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Background: Breast cancer prognosis has dramatically improved over 40 years. There is, however, no proof of population 'cure'. This research aimed to examine the pattern of long-term excess mortality due to breast cancer and evaluate its determinants in the context of cancer registry data.Methods: We used data from the Geneva Cancer Registry to identify women younger than 75 years diagnosed with invasive, localised and operated breast cancer between 1995 and 2002. Flexible modelling of excess mortality hazard, including time-dependent (TD) regression parameters, was used to estimate mortality related to breast cancer. We derived a single "final" model using a backward selection procedure and evaluated its stability through sensitivity analyses using a bootstrap technique.Results: We analysed data from 1574 breast cancer women including 351 deaths (22.3%). The model building strategy retained age at diagnosis (TD), tumour size and grade (TD), chemotherapy and hormonal treatment (TD) as prognostic factors, while the sensitivity analysis on bootstrap samples identified nodes involvement and hormone receptors (TD) as additional long-term prognostic factors but did not identify chemotherapy and hormonal treatment as important prognostic factors.Conclusions: Two main issues were observed when describing the determinants of long-term survival. First, the modelling strategy presented a lack of robustness, probably due to the limited number of events observed in our study. The second was the misspecification of the model, probably due to confounding by indication. Our results highlight the need for more detailed data and the use of causal inference methods. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic inequalities in survival were observed for many cancers in England during 1981-1999. The NHS Cancer Plan (2000) aimed to improve survival and reduce these inequalities. This study examines trends in the deprivation gap in cancer survival after implementation of the Plan.Materials and Method: We examined relative survival among adults diagnosed with 1 of 21 common cancers in England during 1996-2006, followed up to 31 December 2007. Three periods were defined: 1996-2000 (before the Cancer Plan), 2001-2003 (initialisation) and 2004-2006 (implementation). We estimated the difference in survival between the most deprived and most affluent groups (deprivation gap) at 1 and 3 years after diagnosis, and the change in the deprivation gap both within and between these periods.Results: Survival improved for most cancers, but inequalities in survival were still wide for many cancers in 2006. Only the deprivation gap in 1-year survival narrowed slightly over time. A majority of the socioeconomic disparities in survival occurred soon after a cancer diagnosis, regardless of the cancer prognosis.Conclusion: The recently observed reduction in the deprivation gap was minor and limited to 1-year survival, suggesting that, so far, the Cancer Plan has little effect on those inequalities. Our findings highlight that earlier diagnosis and rapid access to optimal treatment should be ensured for all socioeconomic groups. [ABSTRACT FROM AUTHOR]

The article presents analysis on survival from bladder cancer up to 2001 in England and Wales. Bladder cancer is considered the cause of about 4300 deaths in elderly men each year in these countries and 12% of all the bladder tumors registered from 1986-1999. It found that there is 6-10% survival advantage for men at 1, 5, and 10 years after diagnosis and consistent for both men and women diagnosed from 1980-1990. An overview of statistics of bladder cancer and diagnosis are provided.

The article presents an analysis on survival from brain tumors up to 2001 in England and Wales. It states that brain tumors constitute 2% of all malignant neoplasms in adults in these countries, with some 4000 new cases and 3000 deaths every year. The study found that there is a decline in 5-year survival marked among men and women. It suggests that the trends in survival with the introduction of sensitive new diagnostic techniques in this period may have led to improved diagnosis.

We analysed trends in 5-year survival of the 18 commonest cancers in Scotland diagnosed between 1986 and 2000 and followed up to 2004 in each of five deprivation groups based on patients postcode of residence at diagnosis. We estimated relative survival up to 5 years after diagnosis, adjusting for the different background mortality in each deprivation group by age, sex and calendar period. We estimated trends in overall survival and in the deprivation gap in survival up to 2004. Five-year survival improved for all malignancies except bladder cancer and was associated with a widening in the deprivation gap in survival. For 25 of 30 cancer-sex combinations examined, 5-year survival was lower among more deprived patients diagnosed during 1996-2000, and the deprivation gap in survival had widened since 1986-1990 for 15 of these 25 cancers, similar to the trends seen in England and Wales. [ABSTRACT FROM AUTHOR]

Purpose: To analyse survival from uveal melanoma diagnosed in England and Wales between 1986-1999 and followed up to 2001. Methods: Data from the National Cancer Registry at the Office for National Statistics were analysed. The data were compiled from population-based cancer registries covering all of England and Wales for all adults (aged 15–99) diagnosed with primary ocular malignancy, excluding eyelid tumours. Level of poverty was based on the national classification of area of residence at time of diagnosis. Regression models explored the influence of sex, age, and level of poverty on relative survival for patients diagnosed with uveal melanoma during successive calendar periods. Results: Of 5,519 adults identified with primary ocular malignancy, 4,717 had melanoma, of which 4,308 (91%) were eligible for analysis. Two-thirds (67%) of the ocular melanomas were uveal, 5% conjunctival, and 2% orbital; the subsite was unspecified in 26%. Relative survival from uveal melanoma was 95% at 1 year and 72% at 5 years. There was no statistically significant variation in 1-year or 5-year survival by sex or poverty level and no significant trend over time. Older patients had significantly worse survival (p < 0.001). Conclusions: This study provides national population-based survival estimates for England and Wales for uveal melanoma, the most common primary intraocular malignancy in adults. Five-year relative survival, an important indicator of the quality of cancer care, has not improved since the 1980s. Greater age, but not gender or level of poverty, is associated with a poorer prognosis. A standardised classification of uveal melanoma is required to improve reporting to cancer registries. Further research is required to explore reasons for lower relative survival in older persons. [ABSTRACT FROM AUTHOR]

