Assessment of progress in cancer control at the population level is increasingly important. Population-based survival trends provide a key insight into the overall effectiveness of the health system, alongside trends in incidence and mortality. For this purpose, we aimed to provide a unique measure of cancer survival.

Relative survival

Cancer Survival

10.1016/s0140-6736(14)61396-9

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Citations (420)

Full dates (day, month, year) should be used in population‐based cancer survival studies

International Journal of Cancer (2012)

Laura M. Woods Bernard Rachet Libby Ellis Michel P. Coleman

Accurate survival estimates are essential for monitoring cancer survival trends, for health care planning and for resource allocation. To obtain precise estimates of survival, full dates (day, month and year) rather than partial dates (month and year) are required. In some jurisdictions, however, cancer registries are constrained from providing full dates on the grounds of confidentiality. The bias resulting from the use of partial dates in the estimation and comparison of survival makes it impossible to determine precisely the differences in the risk of death from cancer between population groups or in successive calendar periods. Important operational arguments also exist against the use of incomplete dates for survival analysis, including increased workload for cancer registry staff and the introduction of avoidable complexity for quality control of survival data. Cancer survival is one of the most widely known outputs produced by population-based cancer registries, and it is a crucial metric for the comparative effectiveness of health services. The bodies that set data access guidelines must take a more balanced view of the risks and benefits of using full dates for the estimation of cancer survival.

Cancer Survival

10.1002/ijc.27545

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Survival from cancer of the larynx in England and Wales up to 2001

British Journal of Cancer (2008)

Bernard Rachet M J Quinn Nicola Cooper Michel P. Coleman

Cancer of the larynx is one of the more common malignancies in England and Wales (ranking 20th in both sexes combined).Approximately 1800 new cases are diagnosed each year, 80% of them in men.Incidence rates are approximately 6.2 and 1.3 per 100 000 per year in men and women, respectively.Incidence has fallen by approximately 5% in men over the last decade, but little change has occurred in women.Laryngeal cancer is rare under the age of 40, but the risk rises rapidly with age.There is a marked socioeconomic gradient, with risk twice as high in the most deprived groups as in the most affluent groups (Quinn et al, 2001).Geographic variation in risk is also wide, with incidence less than 70% of the United Kingdom and Ireland average in southwest England and parts of the southeast, but 50% or more above the average in much of Scotland and in the main urban areas of northwest and northeast England.The combined effect is a striking regional disparity in the socioeconomic profile of the disease.In the Oxford region, for example, 50% of cases occur in affluent groups, although in the West Midlands and the northwest, that proportion is approximately 20%, with 65% of cases among the most deprived (data not shown).The annual death rate of laryngeal cancer in England and Wales is approximately 2.3 per 100 000 in men (570 deaths a year) and 0.6 in women (150 deaths a year).The main risk factors for laryngeal cancer are alcohol and tobacco, and their effects are synergistic (Tuyns and Audigier, 1976;Tuyns et al, 1988).Tobacco dominates the risk for cancers of the vocal cords and glottis, whereas alcohol is more prominent for cancers of the supraglottis.This has a direct impact on survival in men and women for all laryngeal cancers combined, because the main causal exposures and the most common anatomic location of tumours within the larynx differ between the sexes, as do their diagnosis, treatment and outcome.Glottal cancers are more common in men; they give rise to hoarseness when the tumour is still small.They can often be treated surgically and are responsive to radiotherapy.They tend to have higher survival than supraglottic tumours.Cancers of the supraglottis are more common in women and do not give rise to early symptoms of hoarseness.Diagnosis from dysphagia or sore throat is often later than for cancers of the glottis, curative radiotherapy and surgery may be less successful, and survival is lower.

Cancer Survival

10.1038/sj.bjc.6604581

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Citations (37)

Book Report- The Richest Man in Babylon

Docs.school Publications (2014)

Bernard Rachet

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Screening mammography and socioeconomic inequalities in breast cancer survival

Annals of Oncology (2011)

Laura M. Woods Peter Sasieni Bernard Rachet

Mammography screening

10.1093/annonc/mdr557

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Estimation of net survival for cancer patients: Relative survival setting more robust to some assumption violations than cause-specific setting, a sensitivity analysis on empirical data

European Journal of Cancer (2016)

Robin Schaffar Bernard Rachet Aurélien Belot Laura M. Woods

Relative survival

Censoring (clinical trials)

10.1016/j.ejca.2016.11.019

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Citations (34)

Economic impact of avoidable cancer deaths caused by diagnostic delay during the COVID-19 pandemic: A national population-based modelling study in England, UK

European Journal of Cancer (2021)

