title: Survival variations by country and age for lymphoid and myeloid malignancies in Europe 2000-2007: Results of EUROCARE-5 population-based study.
abstract: BACKGROUND
  Significant advances in the management of patients with lymphoid and myeloid malignancies entered clinical practice in the early 2000's. The EUROCARE-5 study database provides an opportunity to assess the impact of these changes at the population level by country in Europe. We provide survival estimates for clinically relevant haematological malignancies (HM), using the International Classification of Diseases for Oncology 3, by country, gender and age in Europe.
  
  
  METHODS
  We estimated age-standardised relative survival using the complete cohort approach for 625,000 adult patients diagnosed in 2000-2007 and followed up to 2008. Survival information was provided by 89 participating cancer registries from 29 European countries. Mean survival in Europe was calculated as the population weighted average of country-specific estimates.
  
  
  RESULTS
  On average in Europe, 5-year relative survival was highest for Hodgkin lymphoma (81%; 40,625 cases), poorest for acute myeloid leukaemia (17%; 57,026 cases), and intermediate for non-Hodgkin lymphoma (59%; 329,204 cases), chronic myeloid leukaemia (53%; 17,713 cases) and plasma cell neoplasms (39%; 94,024 cases). Survival was generally lower in Eastern Europe and highest in Central and Northern Europe. Wider between country differences (>10%) were observed for malignancies that benefited from therapeutic advances, such as chronic myeloid leukaemia, chronic lymphocytic leukaemia, follicular lymphoma, diffuse large B-cell lymphoma and multiple myeloma. Lower differences (<10%) were observed for Hodgkin lymphoma.
  
  
  CONCLUSIONS
  Delayed or reduced access to innovative and appropriate therapies could plausibly have contributed to the observed geographical disparities between European regions and countries. Population based survival by morphological sub-type is important for measuring outcomes of HM management. To better inform quality of care research, the collection of detailed clinical information at the population level should be prioritised.
authors.affiliation: Centro Nazionale di Epidemiologia, Sorveglianza e promozione della Salute (CNESPS), Istituto Superiore di Sanità (ISS), Rome, Italy. Electronic address: roberta.deangelis@iss.it.
authors.forename: Roberta
authors.initials: R
authors.lastname: De Angelis
authors.affiliation: Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Minicozzi
authors.affiliation: Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Sant
authors.affiliation: Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.
authors.forename: Luigino
authors.initials: L
authors.lastname: Dal Maso
authors.affiliation: Scottish Cancer Registry, Public Health & Intelligence, NHS National Services Scotland, Edinburgh EH12 9EB, UK.
authors.forename: David H
authors.initials: DH
authors.lastname: Brewster
authors.affiliation: Epidemiology Unit and Girona Cancer Registry (Oncology Coordination Plan), Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute, Girona, Spain; Research Group on Statistics, Econometrics and Health (GRECS), Universitat de Girona, Girona, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Osca-Gelis
authors.affiliation: Department of registration, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands.
authors.forename: Otto
authors.initials: O
authors.lastname: Visser
authors.affiliation: Registre des Hémopathies Malignes de Côte d'Or, EA 4184, Université de Bourgogne, Service d'Hématologie Biologique, CHU de Dijon, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Maynadié
authors.affiliation: Epidemiology Unit and Girona Cancer Registry (Oncology Coordination Plan), Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute, Girona, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Marcos-Gragera
authors.affiliation: Registre Régional des Hémopathies Malignes de Basse Normandie, CHU Côte de Nacre, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Troussard
authors.affiliation: Malta National Cancer Registry, Malta.
authors.forename: Dominic
authors.initials: D
authors.lastname: Agius
authors.affiliation: Servizio Elaborazione Dati (SIDBAE), Istituto Superiore di Sanità (ISS), Roma, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Roazzi
authors.affiliation: Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Meneghini
authors.affiliation: Registre des hémopathies malignes de la Gironde, Institut Bergonié, Bordeaux, France 12 Centre Inserm U897, CIC 1401, Bordeaux, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Monnereau
keywords: Cancer registry; Europe; Hodgkin lymphoma; Leukaemia; Lymphoma; Multiple myeloma; Non-Hodgkin lymphoma; Relative survival