Trends in the survival of patients diagnosed with malignant neoplasms of lymphoid, haematopoietic, and related tissue in the Nordic countries 1964-2003 followed up to the end of 2006.
BACKGROUND
Hodgkin lymphoma, Non-Hodgkin lymphoma, multiple myeloma, and acute and other leukaemias constitute about 7% of the overall cancer incidence and 8% of cancer mortality in the Nordic countries. The aim of this study is to describe and interpret the trends in relative survival and excess mortality in the five Nordic populations among these patients.


METHODS
Using the NORDCAN database 1964-2003, we estimated age-standardised incidence and mortality rates, 5-year relative survival, and excess mortality rates for varying follow-up periods, and age-specific 5-year relative survival by country, sex, and 5-year diagnostic period.


RESULTS
Taking into account classification and registration problems in the earlier periods, the patterns of incidence, mortality, and survival are fairly similar between the countries within each cancer form studied. High 5-year relative survival ratios of over 80% were seen in the most recent period 1999-2003 for Hodgkin lymphoma, between 50 and 60% for Non-Hodgkin lymphoma, 38-49% for acute leukaemia and 60-73% for other leukaemia. The variations were between 28 and 41% for multiple myeloma. Danish patients diagnosed with these malignancies tend to fare slightly worse than their Nordic neighbours, with excess mortality rates marginally higher one to three months after diagnosis.


CONCLUSIONS
Although the recent trends and absolute levels of incidence, mortality and survival for the lympho-haematopoietic malignancies are similar, the consistently lower survival of Danish patients--irrespective of type of malignancy--points to an impact of co-morbidity related lifestyle factors, which may negatively affect the chemotherapy and radiation offered as standard treatments for these diseases.
Storm
Hans H
HH
Department of Cancer Prevention and Documentation, Danish Cancer Society, Strandboulevarden 49, Copenhagen, Denmark. hans@cancer.dk
Klint
Asa
A
Tryggvadóttir
Laufey
L
Gislum
Mette
M
Engholm
Gerda
G
Bray
Freddie
F
Hakulinen
Timo
T
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D006689:Hodgkin Disease / Q000401:mortality / Q000821:virology; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D007938:Leukemia / Q000453:epidemiology / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D008223:Lymphoma / Q000453:epidemiology / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009101:Multiple Myeloma / Q000401:mortality; D009367:Neoplasm Staging; D009664:Norway / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology