Cancer survival in Africa, Asia, and Central America: a population-based study.
BACKGROUND
Population-based cancer survival data, a key indicator for monitoring progress against cancer, are not widely available from countries in Africa, Asia, and Central America. The aim of this study is to describe and discuss cancer survival in these regions.


METHODS
Survival analysis was done for 341 658 patients diagnosed with various cancers from 1990 to 2001 and followed up to 2003, from 25 population-based cancer registries in 12 countries in sub-Saharan Africa (The Gambia, Uganda), Central America (Costa Rica), and Asia (China, India, Pakistan, Philippines, Saudi Arabia, Singapore, South Korea, Thailand, Turkey). 5-year age-standardised relative survival (ASRS) and observed survival by clinical extent of disease were determined.


RESULTS
For cancers in which prognosis depends on stage at diagnosis, survival was highest in China, South Korea, Singapore, and Turkey and lowest in Uganda and The Gambia. 5-year ASRS ranged from 76-82% for breast cancer, 63-79% for cervical cancer, 71-78% for bladder cancer, and 44-60% for large-bowel cancers in China, Singapore, South Korea, and Turkey. Survival did not exceed 22% for any cancer site in The Gambia; in Uganda, survival did not exceed 13% for any cancer site except breast (46%). Variations in survival correlated with early detection initiatives and level of development of health services.


CONCLUSIONS
The wide variation in cancer survival between regions emphasises the need for urgent investments in improving awareness, population-based cancer registration, early detection programmes, health-services infrastructure, and human resources.


BACKGROUND
Association for International Cancer Research (AICR; St Andrews, UK), Association pour la Recherche sur le Cancer (ARC, Villejuif, France), and the Bill & Melinda Gates Foundation (Seattle, USA).
Sankaranarayanan
Rengaswamy
R
Screening Group, International Agency for Research on Cancer, Lyon, France. sankar@iarc.fr
Swaminathan
Rajaraman
R
Brenner
Hermann
H
Chen
Kexin
K
Chia
Kee Seng
KS
Chen
Jian Guo
JG
Law
Stephen C K
SC
Ahn
Yoon-Ok
YO
Xiang
Yong Bing
YB
Yeole
Balakrishna B
BB
Shin
Hai Rim
HR
Shanta
Viswanathan
V
Woo
Ze Hong
ZH
Martin
Nimit
N
Sumitsawan
Yupa
Y
Sriplung
Hutcha
H
Barboza
Adolfo Ortiz
AO
Eser
Sultan
S
Nene
Bhagwan M
BM
Suwanrungruang
Krittika
K
Jayalekshmi
Padmavathiamma
P
Dikshit
Rajesh
R
Wabinga
Henry
H
Esteban
Divina B
DB
Laudico
Adriano
A
Bhurgri
Yasmin
Y
Bah
Ebrima
E
Al-Hamdan
Nasser
N
D017954:Africa South of the Sahara / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D002489:Central America / Q000453:epidemiology; D006801:Humans; D009369:Neoplasms / Q000401:mortality*; D012042:Registries; D016019:Survival Analysis