denmark, Estonia, Germany, the Netherlands, and Slovenia) and the US SEER database from 2010–2015. The study computed cancer incidence, survival, and age-standardized proportions of the use of various therapies. Multivariable logistic regression models were used to assess associations between resection and demographic and clinical parameters. A total of 428,107 records were analyzed. Among all countries, Estonia had the highest surgical resection rate (79.3 %) and the lowest radiation rate (7.3 %) for stage I patients. The Netherlands had the highest rate of radiotherapy across all years of investigation and the lowest surgery rate between 2012 and 2015. The primary treatment for early-stage NSCLC showed significant international variation, with the USA having a decrease in surgical rates from 67.6 % to 59.5 %. Resection was less frequently performed as tumor stage increased, patients aged, other lung cancer besides adenocarcinoma was present, and when the tumor site overlapped multiple lobes. Resection rates have declined in some studied European countries and the USA and resection rates vary substantially among countries. Interpretation of current scientific lung cancer evidence and international guidelines results in wide variations in patient treatment. • Primary treatment of early stage NSCLC varies widely in Europe and the USA. • The Netherlands had the relatively highest SBRT rates and the lowest resection rates for stage I NSCLC. • The USA experienced a significant decreasing trend in Stage I surgical resections. • Higher Age/Stage and unknown histology are strongly associated with lower surgery rates. [ABSTRACT FROM AUTHOR]

Introduction: We investigated survival in breast cancer patients by age group, focussing on those covered by screening programmes, using data from 12 European population-based cancer registries participating in the European Network for Indicators on Cancer Survival Working Group. Methods: We calculated period estimates of 5-year relative survival for 2000–2004 and examined the change in survival estimates for four age groups between 1990–1994 and 2000–2004. Trends in age specific incidence, survival and mortality were additionally compared to those in the United States based on results from the Surveillance Epidemiology and End Results (SEER) programme. Results: Breast cancer survival uniformly increased particularly in areas with lower breast cancer survival for patients diagnosed in 1990–1994. With the exception of Geneva, Scotland and Estonia, the rise in survival was always larger among the younger age groups than in the 70+ age group and the age-gradient widened over time. The 5-year relative survival of patients aged 70 and above in the European registries was at least 7 percentage points lower than the 5-year relative survival of patients in the same age group in the US in 2000–2004. During the study period, incidence increased in all age groups and populations with a few exceptions, an observation paralleled by declining mortality. Conclusions: Results showed that some of the geographical differences in overall survival are even larger when considering age groups, in particular between Western and Eastern European countries. Furthermore, some of the differences in survival within the Northern and Western European areas could be due to variations in the implementation of screening programmes rather than economic inequalities. [Copyright &y& Elsevier]