Cancer Survival Rates Vary by Country
Study Shows U.S., Japan, and France Have Highest Cancer Survival Rates
By
Kathleen Doheny
WebMD Health News
Reviewed By
Louise Chang, MD
July 16, 2008 — Where you live plays a role in cancer survival, according to a
new study that shows the U.S., Japan, and France recorded the highest survival
rates among 31 nations for four types of cancer. Algeria had the lowest
survival rates for all four cancers.
"This is the first direct comparison of so many countries as far as I am
aware," says Michel Coleman, MD, a professor of epidemiology and vital
statistics at the London School of Hygiene and Tropical Medicine and the
study's lead author.
While Coleman and other epidemiologists have long known that cancer survival
rates vary country by country, and even within a country, the study lends hard
numbers to the fact. Still, there were surprises. "I think the surprises
were that the range in global survival is really quite wide," Coleman tells
WebMD.
"Survival in the USA is high on a global scale but varies quite widely
among individual states as well as between blacks and whites within the
USA," he tells WebMD.
Cancer Survival by Country
Coleman and colleagues drew on data from nearly 2 million cancer patients,
ages 15 to 99, whose medical information was entered into 101 population-based
cancer registries in 31 countries. The patients had been diagnosed with one of
four cancers: breast, colon, rectum, or prostate cancers during the years
1990-1994. They were followed up to 1999, with the researchers comparing
five-year survival rates.
The highest survival rates were found in the U.S. for breast and prostate cancer, in Japan for
colon and rectal cancers in men, and in France for colon and rectal cancers in
women, Coleman's team reports.
In Canada and Australia, survival was also high for most cancers.
The lowest cancer survival rates for all four cancers were found in
Algeria.
Cancer Survival: A Closer Look at the U.S.
Survival rates varied among the 16 states and six metropolitan areas
included in the study.
Idaho had the best survival rates for rectal cancer in men and Seattle
was highest for rectal cancer in women. Patients in Seattle also had the best
survival rates for prostate cancer. For all other cancers studied, patients in
Hawaii had the highest survival rates.
Patients in New York City had the lowest survival rates for all four cancers
except rectal cancer in both men and women. For those, patients in Wyoming had
the lowest survival rate.
A racial gap in survival was evident, with white patients more likely than
blacks to survive, especially breast cancer. "The
comparison is confirmed right across the USA, in all 16 states," Coleman
says of the racial gap.
For the study, the researchers estimated relative survival, adjusting for
such factors as wide differences in death rates from country to country and for
age.
Cancer Survival Study: Second Opinion
"This is a very good way of presenting data worldwide, using the same
method of analysis," says Ahmedin Jemal, PhD, strategic director for cancer
occurrence for the American Cancer Society, who reviewed the study for
WebMD.
The state-by-state differences in cancer survival rates do not surprise him,
he says. "Previous studies have shown differences in treatment for breast
cancer, for example, across states." Differences in screening have also
been detected, he says, with the percentage of women getting regular
mammograms, found to vary widely from state to state.
Coleman and Jemal hope the study results will motivate public health policy
makers. "What is required here on a policy level is understanding why those
differences occur and remedying those differences so the entire population can
benefit from the improvement," Coleman says.
Within the U.S., Jemal says, he is hopeful the report will motivate cancer
control program organizers at the state level. Policymakers in a state with
lower cancer survival rates could consult with neighboring state policymakers
with higher survival rates and adopt some of their programs, he says.
The study is published early online and in the August edition of The
Lancet Oncology. Funding was provided by the CDC, the Department of Health
in London, and Cancer Research UK in London.
SOURCES: Michel Coleman, MD, professor of epidemiology and vital statistics, London
School of Hygiene and Tropical Medicine, UK. Coleman, M. The Lancet Oncology, early online; August 2008. Ahmedin Jemal, PhD, strategic director for cancer occurrence, American Cancer Society, Atlanta.
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