How many deaths have been avoided through improvements in cancer survival?

被引:66
作者
Richards, MA
Stockton, D
Babb, P
Coleman, MP
机构
[1] Univ London London Sch Hyg & Trop Med, Dept Epidemiol & Populat Hlth, London WC1E 7HT, England
[2] St Thomas Hosp, Dept Palliat Med, London SE17 7EH, England
[3] Informat & Stat Div, Scottish Canc Intelligence Unit, Canc Surveillance Grp, Edinburgh EH5 3SQ, Midlothian, Scotland
[4] Off Natl Stat, Demog & Hlth Div, London SW1V 2QQ, England
关键词
D O I
10.1136/bmj.320.7239.895
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To estimate holy many deaths from cancer have been avoided in England and Wales because of recent improvements in survival. Design Analysis of national statistics. Setting England and Wales. Subjects 1.5 million adults with diagnosis of one of 47 different cancers during 1981-5 or 1986-90. Main outcome measures Reduction in number of cancer deaths within five years of diagnosis among patients with cancer diagnosed during 1986-90 compared with patients with cancer diagnosed during 1981-5, Results 17 041 deaths were avoided within five years of diagnosis among patients with cancer diagnosed during 1986-90. This represents 3.3% of the cancer deaths that would have been expected if survival had been the same as for patients with cancer diagnosed during 1981-5, Two thirds of the avoided deaths arose from improvements in survival for just five cancers: female br east cancer (4822), cancers of the colon (2560), rectum (1090), and bladder (1157), and melanoma of the skin (1098). The largest proportionate reductions in excess deaths were for melanoma of the skin (23%) and cancers of the testis (17%) and bone (17%). About 12 000 (70%) of the avoided deaths arose among adults aged under 75 at death. Improvements in survival from cancers of lung, prostate, stomach, ovary, and brain were small: the) accounted for 33% of all cancers but only 11% of avoided deaths. Conclusions Small gains in survival from common cancers save more lives than larger gains for uncommon cancers. If recent rates of improvement in cancer survival continue, about 24 000 deaths within five years of diagnosis would be avoided in patents aged under 75 by the year 2010, representing about a quarter of the government's overall target of 100 000 fewer cancer deaths.
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页码:895 / 898
页数:4
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