title: Improving but inferior survival in patients with chronic lymphocytic leukemia in taiwan: a population-based study, 1990-2004.
abstract: BACKGROUND
  Chronic lymphocytic leukemia (CLL) is much less prevalent in Asian countries. Whether there are differences in survival outcomes between the East and West, however, remain unclear.
  
  
  METHODS
  The survival data for CLL patients identified in the Taiwan Cancer Registry database between 1990 and 2004, together with corresponding data in the US Surveillance, Epidemiology, and End Results database, were retrieved. The relative survivals (RS, adjusted for the expected survival in the general population) were estimated in patients diagnosed in three 5-year periods of time.
  
  
  RESULTS
  CLL drastically shortened patients' life expectancy; more importantly, this negative impact in Taiwan was much larger than that in the US: the 5-year RS in Taiwan and US were 59% and 76%, and the 10-year RS, 45% and 56%, respectively. Nevertheless, survival in Taiwan was better in the periods after 1995 (5-year RS, from 53.0% to 60.6%), a time period corresponding to the introduction of the Taiwan National Health Insurance scheme. Such improvement was largely due to decreased mortality in patients younger than 65 (5-year RS, from 53.5% to 69.1%). Despite the improvement, patients' RS in Taiwan in recent periods remain steadily 15∼20% inferior to that in the US in both younger and older patient groups.
  
  
  CONCLUSIONS
  The improved RS in Taiwan implies that therapeutic advances are changing the prognosis of CLL. The stable RS gap between Taiwanese and the US patients suggests the existence of an ethnic difference in CLL patients' outcomes.
authors: Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors: Shang-Ju
authors: SJ
authors: Wu
authors: Chun-Ju
authors: CJ
authors: Chiang
authors: Chien-Ting
authors: CT
authors: Lin
authors: Hwei-Fang
authors: HF
authors: Tien
authors: Mei-Shu
authors: MS
authors: Lai
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D011379:Prognosis; D012042:Registries; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
references: J Biol Chem. 2011 Jun 24;286(25):22384-92
references: 21561860
references: Eur J Cancer. 2004 Oct;40(15):2307-16
references: 15454257
references: J Formos Med Assoc. 2004 Apr;103(4):280-5
references: 15175823
references: Br J Haematol. 2008 Aug;142(4):606-9
references: 18503582
references: J Clin Oncol. 2005 Jun 20;23(18):4009-12
references: 15767640
references: Am J Epidemiol. 1999 Jul 15;150(2):223
references: 10412973
references: Biol Blood Marrow Transplant. 2009 Jan;15(1 Suppl):53-8
references: 19147079
references: J Chronic Dis. 1958 Dec;8(6):699-712
references: 13598782
references: Cell Death Differ. 2007 Feb;14(2):318-26
references: 16778834
references: Jpn J Clin Oncol. 2010 Oct;40(10):897-904
references: 20495192
references: Cancer Epidemiol Biomarkers Prev. 2006 May;15(5):856-61
references: 16702360
references: N Engl J Med. 1995 Oct 19;333(16):1052-7
references: 7675049
references: Eur J Cancer. 2011 Sep;47(14):2202-10
references: 21549589
references: Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1986-90
references: 16103449
references: Ann Oncol. 1998 Jul;9(7):717-20
references: 9739436
references: Blood. 2010 Nov 25;116(22):4430-5
references: 20713960
references: Br J Haematol. 1989 Jun;72(2):141-9
references: 2757960
references: Cancer. 2007 Aug 15;110(4):896-905
references: 17594697
references: Hematology Am Soc Hematol Educ Program. 2007;:339-45
references: 18024649
references: Nat Med. 2012 Mar 18;18(4):521-8
references: 22426421
references: J Formos Med Assoc. 2009 Nov;108(11):849-55
references: 19933028
references: Ann Hematol. 2013 Jun;92(6):799-806
references: 23417757
references: Blood. 1997 Jun 1;89(11):3909-18
references: 9166827
references: Oncogene. 2007 Oct 25;26(49):7038-48
references: 17486061
references: Blood. 2008 May 15;111(10):4916-21
references: 18309034
references: Blood. 2011 Mar 31;117(13):3505-13
references: 21190994
references: Br J Haematol. 2007 Dec;139(5):809-19
references: 17941952
references: Clin Adv Hematol Oncol. 2008 Jun;6(6):409-10, 468
references: 18567984
references: Blood. 2010 Oct 7;116(14):2531-42
references: 20570860
references: BMC Health Serv Res. 2008 Dec 17;8:261
references: 19091093
references: Natl Cancer Inst Monogr. 1961 Sep;6:101-21
references: 13889176
references: Cancer. 2000 Oct 1;89(7):1586-92
references: 11013375
references: Blood. 2009 Sep 3;114(10):2044-50
references: 19553638
references: J Clin Oncol. 2008 Oct 20;26(30):4864-5
references: 18794537