title: Lung cancer survival in Germany: A population-based analysis of 132,612 lung cancer patients.
abstract: OBJECTIVE
  Lung cancer is the most common cancer-related death worldwide. In Germany it accounts for 25% of cancer deaths in men, and 14% in women. The aim of this study is to provide an overview of 5-year relative survival by sex, age, histology, and tumour stage in Germany representing a population of 26.7 million people.
  
  
  METHODS
  The study is based on a pooled German dataset including data from 12 population-based cancer registries covering around one third of the German population. A total of 132,612 patients diagnosed with lung cancer from 2002 to 2010 were included in the analysis. Survival estimates for the time period 2007-2010 were calculated using period analysis. Differences in survival between sexes were tested for statistical significance by model-based period analysis (poisson regression model). The relative excess risk (RER) of death (women vs. men) was extracted from the model with the p value for the difference in RER.
  
  
  RESULTS
  The overall age adjusted 5-year relative survival was 15.5% (standard error (SE) 0.2) for men and 20.3% (SE 0.3) in women. Survival differed markedly according to age (men: <60 years 18.5% vs. 80+ years 8.4% and women 23.7% vs. 10.6%, respectively), histology (largest difference between histological groups: men 25.7 and women 44.4% points) and stage (men: UICC Ia 62.9%, vs. UICC IV 4.6% and women 75.2% vs. 7.0%, respectively). Our study showed survival advantages for women compared to men, most notably in younger aged patients (RER 0.83, p<0.0001), patients with adenocarcinoma (RER 0.80, p<0.0001), and patients with lower stage cancer (RER 0.62, p<0.0001).
  
  
  CONCLUSIONS
  This study presents up-to-date survival estimates for lung cancer in Germany. Compared to other European countries survival was relatively high. Women showed higher survival than men independent of age, histology and stage. The reasons for the survival differences require further clarification.
authors.affiliation: Bremen Cancer Registry, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany. Electronic address: eberle@bips.uni-bremen.de.
authors.forename: Andrea
authors.initials: A
authors.lastname: Eberle
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Lina
authors.initials: L
authors.lastname: Jansen
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Felipe
authors.initials: F
authors.lastname: Castro
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Agne
authors.initials: A
authors.lastname: Krilaviciute
authors.affiliation: Bremen Cancer Registry, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Luttmann
authors.affiliation: Cancer Registry of Rhineland-Palatinate, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Emrich
authors.affiliation: Saarland Cancer Registry, Saarbrücken, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: Hamburg Cancer Registry, Authority for Health and Consumer Protection, Hamburg, Germany.
authors.forename: Alice
authors.initials: A
authors.lastname: Nennecke
authors.affiliation: Cancer Registry of Schleswig-Holstein, Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Katalinic
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D012042:Registries; D012737:Sex Factors; D055815:Young Adult
keywords: Cancer registry; Germany; Lung cancer survival; Period analysis; Population-based study