Toward a comparison of survival in American and European cancer patients

BACKGROUND. Only recently have extensive population-based cancer survival d ata become available in Europe, providing an opportunity to compare surviva l in Europe and the United States. METHODS, The authors considered 12 cancers: lung, breast, stomach, colon, r ectum, melanoma, cervix uteri, corpus uteri, ovary prostate, Hodgkin diseas e, and non-Hodgkin lymphoma. The authors analyzed 738,076 European and 282, 398 U.S. patients, whose disease was diagnosed in 1985-1989, obtained from 41 EUROCARE cancer registries in 17 countries and 9 U.S. SEER registries. R elative survival was estimated to correct for competing causes of mortality . RESULTS, Europeans had significantly lower survival rates than U.S. patient s for most cancers. Differences in 5-year relative survival rates were high er for prostate (56% vs. 81%), skin melanoma (76% vs. 86%), colon (47% vs. 60%), rectum (43% vs. 57%), breast (73% vs. 82%), and corpus uteri (73% vs. 83%). Survival declined with increasing age at diagnosis for most cancers in both the U.S. and Europe but was more marked in Europe. CONCLUSIONS. Survival for most major cancers was worse in Europe than the U .S. especially for older patients. Differences in data collection, analysis , and quality apparently had only marginal influences on survival rate diff erences. Further research is required to clarify the reasons for the surviv al rate differences. (C) 2000 American Cancer Society.