title: Modest improvements of survival for patients with small cell lung cancer aged 45 to 59 years only, diagnosed in the Netherlands, 1989 to 2008.
abstract: BACKGROUND
  Lung cancer was a major epidemic in the last decades; 10 to 15% of lung cancer consists of small cell lung cancer (SCLC). Several changes in the diagnostic and treatment procedures took place during the last 20 years. This article focuses on trends in incidence, treatment, and survival of SCLC observed since the 1990 s.
  
  
  METHODS
  All cases with SCLC diagnosed in 1989 to 2009 in the Netherlands were included (n = 34,100). Follow-up was complete until January 1, 2010.
  
  
  RESULTS
  The proportion of patients with extensive disease increased from 47 to 63%. The proportion of patients with limited disease receiving chemoradiation increased from 22% in 1989 to 2003 to 72% in 2004 to 2009 among those younger than 45 to 59 years, from 15 to 58% among those aged 60 to 74 years, and from 7 to 27% among those 75 years or older. Among patients with extensive disease, the proportion receiving chemotherapy remained stable over time (84, 75, and almost 50% for the above mentioned age groups, respectively). Significant improvements in 1-year relative survival occurred for patients aged 45 to 59 years, but not for the other age groups. Relative survival has significantly increased for both stage groups.
  
  
  CONCLUSIONS
  Improved staging resulted in improved survival for both stage groups, whereas survival of the total group has only significantly improved for patients aged 45 to 59 years. The latter is possibly related with improved treatment strategies. As survival is still very poor, prevention of lung cancer remains important.
authors.affiliation: Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands. research@viecuri.nl
authors.forename: Maryska L G
authors.initials: ML
authors.lastname: Janssen-Heijnen
authors.forename: Henrike E
authors.initials: HE
authors.lastname: Karim-Kos
authors.forename: Miep A
authors.initials: MA
authors.lastname: van der Drift
authors.forename: Harry J M
authors.initials: HJ
authors.lastname: Groen
authors.forename: Vincent K Y
authors.initials: VK
authors.lastname: Ho
authors.forename: Caro
authors.initials: C
authors.lastname: Koning
authors.forename: Esther
authors.initials: E
authors.lastname: de Vries
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D018288:Carcinoma, Small Cell / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D059248:Chemoradiotherapy / Q000639:trends; D004358:Drug Therapy / Q000639:trends*; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends*