ASH Clinical News ACN_4.5_FULL_ISSUE_DIGITAL - Page 27

CLINICAL NEWS Weighing the Global Cancer Burden: CONCORD-3 Finds Cancer Survival Varies by Location Five-year cancer survival rates are increasing globally, but disparities exist between regions, according to results from the CONCORD-3 global cancer surveillance program published in The Lancet. CONCORD-3 is the largest international study of cancer survival trends, including data on more than 37.5 million patients diagnosed with cancer between 2000 and 2014. Participating countries were home to two-thirds of the world’s population in 2014, according to Claudia Allemani, PhD, of the Department of Non-Communicable Disease Epidemiology at the London School of Hygiene & Tropical Medicine, and co-authors. The study included data from 322 population-based cancer registries of 71 countries and territories; 47 of these registries covered 100 percent of the population. The analysis included data on 18 common cancers that together represent 75 percent of all diagnosed cancers worldwide, including melanomas and esophageal, stomach, colon, rectal, liver, pancreatic, lung, breast, cervical, ovary, and prostate cancers in adults; and brain tumors, leukemias, and lymphomas in adults and children. Patients with in situ cancer were excluded from survival analyses. Registries were asked to submit data with follow-up for at least five years or through December 31, 2014, for patients diagnosed between 2010 and 2014. Outcomes data were stratified by time period: 2000 to 2004, 2005 to 2009, and 2010 to 2014. The authors estimated net survival up to five years after cancer diagnosis, correcting for “background mortality” (other causes of death). This benchmark “has been recognized by clinicians as an index of the effectiveness of the treat- ment of cancer,” the authors noted. This study builds on CONCORD-2, which evaluated survival trends for 10 cancers between 1995 and 2014. The CONCORD-3 update includes data on adult and pediatric lymphoma outcomes for the first time. “Survival for most cancers remains among the highest in the world in the U.S., Canada, Australia, and New Zea- land, and in Finland, Iceland, Norway, and Sweden,” the researchers wrote of their findings. However, cancer incidence across the world is continuing to rise. “Prevention is crucial, but implementa- tion has been slow and incomplete, even in high-income countries. Prevention is a long-term strategy, and not all cancers can be prevented.” Reported here are the findings for hematologic malignancies in adults (defined as 15-99 years) and children included in the CONCORD program. HELP HEMATOLOGY PATIENTS FIND YOU! Myeloid Malignancies CONCORD-3 included 1,151,226 adults from 286 registries in 61 countries. Dur- ing the 2010 to 2014 period, five-year, age-standardized survival rates were highest in France (57.5%) and lowest in Chile (16.5%). Survival rates were within the 30 to 50 percent range for most coun- tries; however, countries in southeast Asia consistently had survival rates lower than 30 percent. “It is crucial for national and regional governments to recognize that population- based cancer registries are key policy tools.” —CLAUDIA ALLEMANI, PhD Over the 15 years of the CONCORD-3 analysis, five-year survival rates increased by 5 to 10 percent in the following countries: U.S., China, Japan, Singapore, Taiwan; northern Europe (Ireland and the U.K.); southern Europe (Portugal and Spain); eastern Europe (Poland); western Europe (Austria, Belgium, and Germa- ny), and Australia. Korea, Denmark, the Netherlands, and Norway saw increases greater than 10 percent, and “survival increased dra- matically in Lithuania (27.4%), Sweden ASH members can help patients find their hematology practice by signing up to be included in ASH’s Find a Hematologist directory. Visit to add your information! ASH Clinical News 25