Population‐based cancer survival (2001 to 2009) in the United States: Findings from the CONCORD‐2 study

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BACKGROUND Results from the second CONCORD study (CONCORD-2) indicated that 5-year net survival for lung cancer was low (range, 10%–20%) between 1995 and 2009 in most countries, including the United States, which was at the higher end of this range. METHODS Data from CONCORD-2 were used to analyze net survival among patients with lung cancer (aged 15–99 years) who were diagnosed in 37 states covering 80% of the US population. Survival was corrected for background mortality using state-specific and race-specific life tables and age-standardized using International Cancer Survival Standard weights. Net survival was estimated for patients diagnosed between 2001 and 2003 and between 2004 and 2009 at 1, 3, and 5 years after diagnosis by race (all races, black, and white); Surveillance, Epidemiology, and End Results Summary Stage 2000; and US state. RESULTS Five-year net survival increased from 16.4% (95% confidence interval, 16.3%–16.5%) for patients diagnosed 2001–2003 to 19.0% (18.8%–19.1%) for those diagnosed 2004–2009, with increases in most states and among both blacks and whites. Between 2004 and 2009, 5-year survival was lower among blacks (14.9%) than among whites (19.4%) and ranged by state from 14.5% to 25.2%. CONCLUSIONS Lung cancer survival improved slightly between the periods 2001–2003 and 2004–2009 but was still low, with variation between states, and persistently lower survival among blacks than whites. Efforts to control well established risk factors would be expected to have the greatest impact on reducing the burden of lung cancer, and efforts to ensure that all patients receive timely and appropriate treatment should reduce the differences in survival by race and state.

Section: Discussionmentioning

confidence: 99%

“…5 Survival differences between populations may be attributable to disparities in access to early diagnosis and optimal treatment. 6 …”

Section: Introductionmentioning

confidence: 99%

Lung cancer survival in the United States by race and stage (2001‐2009): Findings from the CONCORD‐2 study

Richards

Henley

Puckett

et al. 2017

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“…Population‐based cancer survival provides an indicator of the overall effectiveness of the health care system to deliver screening, early diagnosis, and evidenced‐based treatment services to all persons in the population being served . Survival differences between populations may be attributable to disparities in access to early diagnosis and optimal treatment .…”

Section: Introductionmentioning

confidence: 99%

Rectal cancer survival in the United States by race and stage, 2001 to 2009: Findings from the CONCORD‐2 study

Joseph

Johnson²,

White

et al. 2017

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Background In the first CONCORD study, overall 5-year survival for rectal cancers diagnosed between 1990 and 1994 was below 60%, with large racial disparities in most participating states. We have updated these findings to 2009 by examining population-based survival by stage at diagnosis, race, and calendar period. Methods We used data from the CONCORD-2 study to compare survival among people (age 15-99 years) diagnosed in 37 states covering up to 80% of the U.S. population. Survival was adjusted for background mortality (net survival) using state- and race-specific life tables and age-standardized using the International Cancer Survival Standard weights. Survival up to five years is presented by race (all, black and white) for 2001-2003 and 2004-2009 to account for changes in collecting SEER Summary Stage 2000. Results There was a small increase in 1-, 3- and 5-year net survival between the two time periods (84.6%, 70.7% and 63.2% respectively in 2001-2003; 85.1%, 71.5%, and 64.1% respectively in 2004-2009). Blacks had lower 1-, 3-, and 5-year survival than whites in both periods; the absolute difference in survival between blacks and whites declined only for 5-year survival. Blacks had lower 5-year survival than whites for each stage at diagnosis in both time periods. Conclusions There was little improvement in net survival for rectal cancer, with persistent, but narrowing disparities between blacks and whites. Additional investigation is needed to identify and implement effective interventions to ensure consistent and equitable use of high-quality screening, diagnosis, and treatment to improve survival for rectal cancer.

“…Measures of cancer survival at the population level rely on our extensive surveillance infrastructure, particularly a national network of high‐quality cancer registries. These cancer survival measures offer new insights into the need to address inequities in cancer diagnosis, treatment, and survivorship . Together with data regarding cancer incidence and death rates, cancer survival measures provide a comprehensive picture of the burden of cancer in a population and support public health efforts to prevent new cancers, extend survival and quality of life after a cancer diagnosis, and reduce cancer health disparities.…”

Section: Discussionmentioning

confidence: 99%

The history and use of cancer registry data by public health cancer control programs in the United States

White

Babcock

Hayes

et al. 2017

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105

Because cancer registry data provide a census of cancer cases, registry data can be used to: 1) define and monitor cancer incidence at the local, state, and national levels; 2) investigate patterns of cancer treatment; and 3) evaluate the effectiveness of public health efforts to prevent cancer cases and improve cancer survival. The purpose of this article is to provide a broad overview of the history of cancer surveillance programs in the United States, and illustrate the expanding ways in which cancer surveillance data are being made available and contributing to cancer control programs. The article describes the building of the cancer registry infrastructure and the successful coordination of efforts among the 2 federal agencies that support cancer registry programs, the Centers for Disease Control and Prevention and the National Cancer Institute, and the North American Association of Central Cancer Registries. The major US cancer control programs also are described, including the National Comprehensive Cancer Control Program, the National Breast and Cervical Cancer Early Detection Program, and the Colorectal Cancer Control Program. This overview illustrates how cancer registry data can inform public health actions to reduce disparities in cancer outcomes and may be instructional for a variety of cancer control professionals in the United States and in other countries.