Global surveillance of cancer trends reveals wide variances in survival rate [CONCORD-2 study]

1. Some global cancer trends were more promising, such as those for colon and rectal cancer, which reached 60% 5-year survival rates or more in 22 countries. This rise potentially indicates increased access to screening procedures and treatment on a broad scale.

2. Global trends of other cancers demonstrated wide disparities. Childhood leukemia, for example, showed a 5-year survival rate of less than 60% in several countries but was as high as 90% in others, indicating potential deficiencies in the diagnosis and treatment of disease that is potentially curable.  

Evidence Rating Level: 1 (Good)          

Study Rundown: To reduce the global cancer burden, health systems are called to focus on crucial prevention strategies to decrease incidence while simultaneously building strategies to improve survival. In the current study, population-based cancer registries across 67 countries were analyzed for net 5-year survivals. Survival trends for 10 different types of invasive primary cancer comprising roughly two-thirds of the global cancer burden were assessed. Wide differences were apparent in survival trends, likely due to inequity of access to timely diagnosis and treatment. For example, 5-year survival for prostate cancer varied from below 60% in Thailand to more than 95% in the USA. 5-year survival for stomach cancer varied from 54-58% in South Korea and Japan to 18-23% in other nations. The worldwide extent of this study lends strength to its analysis. Geographical areas not represented in this study may be resource limited with low access to cancer registries. Therefore, survival rates may be even lower in these areas and global outcomes gaps may be even wider than those reported in this study.

This study was funded by the Canadian Partnership Against Cancer (Toronto, Canada), Cancer Focus Northern Ireland (Belfast, UK), Cancer Institute New South Wales (Sydney, Australia), Cancer Research UK (London, UK), Centers for Disease Control and Prevention (Atlanta, GA, USA), Swiss Re (London, UK), Swiss Cancer Research foundation (Bern, Switzerland), Swiss Cancer League (Bern, Switzerland), and University of Kentucky (Lexington, KY, USA).

Click to read the study, published today in The Lancet Oncology

Relevant Reading: Cancer survival in five continents: a worldwide population-based study (CONCORD)

In-Depth [retrospective cohort]: This study analyzed net 5-year survival trends in order to gauge effectiveness of health care systems and inform global cancer control policy. Data from 279 population-based databases with publishable reports or known follow-up on survival were analyzed for survival trends for the 15-year period from 1995-2009, covering 25.7 million adults (age 15-99) and 75,000 children (age 0-14 years). The study evaluated trends for cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, as well as trends for adult and childhood leukemia.

Global cancer survival trends varied widely in both 5-year survival trends over time and between nations for the same type of cancer. Breast cancer demonstrated an increase in 5-year survival to 85% or more in 17 countries, whereas 5-year survival for ovarian cancer reached 40% in only 17 countries. Liver and lung cancer remained highly deadly in both high and low to middle-income countries alike, with 5-year survival typically less than 20%. Cervical cancer 5-year survival varied from 50% to 70%, demonstrating a potential disparity in screening and management of a largely preventable disease.

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