title: Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004-2007.
abstract: BACKGROUND
  The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007.
  
  
  METHODS
  Routinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis.
  
  
  RESULTS
  Age-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer.
  
  
  CONCLUSIONS
  There are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved.
authors: Department of Non Communicable Disease Epidemiology , London School of Hygiene and Tropical Medicine, London, UK. sarah.walters@lshtm.ac.uk
authors: Sarah
authors: S
authors: Walters
authors: Camille
authors: C
authors: Maringe
authors: Michel P
authors: MP
authors: Coleman
authors: Michael D
authors: MD
authors: Peake
authors: John
authors: J
authors: Butler
authors: Nicholas
authors: N
authors: Young
authors: Stefan
authors: S
authors: Bergström
authors: Louise
authors: L
authors: Hanna
authors: Erik
authors: E
authors: Jakobsen
authors: Karl
authors: K
authors: Kölbeck
authors: Stein
authors: S
authors: Sundstrøm
authors: Gerda
authors: G
authors: Engholm
authors: Anna
authors: A
authors: Gavin
authors: Marianne L
authors: ML
authors: Gjerstorff
authors: Juanita
authors: J
authors: Hatcher
authors: Tom Børge
authors: TB
authors: Johannesen
authors: Karen M
authors: KM
authors: Linklater
authors: Colleen E
authors: CE
authors: McGahan
authors: John
authors: J
authors: Steward
authors: Elizabeth
authors: E
authors: Tracey
authors: Donna
authors: D
authors: Turner
authors: Michael A
authors: MA
authors: Richards
authors: Bernard
authors: B
authors: Rachet
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009664:Norway / Q000453:epidemiology; D011159:Population Surveillance; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Clinical Epidemiology; Non-Small Cell Lung Cancer; Small Cell Lung Cancer