title: Lung cancer survival in Norway, 1997-2011: from nihilism to optimism.
abstract: We examine changes in survival and patient-, tumour- and treatment-related factors among resected and nonresected lung cancer patients, and identify subgroups with the largest and smallest survival improvements.National population-based data from the Cancer Registry of Norway, Statistics Norway and the Norwegian Patient Register were linked for lung cancer patients diagnosed during 1997-2011. The 1- and 5-year relative survival were estimated, and Cox proportional hazard regression, adjusted for selected patient characteristics, was used to assess prognostic factors for survival in lung cancer patients overall and stratified by resection status.We identified 34 157 patients with lung cancer. The proportion of histological diagnoses accompanied by molecular genetics testing increased from 0% to 26%, while those accompanied by immunohistochemistry increased from 8% to 26%. The 1-year relative survival among nonresected and resected patients increased from 21.7% to 34.2% and 75.4% to 91.5%, respectively. The improved survival remained significant after adjustment for age, sex, stage and histology. The largest improvements in survival occurred among resected and adenocarcinoma patients, while patients ≥80 years experienced the smallest increase.Lung cancer survival has increased considerably in Norway. The explanation is probably multifactorial, including improved attitude towards diagnostic work-up and treatment, and more accurate diagnostic testing that allows for improved selection for resection and improved treatment options.
authors.affiliation: Dept of Registration, Cancer Registry of Norway, Oslo, Norway yngvar.nilssen@kreftregisteret.no.
authors.forename: Yngvar
authors.initials: Y
authors.lastname: Nilssen
authors.affiliation: Dept of Registration, Cancer Registry of Norway, Oslo, Norway.
authors.forename: Trond Eirik
authors.initials: TE
authors.lastname: Strand
authors.affiliation: Dept of Respiratory Medicine, Oslo University Hospital, Oslo, Norway Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Fjellbirkeland
authors.affiliation: Division of Cardiothoracic and Respiratory Medicine, University Hospital North Norway, Tromsø, Norway Institute of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.
authors.forename: Kristian
authors.initials: K
authors.lastname: Bartnes
authors.affiliation: Dept of Registration, Cancer Registry of Norway, Oslo, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Møller
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000401:mortality* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011013:Pneumonectomy; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D055752:Small Cell Lung Carcinoma / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate