Dal Maso L., Guzzinati S., De Angelis R.

IARC conference

Lion, 7-10 giugno 2016

 

Abstract 

PURPOSE:
To provide estimates of indicators of long-term survival and cure for 50 cancer types, presently lacking.


METHODS
Data from 1.6 million Italian cancer patients, diagnosed until 2010 (AIRTUM), were included. Validated statistical models were used to estimate four population-based original indicators of cancer cure, by sex, age, and period:
1.Cure fraction: Proportion of patients expected to reach the same death rates of the general population;
2.Time to cure: Years after cancer diagnosis necessary to eliminate the excess mortality of patients vs the general population. This occurs when 5-year conditional relative survival (CRS, probability of surviving an additional 5 years) becomes>95%;
3. Already cured patients: Proportion of patients who have survived longer than Time to cure;
4. Cure prevalence: Proportion of all prevalent cases who will not die of that cancer.


RESULTS
The cure fractions ranged from>90% for patients aged<60 years with thyroid and testis cancers to <10% for those with liver and pancreatic cancers. For several cancers they increased >10% from the 1980s to 2000s. Five-year CRS>95% was reached in <10 years by patients with cancers of the stomach, colon–rectum, pancreas, corpus and cervix uteri, and Hodgkin lymphoma. Mortality rates similar to the ones reported by the general population were reached after approximately 20 years for breast and prostate cancer patients. Five-year CRS remained <95% for >25 years after cancer diagnosis in patients with liver and larynx cancers, non-Hodgkin lymphoma, myeloma, and leukaemia. Time to cure was reached by 27% (20% in men and 33% in women) of all people living after a cancer diagnosis, defined as already cured. Therefore, the cure prevalence was 67% in men and 77% in women.


CONCLUSIONS
The availability of these indicators has a high potential impact on health planning, clinical practice, and patients’ perspective.