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

Abstract

BACKGROUND Stomach cancer was a leading cause of cancer-related deaths early in the 20th century and has steadily declined over the last century in the United States. Although incidence and death rates are now low, stomach cancer remains an important cause of morbidity and mortality in black, Asian and Pacific Islander, and American Indian/Alaska Native populations. METHODS Data from the CONCORD-2 study were used to analyze stomach cancer survival among males and females aged 15 to 99 years who were diagnosed in 37 states covering 80% of the US population. Survival analyses were corrected for background mortality using state-specific and race-specific (white and black) life tables and age-standardized using the International Cancer Survival Standard weights. Net survival is presented up to 5 years after diagnosis by race (all, black, and white) for 2001 through 2003 and 2004 through 2009 to account for changes in collecting Surveillance, Epidemiology, and End Results Summary Stage 2000 data from 2004. RESULTS Almost one-third of stomach cancers were diagnosed at a distant stage among both whites and blacks. Age-standardized 5-year net survival increased between 2001 to 2003 and 2004 to 2009 (26.1% and 29%, respectively), and no differences were observed by race. The 1-year, 3-year, and 5-year survival estimates were 53.1%, 33.8%, and 29%, respectively. Survival improved in most states. Survival by stage was 64% (local), 28.2% (regional), and 5.3% (distant). CONCLUSIONS The current results indicate high fatality for stomach cancer, especially soon after diagnosis. Although improvements in stomach cancer survival were observed, survival remained relatively low for both blacks and whites. Primary prevention through the control of well-established risk factors would be expected to have the greatest impact on further reducing deaths from stomach cancer.

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

“…A description of the data from the 37 participating cancer registries, and the rigorous and advanced statistical methods used to evaluate and analyze the data, are presented in an accompanying article by Allemani et al We focused on patients diagnosed during 2 calendar periods (2001‐2003 and 2004‐2009) because the method used by US cancer registries to collect and report anatomic stage (SEER Summary Stage 2000) changed beginning on January 1, 2004. We observed 5‐year survival to be high (≥80%) for breast cancer in women, prostate cancer, and acute lymphoblastic leukemia (ALL) in children; moderate (50%‐80%) for cancers of the colon, rectum, and cervix; and low (<50%) for cancers of the stomach, liver, lung, and ovary (Table ) . These observations are consistent with those of long‐term trends in survival in the United States for many leading cancers in both males and females and children .…”

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

“…We observed that age-standardized 5-year net survival for lung cancer (19.0%) was 4.2% higher than that for liver cancer (14.8%) 18 but lower than for the other cancers addressed in this Supplement, including stomach cancer (29.0%), 19 ovarian cancer (41.0%), 20 cervical cancer (62.8%), 21 rectal cancer (64.0%), 22 colon cancer (64.6%), 23 acute lymphoblastic leukemia in children (88.1%), 24 breast cancer (88.6%), 25 and prostate cancer (96.9%). 26 …”

Population‐based cancer survival in the United States: Data, quality control, and statistical methods

“…If an age‐specific estimate could not be obtained, we merged data for adjacent age groups and assigned the combined estimate to both age groups. If 2 or more age‐specific estimates could not be obtained, we present only the pooled, unstandardized estimates for all ages combined: these estimates are italicized in Supporting Tables 2 and 3 in other articles of this supplement …”