Abstract
BackgroundSurvival trends in oesophageal and gastric cancer need to be updated. A nationwide Swedish population-based study in 1961–2009 was based on registry data.Methodology/Principal FindingsRelative survival rate, i.e. the ratio of the observed to the expected survival, adjusted for age, sex, and calendar period, and presented with 95% confidence intervals (CI), was the main outcome measure. The expected survival was calculated using the corresponding Swedish general population with no exclusions. The relative survival rates in oesophageal and gastric cardia adenocarcinoma have improved since the 1990s (p for trend <0.001), but not in oesophageal squamous cell carcinoma or gastric non-cardia adenocarcinoma. The relative 5-year survival rates during the two recent periods 1990–1999 and 2000–2008 were 12.5% (95%CI 10.1%–14.9%) and 10.3% (95%CI 8.5–12.0%) for oesophageal squamous cell carcinoma, 12.5% (95%CI 10.1%–14.9%) and 14.6% (95%CI 12.6–16.6%) for oesophageal adenocarcinoma, 11.1% (95%CI 9.6%–12.6%) and 14.3% (95%CI 12.3–16.3%) for gastric cardia adenocarcinoma, and 20.2% (95%CI 19.2%–21.1%) and 19.0% (95%CI 17.7–20.2%) for gastric non-cardia adenocarcinoma. The 3-year survival in tumour stage III in 2004–2008 was about 25% for all four tumour types.Conclusions/SignificanceThe survival in oesophageal and cardia adenocarcinoma is increasing, but the lack of such increase in oesophageal squamous cell carcinoma and gastric non-cardia adenocarcinoma is a concern.
Highlights
A shared characteristic of cancers of the oesophagus and the stomach is the poor overall prognosis
There is a complete assessment of all individuals through the personal identity numbers; [2] the Swedish Cancer Register has a complete recording of oesophageal and gastric cancer; [3,4] data on dates of death and emigration is complete by virtue of the Register of the Total Population
We have previously reported the survival rates in oesophageal cancer in Sweden until year 1996, showing that the relative 5-year survival had improved from about 5% to about 10% in both squamous cell carcinoma and adenocarcinoma of the oesophagus during the 1990s [5]
Summary
A shared characteristic of cancers of the oesophagus and the stomach is the poor overall prognosis. Sweden offers excellent opportunities to assess population-based survival in cancer. There is a complete assessment of all individuals through the personal identity numbers; [2] the Swedish Cancer Register has a complete recording of oesophageal and gastric cancer; [3,4] data on dates of death and emigration is complete by virtue of the Register of the Total Population. Survival studies from Sweden can be conducted in a population-based design. We have previously reported the survival rates in oesophageal cancer in Sweden until year 1996, showing that the relative 5-year survival had improved from about 5% to about 10% in both squamous cell carcinoma and adenocarcinoma of the oesophagus during the 1990s [5]. The present study was conducted to provide recent population-based survival rates in oesophageal and gastric cancers by histological type and by subsite. A nationwide Swedish populationbased study in 1961–2009 was based on registry data
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