Worldwide trends in esophageal cancer survival,by sub-site,morphology,and sex:an analysis of 696,974 adults diagnosed in 60 countries during 2000-2014(CONCORD-3)

Background Esophageal cancer survival is poor worldwide,though there is some variation.Differences in the distribution of anatomical sub-site and morphological sub-type may help explain international differences in survival for all esophageal cancers combined.We estimated survival by anatomic sub-site and morphological sub-type to understand further the impact of topography and morphology on international comparisons of esophageal cancer survival.Methods We estimated age-standardized one-year and five-year net survival among adults(15-99 years)diagnosed with esophageal cancer in each of 60 participating countries to monitor survival trends by calendar period of diagnosis(2000-2004,2005-2009,2010-2014),sub-site,morphology,and sex.Results For adults diagnosed during 2010-2014,tumors in the lower third of the esophagus were the most common,followed by tumors of overlapping sub-site and sub-site not otherwise specified.The proportion of squamous cell carcinomas diagnosed during 2010-2014 was generally higher in Asian countries(50%-90%),while adenocarcinomas were more common in Europe,North America and Oceania(50%-60%).From 2000-2004 to 2010-2014,the proportion of squamous cell carcinoma generally decreased,and the proportion of adenocarcinoma increased.Over time,there were few improvements in age-standardized five-year survival for each sub-site.Age-standardized one-year survival was highest in Japan for both squamous cell carcinoma(67.7%)and adenocarcinoma(69.0%),ranging between 20%-60%in most other countries.Age-standardized five-year survival from squamous cell carcinoma and adenocarcinoma was similar for most countries included,around 15%-20%for adults diagnosed during 2010-2014,though international variation was wider for squamous cell carcinoma.In most countries,survival for both squamous cell carcinoma and adenocarcinoma increased by less than 5%between 2000-2004 and 2010-2014.Conclusions Esophageal cancer survival remains poor in many countries.The distributions of sub-site and morphological sub-type vary between countries,but these differences do not fully explain international variation in esophageal cancer survival.

Pancreatic cancer survival trends in the US from 2001 to 2014:a CONCORD-3 study

Background:Survival from pancreatic cancer is low worldwide.In the US,the 5-year relative survival has been slightly higher for women,whites and younger patients than for their counterparts,and differences in age and stage at diagnosis[Corrections added Nov 16,2022,after first online publication:a new affiliation is added to Maja Nikšić]may contribute to this pattern.We aimed to examine trends in survival by race,stage,age and sex for adults(15-99 years)diagnosed with pancreatic cancer in the US.Methods:This population-based study included 399,427 adults registered with pancreatic cancer in 41 US state cancer registries during 2001-2014,with followup to December 31,2014.We estimated age-specific and age-standardized net survival at 1 and 5 years.Results:Overall,12.3%of patients were blacks,and 84.2%were whites.About 9.5%of patients were diagnosed with localized disease,but 50.5%were diagnosed at an advanced stage;slightly more among blacks,mainly among men.No substantial changes were seen over time(2001-2003,2004-2008,2009-2014).In general,1-year net survival was higher in whites than in blacks(26.1%vs.22.1%during 2001-2003,35.1%vs.31.4%during 2009-2014).This difference was particularly evident among patients with localized disease(49.6%in whites vs.44.6%in blacks during 2001-2003,60.1%vs.55.3%during 2009-2014).The survival gap between blacks and whites with localized disease was persistent at 5 years after diagnosis,and it widened over time(from 24.0%vs.21.3%during 2001-2003 to 39.7%vs.31.0%during 2009-2014).The survival gap was wider among men than among women.Conclusions:Gaps in 1-and 5-year survival between blacks and whites were persistent throughout 2001-2014,especially for patients diagnosed with a localized tumor,for which surgery is currently the only treatment modality with the potential for cure.