Adrian Gheorghe Camille Maringe James Spice Arnie Purushotham Kalipso Chalkidou

IntroductionDelays in cancer diagnosis arose from the commencement of non-pharmaceutical interventions (NPI) introduced in the UK in March 2020 in response to the COVID-19 pandemic. Our earlier work predicted this will lead to approximately 3620 avoidable deaths for four major tumour types (breast, bowel, lung, and oesophageal cancer) in the next 5 years. Here, using national population-based modelling, we estimate the health and economic losses resulting from these avoidable cancer deaths. We also compare these with the impact of an equivalent number of COVID-19 deaths to understand the welfare consequences of the different health conditions.MethodsWe estimate health losses using quality-adjusted life years (QALYs) and lost economic productivity using the human capital (HC) approach. The analysis uses linked English National Health Service (NHS) cancer registration and hospital administrative datasets for patients aged 15–84 years, diagnosed with breast, colorectal, and oesophageal cancer between 1st Jan to 31st Dec 2010, with follow-up data until 31st Dec 2014, and diagnosed with lung cancer between 1st Jan to 31st Dec 31 2012, with follow-up data until 31st Dec 2015. Productivity losses are based on the estimation of excess additional deaths due to cancer at 1, 3 and 5 years for the four cancer types, which were derived from a previous analysis using this dataset. A total of 500 random samples drawn from the total number of COVID-19 deaths reported by the Office for National Statistics, stratified by gender, were used to estimate productivity losses for an equivalent number of deaths (n = 3620) due to SARS-CoV-2 infection.ResultsWe collected data for 32,583 patients with breast cancer, 24,975 with colorectal cancer, 6744 with oesophageal cancer, and 29,305 with lung cancer. We estimate that across the four site-specific cancers combined in England alone, additional excess cancer deaths would amount to a loss of 32,700 QALYs (95% CI 31,300-34,100) and productivity losses of £103.8million GBP (73.2–132.2) in the next five years. For breast cancer, we estimate a loss of 4100 QALYS (3900–4400) and productivity losses of £23.2 m (18.2–28.6); for colorectal cancer, 15,000 QALYS (14,100–16,000) lost and productivity losses of £35.7 m (22.4–48.7); for lung cancer 10,900 QALYS (9,900–11,700) lost and productivity losses of £38.3 m (14.0–59.9) for lung cancer; and for oesophageal cancer, 2700 QALYS (2300–3,100) lost and productivity losses of £6.6 m (–6 to –17.6). In comparison, the equivalent number of COVID-19 deaths caused approximately 21,450 QALYs lost, as well as productivity losses amounting to £76.4 m (73.5–79.2).ConclusionPremature cancer deaths resulting from diagnostic delays during the first wave of the COVID-19 pandemic in the UK will result in significant economic losses. On a per-capita basis, this impact is, in fact, greater than that of deaths directly attributable to COVID-19. These results emphasise the importance of robust evaluation of the trade-offs of the wider health, welfare and economic effects of NPI to support both resource allocation and the prioritisation of time-critical health services directly impacted in a pandemic, such as cancer care.

Pandemic

10.1016/j.ejca.2021.04.019

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Continuing Rapid Increase in Esophageal Adenocarcinoma in England and Wales

The American Journal of Gastroenterology (2008)

Côme Lepage Bernard Rachet Valérie Jooste Jean Faivre Michel P. Coleman

BACKGROUND AND AIMS Substantial changes have occurred in the epidemiology of esophageal adenocarcinoma. We examined trends in incidence in a large national population. METHODS All esophageal adenocarcinomas registered in England and Wales over a 31-year period (1971–2001) were included. Incidence rates were calculated by age, sex, and socio-economic category, by 5-year period, and by birth cohort. RESULTS A total of 43,753 esophageal adenocarcinomas were analyzed. Age-standardized (world) incidence rates rose rapidly, by an average of 39.6% (95% CI 38.6–40.6) every 5 years in men, and 37.5% (35.8–39.2) every 5 years in women. Incidence has increased about three-fold in men and women since 1971. Incidence has risen in all deprivation categories since 1986, especially in the most affluent groups. The cumulative risk of esophageal adenocarcinoma over the age range 15–74 years in men rose ten-fold, from 0.1% for those born in 1900 to 1.1% for those born in 1940. The cumulative risk rose five-fold in women. CONCLUSIONS The incidence of esophageal adenocarcinoma has increased sharply over the past few decades, both by period and birth cohort. Etiological studies are required to explain the rapid increase of this lethal cancer.

Cumulative incidence

Esophageal adenocarcinoma

Etiology

Cohort effect

10.1111/j.1572-0241.2008.02191.x

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Citations (269)

Cancer survival: five year relative survival rates in England by Health Authority up to 2000 - four further cancer sites

Bernard Rachet Michel P. Coleman Nicola Cooper Michael Quinn

This dataset presents the latest five-year relative survival rates up to the end of 2000 for those people diagnosed between 1993-95 for cancers of the bladder, stomach, oesophagus and cervix with data for the health regions and authorities. (Health region and authority data not by sex).

Relative survival

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