Trends In Survival From Ovarian Cancer In Six European Latin Countries: Results From The SUDCAN Population-Based Study

CHIRLAQUE M. 1,2,3 , UHRY Z. 4,5,6,7,8 , SALMERÓN D. 1,2,3 , SÁNCHEZ-ZAPATA M. 9 , ZANONNI G. 10 , NAVARRO C. 1,2,3

1 Department of Epidemiology, Murcia Health Council, IMIB-Arrixaca, Murcia, Spain.
2 CIBER Epidemiology and Public Health (CIBERESP), Spain.
3 Department of Health and Social Sciences, Universidad de Murcia, Spain.
4 Service de Biostatistique, Hospices Civils de Lyon, Lyon, France.
5 Département des Maladies Chroniques et Traumatismes, Institut de Veille Sanitaire, Saint-Maurice, France.
6 CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France.
7 Université Lyon 1, Villeurbanne, France.
8 Université de Lyon, Lyon, France.
9 Department of Gynaecology, University Hospital Santa Lucia, Cartagena, Murcia, Spain.
10 Facoltŕ di Medicina e Chirurgia. Universitŕ Cattolica del Sacro Cuore. Roma. Italy.

Purpose: The SUDCAN study is an initiative of the GRELL in collaboration with EUROCARE. Suboptimal survival results on ovarian cancer (European 5-year net survival 37.6%) make necessary major efforts to detect differences in survival trends and improve prognosis. We studied the trends in 1 and 5-years net survival from ovarian cancer over the 1992-2004 period in six participating European Latin countries.
Methods: The data were extracted from EUROCARE-5 database (end of follow-up: 01/01/2009). The results are reported from 1992 to 2004 in France, Italy, Spain, and Switzerland and from 2000 to 2004 in Belgium and Portugal. Analyses included 33,178 cases from 28 registries. Exclusions (mainly DCO) ranged from 0% to 3.4% depending on the country. Trend analyses were performed using an original flexible excess rate modelling strategy applied for each country. A model was selected among 19 that differed in the modelling of the effect of the year of diagnosis in terms of linearity, proportionality and change with age, based on the Akaike Information Criterion.
Results: In 2004, the 5-year age-standardized net survival (ASNS) was about 38% in Spain, Switzerland and Italy and about 42% in France, Portugal, and Belgium. Between 1992 and 2004, 1 and 5-year ASNS improved substantially in all countries; the absolute increases ranged from 7% to 12% and from 5% to 8%, respectively. In Belgium and Portugal, the 5-year ASNS increased too between 2000 and 2004. Differences in 1-year ASNS between countries were maintained along the study-period whereas differences in 5-year ASNS widened, especially in the most recent years, due to lower increases in Switzerland and Spain.
Conclusions: Improvements in survival from ovarian cancer were seen across Latin European countries but some differences between countries remain. These results underline the necessity of studying the variability in ovarian cancer care.
Funding source: French Ligue contre le Cancer.