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Explanations for worsening cancer survival

Nature Reviews Clinical Oncology volume 7, pages 60–63 (2010)Cite this article

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Abstract

If cancer survival is reported to be worsening over time or inferior compared to other countries, politicians and health-care workers may get blamed because suboptimal care is presumed to be the cause. Yet, a variety of reasons exist for cancer survival statistics to change for the worse, of which deterioration of care is only one. Another explanation is that the improved diagnosis of premalignant lesions causes survival statistics to reflect only the most aggressive cancers—those with the poorest prognosis. In addition, deleterious changes in the distribution of prognostic factors and in the distribution of sociodemographic characteristics may negatively affect survival proportions. In this article, we identify the pitfalls that might be encountered in comparisons of published, population-based survival data from different time periods or populations.

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Acknowledgements

This work was performed within the framework of the research project 'Progress against cancer in The Netherlands since the 1970s' (Dutch Cancer Society grant 715,401), and was co-funded by the Comprehensive Cancer Center South, Eindhoven, The Netherlands.

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Authors and Affiliations

  1. Department of Public Health, Erasmus MC University Medical Center, P. O. Box 2040, Rotterdam, 3000, CA, The Netherlands

    Esther de Vries, Henrike E. Karim-Kos, Isabelle Soerjomataram & Jan Willem W. Coebergh

  2. Eindhoven Cancer Registry, Comprehensive Cancer Center South, P. O. Box 231, Eindhoven, 5600, AE, The Netherlands

    Maryska L. G. Janssen-Heijnen

  3. Department of Epidemiology, Biostatistics & HTA, Radboud University Nijmegen Medical Centre, Postbus 9101, Nijmegen, 6500, HB, The Netherlands

    Lambertus A. Kiemeney

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  1. Esther de Vries
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  2. Henrike E. Karim-Kos
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  6. Jan Willem W. Coebergh
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Correspondence to Esther de Vries.

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de Vries, E., Karim-Kos, H., Janssen-Heijnen, M. et al. Explanations for worsening cancer survival. Nat Rev Clin Oncol 7, 60–63 (2010). https://doi.org/10.1038/nrclinonc.2009.184

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