Complete prevalence and indicators of cancer cure: enhanced methods and validation in Italian population-based cancer registries

Frontiers in Oncology

Oncology

Giuseppe Cascone¹  Ettore Bidoli²  Diego Serraino²  Luigino Dal Maso²  Emanuele Crocetti²  Federica Toffolutti²  Rossella Cavallo³  Lorenza Boschetti⁴  Walter Mazzucco⁵  Silvia Rossi⁶  Roberta De Angelis⁶  Stefano Ferretti⁷  Giuliano Carrozzi⁸  Maria Michiara⁹  Pietro Seghini^1,10  Lucia Mangone^1,11  Alessandra Ravaioli^1,12  Manuel Zorzi^1,13  Stefano Guzzinati^1,13  Angela De Paoli^1,13  Laura Botta^1,14  Michael Mian^1,15  Antonella Puppo^1,16  Maria Teresa Pesce^1,17  Silvia Francisci^1,18  Sandra Mallone^1,18  Daniela Piras^1,19  Pasquala Pinna^2,20  Paola Ballotari^2,21  Enrica Migliore^2,22  Mario Fusco^2,23  Francesco Cuccaro^2,24  Maria Gambino^2,25  Margherita Ferrante^2,26  Giuseppe Sampietro^2,27  Francesca Bella^2,28  Anna Clara Fanetti^2,29  Cinzia Gasparotti^3,30  Roberto Vito Rizzello^3,31  Gianfranco Manneschi^3,32  Fabrizio Stracci^3,33  Rocco Galasso^3,34 

[1] Azienda Sanitaria Provinciale (ASP) Ragusa - Dipartimento di Prevenzione -Registro Tumori, Ragusa, Italy;Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy;Cancer Registry Azienda Sanitaria Locale (ASL) Salerno- Dipartimento di Prevenzione, Salerno, Italy;Cancer Registry of the Province of Pavia, Pavia, Italy;Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico (AOUP) di Palermo, Palermo, Italy;Department of Oncology and Molecular Medicine, National Institute of Health, Rome, Italy;Emilia-Romagna Cancer Registry, Ferrara Unit, Local Health Authority, Ferrara, and University of Ferrara, Ferrara, Italy;Emilia-Romagna Cancer Registry, Modena Unit, Public Health Department, Local Health Authority, Modena, Italy;Emilia-Romagna Cancer Registry, Parma Unit, Medical Oncology Unit, University Hospital of Parma, Parma, Italy;Emilia-Romagna Cancer Registry, Piacenza Unit, Public Health Department, AUSL Piacenza, Piacenza, Italy;Emilia-Romagna Cancer Registry, Reggio Emilia Unit, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy;Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Forlì, Italy;Epidemiological Department, Azienda Zero, Padua, Italy;Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy;Innovation, Research and Teaching Service (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Bolzano-Bozen, Italy;Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, Genova, Italy;Monitoraggio rischio ambientale e Registro Tumori ASL Caserta, Caserta, Italy;National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy;Nord Sardegna Cancer Registry, ASL, Sassari, Italy;Nuoro Cancer Registry, RT Nuoro, Servizio Igiene e Sanità Pubblica, ASL Nuoro, Nuoro, Italy;Osservatorio Epidemiologico, ATS Val Padana, Mantova, Italy;Piedmont Cancer Registry, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte and University of Turin, Turin, Italy;Registro Tumori ASL Napoli 3 Sud, Napoli, Italy;Registro Tumori Puglia - Sezione Azienda Sanitaria Locale (ASL) Barletta-Andria-Trani, Epidemiologia e Statistica, Barletta, Italy;Registro tumori ATS Insubria (Provincia di Como e Varese) Responsabile S.S. Epidemiologia Registri Specializzati e Reti di Patologia, Varese, Italy;Registro tumori integrato di Catania-Messina-Enna, Igiene Ospedaliera, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, Catania, Italy;Servizio Epidemiologico ATS di Bergamo, Bergamo, Italy;Siracusa Cancer Registry, Provincial Health Authority of Siracusa, Siracusa, Italy;Sondrio Cancer Registry, Agenzia di Tutela della Salute della Montagna, Sondrio, Italy;Struttura Semplice Epidemiologia, Agenzia di Tutela della Salute (ATS) Brescia, Brescia, Italy;Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy;Tuscany Cancer Registry, Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy;Umbria Cancer Registry, Public Health Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy;Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy;

关键词: prevalence;    cancer cure indicators;    time to cure;    Italy;    survival;    cure fraction;    cure prevalence;   

DOI  :  10.3389/fonc.2023.1168325

 received in 2023-02-17, accepted in 2023-05-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesTo describe the procedures to derive complete prevalence and several indicators of cancer cure from population-based cancer registries.Materials and methodsCancer registry data (47% of the Italian population) were used to calculate limited duration prevalence for 62 cancer types by sex and registry. The incidence and survival models, needed to calculate the completeness index (R) and complete prevalence, were evaluated by likelihood ratio tests and by visual comparison. A sensitivity analysis was conducted to explore the effect on the complete prevalence of using different R indexes. Mixture cure models were used to estimate net survival (NS); life expectancy of fatal (LEF) cases; cure fraction (CF); time to cure (TTC); cure prevalence, prevalent patients who were not at risk of dying as a result of cancer; and already cured patients, those living longer than TTC at a specific point in time. CF was also compared with long-term NS since, for patients diagnosed after a certain age, CF (representing asymptotical values of NS) is reached far beyond the patient’s life expectancy.ResultsFor the most frequent cancer types, the Weibull survival model stratified by sex and age showed a very good fit with observed survival. For men diagnosed with any cancer type at age 65–74 years, CF was 41%, while the NS was 49% until age 100 and 50% until age 90. In women, similar differences emerged for patients with any cancer type or with breast cancer. Among patients alive in 2018 with colorectal cancer at age 55–64 years, 48% were already cured (had reached their specific TTC), while the cure prevalence (lifelong probability to be cured from cancer) was 89%. Cure prevalence became 97.5% (2.5% will die because of their neoplasm) for patients alive >5 years after diagnosis.ConclusionsThis study represents an addition to the current knowledge on the topic providing a detailed description of available indicators of prevalence and cancer cure, highlighting the links among them, and illustrating their interpretation. Indicators may be relevant for patients and clinical practice; they are unambiguously defined, measurable, and reproducible in different countries where population-based cancer registries are active.

【 授权许可】

Unknown   
Copyright © 2023 Toffolutti, Guzzinati, De Paoli, Francisci, De Angelis, Crocetti, Botta, Rossi, Mallone, Zorzi, Manneschi, Bidoli, Ravaioli, Cuccaro, Migliore, Puppo, Ferrante, Gasparotti, Gambino, Carrozzi, Stracci, Michiara, Cavallo, Mazzucco, Fusco, Ballotari, Sampietro, Ferretti, Mangone, Rizzello, Mian, Cascone, Boschetti, Galasso, Piras, Pesce, Bella, Seghini, Fanetti, Pinna, Serraino, Dal Maso and AIRTUM Working Group