Survival of cancer patients in France: A population-based study from The Association of the French Cancer Registries (FRANCIM)

Bossard, Nadine; Velten, Michel; Remontet, Laurent; Belot, Aurélien; Maarouf, Nabil; Bouvier, Anne; Guizard, Anne‐Valérie; Trétarre, Brigitte; Launoy, Guy; Colonna, Marc; Danzon, Arlette; Molinié, F.; Troussard, Xavier; Bourdon-Raverdy, N; Carli, P; Jaffré, Anne; Bessaguet, C.; Sauleau, Erik-André; Schvartz, Claire; Arveux, Patrick; Maynadié, Marc; Grosclaude, Pascale; Estève, Jacques; Faivre, Jean

doi:10.1016/j.ejca.2006.07.021

Cited by 145 publications

(104 citation statements)

References 21 publications

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“…Given the lack of national CRC incidence data for many countries, CRC-mortality data were used along with CRC incidence data in our comparative analyses. As already mentioned, CRC mortality should be a good surrogate parameter given that survival of female and male CRC patients is essentially the same (Bossard et al, 2007). In fact, exactly the same age differences by sex were seen for incidence and mortality in our analyses for the US, where both measures were looked at.…”

Section: Discussionsupporting

confidence: 71%

“…If, on the other hand, progression time differs by age and sex, genderspecific differences in CRC incidence may actually remain the more relevant parameter even for these types of CRC screening programmes. When data on CRC incidence are not available, ageand sex-specific CRC mortality can be used as a good surrogate parameter, given that survival differences between female and male CRC patients are very small (Bossard et al, 2007). …”

mentioning

confidence: 99%

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Gender differences in colorectal cancer: implications for age at initiation of screening

et al. 2007

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There is some variation regarding age at initiation of screening for colorectal cancer (CRC) between countries, but the same age of initiation is generally recommended for women and men within countries, despite important gender differences in the epidemiology of CRC. We have explored whether, and to what extent, these differences would be relevant regarding age at initiation of CRC screening. Using population-based cancer registry data from the US and national mortality statistics from different countries, we looked at cumulative 10-year incidence and mortality of CRC reached among men at ages 50, 55, and 60, and found that women mainly reached equivalent levels when 4 to 8 years older. The gender differences were remarkably constant across populations and over time. These patterns suggest that gender differentiation of age at initiation may be worthwhile to utilise CRC-screening resources more efficiently. With more than one million new cases and more than 500 000 deaths per year, colorectal cancer (CRC) is the third commonest cancer and the fourth commonest cancer cause of death worldwide (Parkin et al, 2005). Owing to its typically slow development, there is a large potential for reducing the burden of the disease by early detection and removal of precancerous lesions or early cancer stages. Various screening examinations, including faecal occult blood testing (FOBT), sigmoidoscopy, and colonoscopy have meanwhile been recommended by expert committees and implemented in screening offers in a number of countries (e.g. Winawer et al, 2003;Schmiegel et al, 2004;Malila et al, 2005;Smith et al, 2006). Regarding the age at initiation of screening, which is a crucial parameter for the effectiveness and cost-effectiveness of screening programmes (Vijan et al, 2001), there is some variation between countries (typically ranging from 50 to 60 years for the population at average risk). However, within countries, the same age of initiation is generally recommended for women and men, despite important gender differences in the epidemiology of CRC. In particular, age-specific CRC incidence and mortality are lower in women than in men, which implies that women reach comparable levels of CRC incidence and mortality at higher ages than men. This paper aims to address the question whether and to what extent these epidemiological differences might be relevant for defining age at initiation of CRC screening among women and men. METHODS Outcome measureWhen attempting to translate the gender differences in the epidemiology of CRC into gender-specific ages at initiation of screening, it is first necessary to define an appropriate outcome measure. In a screening programme that primarily aims at the early detection of CRC, as applies to FOBT-based screening, (cumulative) age-and sex-specific CRC incidence appears to be a natural choice. In a screening programme that aims to detect both CRC and its precursors (adenomas), as applies to endoscopy-based screening, the epidemiology of adenomas might also be considered. However, if the time...

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Section: Discussionsupporting

confidence: 71%

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confidence: 99%

Gender differences in colorectal cancer: implications for age at initiation of screening

et al. 2007

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“…Globalmente el 60% se curan o cronifican. Los cánceres de mama, prós-tata y colorrectal son los cánceres más frecuentes en el anciano (10) y todos ellos presentan en la actualidad unos elevados índices de curación, entendiendo por ello supervivencia a 5 años, desde alrededor del 84% en el cáncer de mama, al 58% en los canceres colorrectales (24). Esta mejora pronóstica tiene un alto precio tanto de tratamiento como de posterior seguimiento y mantenimiento: test de detección precoz de aparición de segundos tumores, trastornos y/o secuelas del tratamiento recibido: radioterapia, cirugías mutilantes, alteraciones orgánicas por citostáticos (cardiacas, neurológicas, tiroideas, etc.)…”

Section: Aspectos Generales Del Cáncer En El Ancianounclassified

“…En un reciente estudio francés, la edad supuso un factor pronóstico negativo pero frecuentemente limitado al primer año tras el diagnóstico (24). La supervivencia global es generalmente menor en los ancianos, si bien se debe a la mayor probabilidad de morir conforme avanza la edad más que por causas relacionadas con el cáncer (21).…”

Section: Diferencias De Comportamiento De Los Cánceres Según La Edadunclassified

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Prevalencia y tratamiento de la patología oncológica en el anciano: El reto que se avecina

Portilla¹,

Lecea²,

Cendoya³

et al. 2008

Rev. esp. enferm. dig.

