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Long-Term Trends in the Survival of Women with Endometrial Cancer in Canada: A Population-Based Study

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DOI: 10.4236/jct.2012.325109    4,762 Downloads   6,882 Views  

ABSTRACT

Introduction: Annually in Canada, endometrial cancer affects approximately 4500 women and 790 are expected to die of their disease. To better understand survival trends across the country we undertook this population based study of Canadian women diagnosed with endometrial cancer. Long term trends in relative survival were evaluated by age and geographic region of residence. Methods: Women with an ICD-10 code of C54 and endometrial cancer were identified from the Canadian Cancer Registry. They were included if the incident diagnosis occurred between 1992 and 2005, and they were 16 years and older at diagnosis. A flexible parametric model was used to determine relative survival ratio (i.e., the observed survival rate among cancer patients divided by the expected survival rate in the general population). Results: 18,486 women were diagnosed with endometrial cancer. Mean age was 63.4 (SD=11.8) year. Relative survival decreased with each successive age group cohort of patient (16-49 yr compared to over 60 years, p<0.001). When relative survival was adjusted for age, women in British Columbia had the best outcomes (eastern Canada compared to other jurisdictions p<0.001). Five-year survival outcomes improved for each age group cohort during the 1992 to 2005 time frame. Conclusions: Regional variations in relative survival were identified across Canada for women with endometrial cancer. This suggests that other factors related to the patient or processes of care are involved. Examining these factors in further detail may provide opportunities to improve the care of women with endometrial cancer in Canada.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

L. Elit, A. Lytwyn and N. Akhtar-Danesh, "Long-Term Trends in the Survival of Women with Endometrial Cancer in Canada: A Population-Based Study," Journal of Cancer Therapy, Vol. 3 No. 5A, 2012, pp. 853-858. doi: 10.4236/jct.2012.325109.

