Poprawa przeżyć chorych na nowotwory złośliwe w polsce. Analiza przeżyć pacjentów zdiagnozowanych w latach 2003-2005

Abstract

Introduction: Population-based survival rates are tools for evaluating the effectiveness of cancer treatment. The observation of changes in rates over time can assess the changes in the effectiveness of treatment resulting from both the introduction of new types of treatment, as well the activities in the field of health prevention programs. The anal ysis shows the survival rates for patients diagnosed in Poland 2003-2005 and this new data was compared with the rates calculated for the period 2000-2002. Material and methods: The survival analysis was based on a set of new cases of cancer in the Polish National Cancer Registry. The analysis included 341,241 patients aged 15-99 years, who were diagnosed with cancer 2003-2005. The analysis excluded cases of cancer in children aged 0-14 years, cases registered on the basis of a death certificate or autopsy (DCO) only, skin cancers other than melanoma (C44) and cancers in situ (D00-D09). The estimated 5-year relative survival rates were calculated using the Hakulinen method by the SURV3 programme. The life tables for the Polish population used in the analysis were provided by the Central Statistical Office in Warsaw. The analysis was performed for the 17 most common cancers in men and women. The results were compared with the rates estimated for patients diagnosed in years 2000-2002 and the survival rates estimated for similar periods of diagnosis by selected regional registries. The results of the current analysis for Poland have not been compared with the European indicators because the survival rates for patients diagnosed after 2003 have not yet been published (EUROCARE-5). Results: The estimated 5-year relative survival rates for patients with all cancers who were diagnosed in 2003-2005 in Poland was 45.5%. The average age of patients at diagnosis was 63 years and the percentage of lost years of life is estimated at nearly 79%. The 5-year survival rates of cancer patients significantly differed between the sexes. Their value was lower in males: 37.3% compared with 53.5% for females. The highest rates in the males were in cancers of the testis (87.6%), thyroid gland (84.4%), Hodgkin's lymphoma (77.8%), prostate (76.4%), and bladder (61.4%). The lowest rates were in cancers of the oesophagus (7.1%), lung (11.9%) and stomach (16.4%). In women the highest rates were estimated for cancers of the thyroid gland (93.3%), Hodgkin's lymphoma (82.7%), uterus (78.7%), breast (77.2%) and melanoma (71.3%). The worst prognosis was in patients with cancers of the lung (16.9%) and stomach (19.8%). In comparison to the previously analyzed period (2000-2002) an improvement in life expectancy was noted among men by 4.4 percentage points and in women by 2.3 percentage points. Comparing the 5-year survival rates of patients living in the three different voivodeships, which were part of the study, the observed variation depending on the location of the tumour with ± 4 percentage points for men and ± 6 percentage points for women. Summary: The analysis of survival of patients diagnosed with cancers in Poland in 2003-2005 showed an increase in survival compared to that observed in previous years. Similar beneficial changes were observed in all regions which estimated survival rates. The increase in survival of cancer patients is due to many reasons, the most important seem to be improved health literacy of patients associated with "epidemiological vigilance", which translates to earlier diagnosis of cancers and a gradual improvement resulting from improved standards of treatment. © Polskie Towarzystwo Onkologiczne.