title: Trends of classification, incidence, mortality, and survival of MDS patients in Switzerland between 2001 and 2012.
abstract: Myelodysplastic syndromes (MDS) are emerging disorders of the elderly with an increasing burden on healthcare systems. He we report on the first population-based, epidemiological analysis of patients diagnosed with MDS in Switzerland between 2001 and 2012. The aim of this study was to characterize the extent and limitations of currently available population-based, epidemiological data and formulate recommendations for future health services research. The investigated outcomes comprised trends of annual case frequency, classification of morphological subtypes, incidence, mortality and survival. Annual case frequency increased by 20% (from 263 to 315 cases per year), whereas age-standardized incidence-/mortality-rates remained stable (2.5/1.1 per 100'000 person-years). This observation reflects population growth as well as higher diagnostic awareness and not an increase of age-specific risk. However, it will inevitably influence the future prevalence of MDS and the impact on healthcare systems. Reporting of classification in MDS subtypes was poor with modest improvement from 20% to 39% and increased awareness for mainly higher-risk diseases. Relative survival for all patients at 5-years (RS) ranged between 37 and 40%. Significant better RS was found for younger compared to older higher-risk MDS patients (48% vs. 17%), reflecting the effect of allogeneic hematopoietic stem-cell transplantation. However, no survival advantage was found in elderly patients after introduction of hypomethylating agents as standard for care in this patient group. Our data is in line with results from other MDS and cancer registries. It allows formulating recommendations for future collaborative health services research on MDS patients with national and international partners.
authors.affiliation: Department of Haematology and Central Haematology Laboratory, Inselspital Bern, University Hospital and University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland. Electronic address: Nicolas.Bonadies@insel.ch.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bonadies
authors.affiliation: Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zurich, Seilergraben 49, CH-8001 Zurich, Switzerland.
authors.forename: Anita
authors.initials: A
authors.lastname: Feller
authors.affiliation: Department of Haematology and Central Haematology Laboratory, Inselspital Bern, University Hospital and University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
authors.forename: Alicia
authors.initials: A
authors.lastname: Rovo
authors.affiliation: Division of Haematology and Central Haematology Laboratory, Cantonal Hospital Lucern, Spitalstrasse, CH-6000 Luzern 16, Switzerland.
authors.forename: Axel
authors.initials: A
authors.lastname: Ruefer
authors.affiliation: Service and Central Laboratory of Haematology, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
authors.forename: Sabine
authors.initials: S
authors.lastname: Blum
authors.affiliation: Clinic of Haematology, Oncology Institute of Southern Switzerland, Via Ospedale, CH-6500 Bellinzona, Switzerland.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gerber
authors.affiliation: Clinic of Haematology, Oncology Institute of Southern Switzerland, Via Ospedale, CH-6500 Bellinzona, Switzerland.
authors.forename: Georg
authors.initials: G
authors.lastname: Stuessi
authors.affiliation: Cantonal Hospital Muensterlingen, Spitalcampus 1, CH-8596, Muensterlingen, Switzerland.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Benz
authors.affiliation: Division of Haematology, University Clinic of Medicine, Kantonsspital Aarau AG, Tellstrasse, CH-5001 Aarau, Switzerland.
authors.forename: Nathan
authors.initials: N
authors.lastname: Cantoni
authors.affiliation: Clinic of Haematology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Holbro
authors.affiliation: Clinic of Medical Oncology and Haematology, City Hospital Triemli Zurich, Birmensdorferstrasse 497, CH-8063 Zurich, Switzerland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: Centre of Laboratory Medicine, Cantonal Hospital St. Gallen, Frohbergstrasse 3, CH-9001 St. Gallen, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehmann
authors.affiliation: Haematology, University and University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
authors.forename: C Matthias
authors.initials: CM
authors.lastname: Wilk
authors.affiliation: Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zurich, Seilergraben 49, CH-8001 Zurich, Switzerland.
authors.forename: Volker
authors.initials: V
authors.lastname: Arndt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008297:Male; D009190:Myelodysplastic Syndromes / Q000145:classification* / Q000453:epidemiology* / Q000401:mortality; D012042:Registries; D012189:Retrospective Studies; D012306:Risk; D016019:Survival Analysis; D013557:Switzerland
keywords: Classification; