title: On-going improvement and persistent differences in the survival for patients with colon and rectum cancer across Europe 1999-2007 - Results from the EUROCARE-5 study.
abstract: BACKGROUND
  Previous population-based studies revealed major variation in survival for patients with colorectal cancer (CRC) in Europe by age and between different countries and regions, but also a sustained improvement in survival for patients with CRC in recent years. This EUROCARE-5 paper aims to update available knowledge from previous studies and to provide the latest survival estimates for CRC patients from Europe.
  
  
  METHODS
  The study analysed data of patients diagnosed with CRC from population-based cancer registries diagnosed in 29 European countries. Estimates of 1-year and 5-year relative survival (RS) were derived for patients diagnosed in 2000-2007 by European region, country and age at diagnosis. Additionally to these cohort estimates, time trends in 5-year RS were obtained for the calendar periods 1999-2001 and 2005-2007, using the period analysis methodology.
  
  
  RESULTS
  European average 5-year RS for patients diagnosed with colon and rectum cancer was 57% and 56%, respectively. The analyses showed persistent differences in cancer survival across Europe with lowest survival for CRC patients observed in Eastern Europe. The analyses further showed a strong gradient in age-specific survival. Even though the study revealed sustained improvement in patient survival between 1999-2001 and 2005-2007 (absolute increase of 4 and 6 percentage points for colon and rectum, respectively), the differences in the survival for CRC patients observed at the beginning of the millennium persisted over time.
  
  
  CONCLUSIONS
  Although survival for CRC patients in Europe improved markedly in the study period, significant geographic variations and a strong age gradient still persisted. Enhanced access to effective diagnostic procedures and treatment options might be the keys to reducing the existing disparities in the survival of CRC patients across Europe.
authors.affiliation: Saarland Cancer Registry, Präsident Baltz Straße 5, 66119 Saarbrücken, Germany. Electronic address: b.holleczek@krebsregister.saarland.de.
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena, 299, 00161 Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Rossi
authors.affiliation: Malta National Cancer Registry, DHIR, 95, G'Mangia Hill, G'Mangia, Malta.
authors.forename: Agius
authors.initials: A
authors.lastname: Domenic
authors.affiliation: National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia.
authors.forename: Kaire
authors.initials: K
authors.lastname: Innos
authors.affiliation: Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine Fondazione IRCCS, Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Minicozzi
authors.affiliation: Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena, 299, 00161 Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Francisci
authors.affiliation: Austrian National Cancer Registry, Statistics Austria, Vienna, Austria.
authors.forename: Monika
authors.initials: M
authors.lastname: Hackl
authors.affiliation: Institute of Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany.
authors.forename: Nora
authors.initials: N
authors.lastname: Eisemann
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), INF 581, 69120 Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ), INF 581, 69120 Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center, INF 280, 69120 Heidelberg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
keywords: Cancer registries; Colorectal cancer; EUROCARE-5 study; Population-based; Relative survival