Abstract
BackgroundEstimated conditional survival for cancer patients diagnosed at different ages and disease stage provides important information for cancer patients and clinicians in planning follow-up, surveillance and ongoing management.MethodsUsing population-based cancer registry data for New South Wales Australia, we estimated conditional 5-year relative survival for 11 major cancers diagnosed 1972–2006 by time since diagnosis and age and stage at diagnosis.Results193,182 cases were included, with the most common cancers being prostate (39,851), female breast (36,585) and colorectal (35,455). Five-year relative survival tended to increase with increasing years already survived and improvement was greatest for cancers with poor prognosis at diagnosis (lung or pancreas) and for those with advanced stage or older age at diagnosis. After surviving 10 years, conditional 5-year survival was over 95% for 6 localised, 6 regional, 3 distant and 3 unknown stage cancers. For the remaining patient groups, conditional 5-year survival ranged from 74% (for distant stage bladder cancer) to 94% (for 4 cancers at different stages), indicating that they continue to have excess mortality 10–15 years after diagnosis.ConclusionThese data provide important information for cancer patients, based on age and stage at diagnosis, as they continue on their cancer journey. This information may also be used by clinicians as a tool to make more evidence-based decisions regarding follow-up, surveillance, or ongoing management according to patients' changing survival expectations over time.
Highlights
Estimated conditional survival for cancer patients diagnosed at different ages and disease stage provides important information for cancer patients and clinicians in planning follow-up, surveillance and ongoing management
This paper provides conditional survival estimates from New South Wales (NSW), Australia stratified by age group and stage at diagnosis for 11 major cancers
5-year relative survival tended to increase when conditional on increasing years after diagnosis and the greatest changes in conditional survival (CS) occurred for cancers with poor prognosis at diagnosis for example, patients with aggressive cancers or those with advanced stage or at older age
Summary
Estimated conditional survival for cancer patients diagnosed at different ages and disease stage provides important information for cancer patients and clinicians in planning follow-up, surveillance and ongoing management. A few published studies provided estimates for many cancer sites [13,14,15,16,17,18], and an even smaller number have included stratification by age group and stage at diagnosis [15,16,17]. Ellison et al [14] acknowledged that a stratification of conditional survival estimates by age group at diagnosis provides more relevant clinical information for clinicians and cancer patients. Other studies have acknowledged the limitation of excluding information about stage at diagnosis [13,15] This has been shown to be an important prognostic factor for survival outcomes [19]. While it has been suggested that the impact of stage reduces and can disappear for long term conditional survival [16], there are currently no published Australian data describing conditional survival outcomes according to the stage at diagnosis
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