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Age-specific cancer survival in Estonia: recent trends and data quality.

Innos K, Lang K, Pärna K, Aareleid T - Clin Epidemiol (2015)

Bottom Line: The main data quality indicators were calculated, and the age-specific effect of missing death certificate initiated (DCI) cases on survival was estimated comparing 5-year RSRs computed from the complete data set with those from data set without DCI cases.The effect of missing DCI cases on survival estimates increased by age and was around 3% units for prostate and kidney cancers among the oldest patients.Young or middle-aged patients in Estonia experienced larger survival gain since the late 1990s than elderly patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.

ABSTRACT

Background: A number of population-based studies have demonstrated lower cancer survival in elderly patients than among middle-aged or younger patients. Also, data quality in cancer registries has been shown to be associated with age. The objective of this study was to examine the recent age-specific cancer survival trends and age-specific quality of cancer data in Estonia.

Methods: Using Estonian Cancer Registry data, we calculated relative survival ratios (RSRs) for eight common cancers in Estonia in 1995-1999 (cohort method) and 2005-2009 (period method) for four major age groups (15-54, 55-64, 65-74, and 75-84 years at diagnosis). The main data quality indicators were calculated, and the age-specific effect of missing death certificate initiated (DCI) cases on survival was estimated comparing 5-year RSRs computed from the complete data set with those from data set without DCI cases.

Results: We observed overall rise in 5-year RSR for all eight cancers over the study period, with a considerable variation by age, with the lowest survival among the oldest patients. The widest age gradient in 5-year RSR was seen for bladder cancer (20% units in 2005-2009), followed by cancers of lung (16% units), kidney (15% units), breast and prostate (13% units), stomach and rectum (11% units), and colon (5% units). All data quality indicators, including proportion of cases with unknown stage showed a similar age-related pattern with the lowest quality in the oldest age group. The effect of missing DCI cases on survival estimates increased by age and was around 3% units for prostate and kidney cancers among the oldest patients.

Conclusion: Young or middle-aged patients in Estonia experienced larger survival gain since the late 1990s than elderly patients. Decreasing quality of cancer registry data along with increasing patient age suggests less thorough clinical investigations in older age groups.

No MeSH data available.


Related in: MedlinePlus

The 5-year relative survival ratios (%) with 95% confidence intervals by cancer site and age at diagnosis, Estonia 1995–1999 and 2005–2009.
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f1-clep-7-355: The 5-year relative survival ratios (%) with 95% confidence intervals by cancer site and age at diagnosis, Estonia 1995–1999 and 2005–2009.

Mentions: The changes in the 5-year RSR over time are shown in Figure 1. Major survival improvement for stomach cancer was seen only among patients aged 65–74 years, leaving the age gradient unchanged. For colon cancer, survival increase was confined to the 55–64 years age group, and the 5-year RSR even declined in the youngest age group, resulting in reduced age gradient (from 13% units to 5% units). There was an indication of considerable survival improvement for rectal cancer in all age groups, particularly among the elderly (14% unit increase in the 75–84 years age group) as well as in the 55–64 years age group (statistically significant 13% unit increase). In lung cancer, the age gradient in survival widened from 3% units to 16% units as the 5-year RSR for the youngest age group doubled over the study period (statistically significant). Breast cancer survival increased significantly in all age groups but the oldest and, as a consequence, the age difference increased from 6% units to 13% units. Major statistically significant survival increases were seen in all age groups of prostate cancer patients. Despite the 16% unit survival increase in the oldest age group over the study period, the age gradient reached 13% units in the most recent period. For kidney cancer, the largest and significant survival increase was seen in the 65–74 years at diagnosis age group; the age gradient, however, remained wide. A steep age gradient was also observed for bladder cancer during both periods.


Age-specific cancer survival in Estonia: recent trends and data quality.

Innos K, Lang K, Pärna K, Aareleid T - Clin Epidemiol (2015)

The 5-year relative survival ratios (%) with 95% confidence intervals by cancer site and age at diagnosis, Estonia 1995–1999 and 2005–2009.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4524267&req=5

f1-clep-7-355: The 5-year relative survival ratios (%) with 95% confidence intervals by cancer site and age at diagnosis, Estonia 1995–1999 and 2005–2009.
Mentions: The changes in the 5-year RSR over time are shown in Figure 1. Major survival improvement for stomach cancer was seen only among patients aged 65–74 years, leaving the age gradient unchanged. For colon cancer, survival increase was confined to the 55–64 years age group, and the 5-year RSR even declined in the youngest age group, resulting in reduced age gradient (from 13% units to 5% units). There was an indication of considerable survival improvement for rectal cancer in all age groups, particularly among the elderly (14% unit increase in the 75–84 years age group) as well as in the 55–64 years age group (statistically significant 13% unit increase). In lung cancer, the age gradient in survival widened from 3% units to 16% units as the 5-year RSR for the youngest age group doubled over the study period (statistically significant). Breast cancer survival increased significantly in all age groups but the oldest and, as a consequence, the age difference increased from 6% units to 13% units. Major statistically significant survival increases were seen in all age groups of prostate cancer patients. Despite the 16% unit survival increase in the oldest age group over the study period, the age gradient reached 13% units in the most recent period. For kidney cancer, the largest and significant survival increase was seen in the 65–74 years at diagnosis age group; the age gradient, however, remained wide. A steep age gradient was also observed for bladder cancer during both periods.

Bottom Line: The main data quality indicators were calculated, and the age-specific effect of missing death certificate initiated (DCI) cases on survival was estimated comparing 5-year RSRs computed from the complete data set with those from data set without DCI cases.The effect of missing DCI cases on survival estimates increased by age and was around 3% units for prostate and kidney cancers among the oldest patients.Young or middle-aged patients in Estonia experienced larger survival gain since the late 1990s than elderly patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.

ABSTRACT

Background: A number of population-based studies have demonstrated lower cancer survival in elderly patients than among middle-aged or younger patients. Also, data quality in cancer registries has been shown to be associated with age. The objective of this study was to examine the recent age-specific cancer survival trends and age-specific quality of cancer data in Estonia.

Methods: Using Estonian Cancer Registry data, we calculated relative survival ratios (RSRs) for eight common cancers in Estonia in 1995-1999 (cohort method) and 2005-2009 (period method) for four major age groups (15-54, 55-64, 65-74, and 75-84 years at diagnosis). The main data quality indicators were calculated, and the age-specific effect of missing death certificate initiated (DCI) cases on survival was estimated comparing 5-year RSRs computed from the complete data set with those from data set without DCI cases.

Results: We observed overall rise in 5-year RSR for all eight cancers over the study period, with a considerable variation by age, with the lowest survival among the oldest patients. The widest age gradient in 5-year RSR was seen for bladder cancer (20% units in 2005-2009), followed by cancers of lung (16% units), kidney (15% units), breast and prostate (13% units), stomach and rectum (11% units), and colon (5% units). All data quality indicators, including proportion of cases with unknown stage showed a similar age-related pattern with the lowest quality in the oldest age group. The effect of missing DCI cases on survival estimates increased by age and was around 3% units for prostate and kidney cancers among the oldest patients.

Conclusion: Young or middle-aged patients in Estonia experienced larger survival gain since the late 1990s than elderly patients. Decreasing quality of cancer registry data along with increasing patient age suggests less thorough clinical investigations in older age groups.

No MeSH data available.


Related in: MedlinePlus