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RESUMENLa esperanza media de vida en España se ha más que duplicado a lo largo del siglo XX, llegando en la actualidad a 75 años en el varón y 83 años en la mujer. Las predicciones de la evolución y crecimiento poblacional a nivel mundial y nacional auguran un shock demográfico cuando en España el número de mayores de 65 años alcance el 33,5% de la población en el 2050.Es conocido que el cáncer está intrínseca y directamente relacionado con la edad, siendo una patología de personas mayores, ya que al menos el 60% de ellos aparecen en mayores de 65 años. Los ancianos constituyen el grupo más importante de la práctica oncológica médica. Las predicciones de envejecimiento de la población española, permiten intuir que el cáncer en el anciano y su tratamiento deba ser considerado un problema sanitario de primer orden.El cáncer ya no es sinónimo de muerte para la mayoría de los pacientes. Globalmente el 60% se curan o cronifican. Esta mejora pronóstico tiene un precio tanto en las expectativas de tratamiento como de posterior seguimiento y mantenimiento de las secuelas que pueden generarse.El mayor y mejor conocimiento y comprensión del proceso de envejecimiento, permitirá identificar y seleccionar aquellos pacientes mayores que pueden beneficiarse de medidas de prevención y tratamiento, y lo más importante permitirá identificar aquellos pacientes que no son candidatos de tratamientos con intención curativa por tratarse de población frágil.Los adelantos en el campo de la cirugía, especialmente en la cirugía mínimamente invasiva y su aplicación al campo de la cirugía oncológica, permiten prever que un mayor número de pacientes ancianos podrán beneficiarse de un tratamiento con intención curativa. La edad no prevendrá de tratamientos apropiados en individuos ancianos con cáncer, especialmente aquellos en los que tengan una adecuada expectativa de vida y reserva funcional. Combatir esta discriminación sanitaria constituye una de las principales prioridades en la estrategia para el mantenimiento de la salud del anciano. ABSTRACTLife expectancy in Spain has more than duplicated during the last 20 th Century, and is currently 75 years for men and 83 years for women. Predictions on the evolution of the National and global population anticipate a demographic shock in Spain when individuals older than 65 years eventually make up more than 33.5% of the Spanish population by year 2050.It is known that cancer is directly related with age, and that it is a disease of older people -at least 60% of all cancers are diagnosed in patients older than 65 years. The older people group is the most important group of patients in oncologic practice today. Predictions on the aging of the Spanish population show that cancer in the aging patient and its treatment must be considered a first-line health problem. The diagnosis of cancer is not associated with death in the majority of patients. Sixty percent of cancers are globally cured or chronified. This advanced prognosis has its toll not only in the expectancy of treatment but also in subseque...

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Validation of the alternating conditional estimation algorithm for estimation of flexible extensions of Cox's proportional hazards model with nonlinear constraints on the parameters

Wynant

Abrahamowicz

2016

Biometrical J

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Standard optimization algorithms for maximizing likelihood may not be applicable to the estimation of those flexible multivariable models that are nonlinear in their parameters. For applications where the model's structure permits separating estimation of mutually exclusive subsets of parameters into distinct steps, we propose the alternating conditional estimation (ACE) algorithm. We validate the algorithm, in simulations, for estimation of two flexible extensions of Cox's proportional hazards model where the standard maximum partial likelihood estimation does not apply, with simultaneous modeling of (1) nonlinear and time-dependent effects of continuous covariates on the hazard, and (2) nonlinear interaction and main effects of the same variable. We also apply the algorithm in real-life analyses to estimate nonlinear and time-dependent effects of prognostic factors for mortality in colon cancer. Analyses of both simulated and real-life data illustrate good statistical properties of the ACE algorithm and its ability to yield new potentially useful insights about the data structure.

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Survival of cancer patients in France: A population-based study from The Association of the French Cancer Registries (FRANCIM)

Cited by 145 publications

References 21 publications

Gender differences in colorectal cancer: implications for age at initiation of screening

Gender differences in colorectal cancer: implications for age at initiation of screening

Prevalencia y tratamiento de la patología oncológica en el anciano: El reto que se avecina

Validation of the alternating conditional estimation algorithm for estimation of flexible extensions of Cox's proportional hazards model with nonlinear constraints on the parameters

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