This population-based study examines prognostic factors and survival trends among adults (15-99 years) diagnosed with small intestinal cancer in England and Wales during 1971-1990 and followed up to 1995. During this period, the 1- and 5-year age-standardised relative survival rates for small intestinal cancers combined were 42% and 23%, respectively. Duodenal tumours, adenocarcinomas, men, patients with advanced age and the most deprived patients had the poorest prognosis. For all small bowel tumours combined, the excess risk of death fell significantly by 6-9% every 4 years over the 20-year period (adjusted excess hazard ratio (EHR) 0.91 at 1 year after diagnosis, 0.94 at 5 years). For duodenal tumours, the EHR fell by about 14% (95% CI 5-22%) every 4 years between 1979 and 1990, and a similar trend for jejunal tumours was of borderline significance. Further population-based investigations linking survival data to individual data on diagnostic methods and types of treatment are needed. [ABSTRACT FROM AUTHOR]

The article presents analysis on survival from prostate cancer up to 2001 in England and Wales. Prostate cancer has become the most common malignancy among men living in these countries and the majority of this cancer is adenocarcinoma. It shows hybrid analysis based on survivors from 2000-2001 which suggests that survival will continue to improve. It also points out that implications for asymptomatic men diagnosed with prostate cancer after a prostate-specific antigen (PSA) test are important.

The article presents an analysis on survival from testicular cancer up to 2001 in England and Wales. This malignant disease has relative increased incidence in men under 50 years of age living in these countries. It examined survival patterns for 18,605 men diagnosed with testicular cancer aged 15-99 year in England and Wales from 1986-1999 and followed up in December 31, 2001. The trend in overall survival attained in men having testicular cancer is discussed.

The article presents an analysis on survival from non-Hodgkin lymphoma as of 2001 in England and Wales. This disease comprises a different set of malignancies of lymphoid tissue with a variety of biological, clinical, and prognostic features other than Hodgkin's disease. The study found that this disease is the most common lympho-haemopoietic malignancy in older males and females. It shows that there has been improving survival for patients with non-Hodgkin lymphoma in these countries.

The article presents a study on survival from multiple myeloma up to 2001 in England and Wales. This disease is characterised by a malignant clone of plasma cells invading bone marrow, with high serum or urine levels of monoclonal immunoglobulin, and lytic bone lesions. The study found that approximately 1800 cases are registered in elderly men and 1500 in elderly women each year in these countries. It shows that short-term and long-term survival remains poor despite overall gains in survival.

The article presents a survival study concerning adult leukemia up to 2001 in England and Wales. It states that acute and chronic myeloid leukemia, chronic lymphoid leukemia (CLL), and monocytic leukemia account for 90% of leukemia in adults in these countries, while acute lymphocytic leukemia is mainly a disease of childhood. It presents the disparities in the trends and socioeconomic inequalities in survival from leukemia between children and adults.

The article presents analysis on survival from cancer of the uterus up to 2001 in England and Wales. It cites cases of about 5,300 women living in these countries with uterine cancer in 1990 and considered the fifth most common cancer in women. It discusses the survival reported in England and Wales which involve more than 53,000 women aged 15-99 years who were registered with uterine cancer during the 14-year period 1986-1999.

The article presents analysis on survival from cancer of the ovary up to 2001 in England and Wales. Ovarian cancer is considered the most common gynaecological cancer representing some 5% of all cancers in women in these countries. It cites the incidence in England and Wales that has increased gradually in 1970 especially in older women. It shows that survival from ovarian cancer did not improve in 1980 and 5-year survival from ovarian cancer is 5-8% below the age-standardized European average.

The article presents an analysis on survival from cancers of the kidney and ureter up to 2001 in England and Wales. It examines the malignant tumors of the kidney and ureter that comprised of 2% of adult cancers in these countries with some 5000 new cases each year. The study found that cancers of the kidney and ureter are common before the age of 50 in especially in men. It states that survival from kidney cancers in these countries has increased for both men and women.

Background: Although survival from breast cancer has greatly improved over the past three decades, there is little consensus as to whether a population of women diagnosed with breast cancer can ever be considered ‘cured’ of the disease. Patients and methods: We examined population ‘cure’ among women aged 15–99 years diagnosed with breast cancer from 1980 to 1995 in the West Midlands (England) and New South Wales (Australia). We calculated interval-specific excess mortality rates and fitted a number of statistical models to evaluate ‘cure’. Results: There was little evidence that these women could ever be considered cured of the disease because excess mortality due to breast cancer was evident among young and middle-aged women up to 23 years after their diagnosis. Older women diagnosed in New South Wales displayed some evidence of ‘cure’. However, this was estimated to occur only after the womens 75th birthday. Conclusions: There is no strong evidence of the existence of a ‘cured’ subpopulation among young or middle-aged women diagnosed with breast cancer in either West Midlands or New South Wales during the period 1980–1995. Additional follow-up data would permit ‘cure’ to be assessed for women diagnosed more recently than 1995. [ABSTRACT FROM AUTHOR]