References

[1] Canadian Cancer Society, “Canadian Cancer Statistics 2010,” Author, Toronto, 2010.
[2] D. S. McMeekin, K. M. Alektiar, P. J.Sabbatini and R. J. Zaino, “Corpus: Epithelial Tumors,” In: R. R. Barakat, M. Markman and M. E. Randall, Eds., Principles and Practice of Gynecologic Oncology, 5th Edition, Lippincott Williams & Wilkins, Baltimore, 2009, pp. 683-732.
[3] J. S. Kwon, M. S. Carey, E. F. Cook, F. Qiu and L. F. Paszat, “Addressing Wait Times for Endometrial Cancer Surgery in Ontario,” Journal of obstetrics and gynaecology Canada, Vol. 29, No. 12, 2007, pp. 982-987.
[4] K. R. Lee, F. A. Tavassoli, J. Prat, M. Dietel, D. J. Gersell, A. I. Karseladze, et al., “Tumours of the Ovary and Peritoneum,” In: F. A. Tavassoli and P. Devilee, Eds., World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Breast and Female Genital Organs, IARC Press, Lyon, 2003, pp. 113-145.
[5] P. W. Dickman, A. Sloggett, M. Hills and T. Hakulinen, “Regression Models for Relative Survival,” Statistics in Medicine, Vol. 23, No. 1, 2004, pp. 51-64. doi:10.1002/sim.1597
[6] P. W. Dickman and H. O. Adami, “Interpreting Trends in Cancer Patient Survival,” Journal of Internal Medicine, Vol. 260, No. 2, 2006, pp. 103-117. doi:10.1111/j.1365-2796.2006.01677.x
[7] F. Ederer, L. M. Axtell and S. J. Cutler, “The Relative Survival Tart: A Statistical Methodology,” National Cancer Institute Monograph, Vol. 6, 1961, pp. 101-102.
[8] A. Pokhrel and T. Hakulinen, “How to Interpret the Relative Survival Ratios of Cancer Patients,” European Journal of Cancer, Vol. 44, No. 1, 2008, pp. 2661-2667. doi:10.1016/j.ejca.2008.08.016
[9] P. C. Lambert and P. Royston, “Further Development of Flexible Parametric Models for Survival Analysis,” The Stata Journal, Vol. 9, No. 2, 2009, pp. 265-290.
[10] P. Royston and M. K. Parmar, “Flexible Parametric Proportional-Hazards and Proportional-Odds Models for Censored Survival Data, with Application to Prognostic Modelling and Estimation of Treatment Effects,” Statistics in Medicine, Vol. 21, No. 15, 2002, pp. 2175-2197. doi:10.1002/sim.1203
[11] Statistics Canada, “Table 102-0504: Deaths and Mortality Rates, by Age Group and Sex, Canada, Provinces and Territories, Annual (2112 Series),” Statistics Canada, 2010.
[12] S. Durrleman and R. Simon, “Flexible Regression Models with Cubic Splines,” Statistics in Medicine, Vol. 8, No. 5, 1989, pp. 551-561. doi:10.1002/sim.4780080504
[13] Statistics Canada, “Table 051-0001: Population by Sex and Age Group, by Province and Territory,” Statistics Canada, 2010. http://www40.statcan.gc.ca/l01/cst01/demo31c-eng.htm
[14] C. M. Beard, L. C. Hartmann, G. L. Keeney, C. S. Crowson, G. D. Malkasian, P. C. O’Brien, et al., “Endometrial Cancer in Olmsted County, MN: Trends in Incidence, Risk Factors and Survival,” Annals of Epidemiology, Vol. 10, No. 2, 2000, pp. 97-105. doi:10.1016/S1047-2797(99)00039-3
[15] A. Jensen, H. Sharif and S. K. Kjaer, “Use of Fertility Drugs and Risk of Uterine Cancer: Results from a Large Danish Population-Based Cohort Study,” American Journal of Epidemiology, Vol. 170, No. 11, 2009, pp. 1408-1414. doi:10.1093/aje/kwp290
[16] A. Klink, L. Tryggvadottir, F. Bray, M. Gislum, T. Hakulinen, H. H. Storm, et al., “Trends in the Survival of Patients Diagnosed with Cancer in Female Genital Organs in the Nordic Countries 1964-2003 Followed Up To The End Of 2006,” Acta Oncologica, Vol. 49, No. 5, 2010, pp. 632-643. doi:10.3109/02841861003691945
[17] L. Minelli, F. Stracci, S. Prandini, I. F. Moffa and R. F. La, “Gynaecological Cancers in Umbria (Italy): Trends of Incidence, Mortality and Survival, 1978-1998,” European Journal of Obstetrics & Gynecology, Vol. 115, No.1, 2004, pp. 59-65. doi:10.1016/j.ejogrb.2003.11.026
[18] N. K. Lee, M. K. Cheung, J. Y. Shin, A. Husain, N. N. Teng, J. S. Berek, et al., “Prognostic Factors for Uterine Cancer in Reproductive-Aged Women,” Obstetrics & Gynecology, Vol. 109, No. 3, pp. 655-662. doi:10.1097/01.AOG.0000255980.88205.15
[19] L. S. Cook, L. M. Kmet, A. M. Magliocco and N. S. Weiss, “Endometrial Cancer Survival among US Black and White Women by Birth Cohort,” Epidemiology, Vol. 17, No. 4, 2006, pp. 469-472. doi:10.1097/01.ede.0000221026.49643.cf
[20] M. E. Sherman and S. S. Devesa, “Analysis of Racial Differences in Incidence, Survival, and Mortality for Malignant Tumors of the Uterine Corpus,” Cancer, Vol. 98, No. 1, 2003, pp. 176-186. doi:10.1002/cncr.11484
[21] K. Aoki, J. Sun, A. Kono and J. Misumi, “Age-Related Characteristics of Uterine Cancer Mortality in Japan,” Archives of Gynecology and Obstetrics, Vol. 273, No. 2, 2005, pp. 110-114. doi:10.1007/s00404-005-0044-8
[22] L. K. Smith, P. C. Lambert and D. R. Jones, “Up-to-Date Estimates of Long-Term Cancer Survival in England and Wales,” British Journal of Cancer, Vol. 89, No. 1, 2003, pp. 74-76. doi:10.1038/sj.bjc.6600976
[23] M. A. Crosby, J. D. Tward, A. Szabo, C. M. Lee and D. K. Gaffney, “Does Brachytherapy Improve Survival in Addition to External Beam Radiation Therapy in Patients with High Risk Stage I and II Endometrial Carcinoma?” American Journal of Clinical Oncology, Vol. 33, No. 4, 2010, pp. 364-349. doi:10.1097/COC.0b013e3181b0c266
[24] J. M. Straughn, Jr., T. M. Numnum, L. C. Kilgore, E. E. Partridge, J. L. Phillips, M. Markman, et al., “The Use of Adjuvant Radiation Therapy in Patients with Intermediate-Risk Stages IC And II Uterine Corpus Cancer: A Patient Care Evaluation Study from the American College of Surgeons National Cancer Data Base,” Gynecologic Oncology, Vol. 99, No. 3, 2005, pp. 530-535. doi:10.1016/j.ygyno.2005.08.034
[25] C. M. Lee, A. Szabo, D. C. Shrieve, O. K. Macdonald and D. K. Gaffney, “Frequency and Effect of Adjuvant Radiation Therapy among Women with Stage I Endometrial Adenocarcinoma,” Journal of the American Medical Association, Vol. 295, No 4, 2006, pp. 389-397. doi:10.1001/jama.295.4.389

  
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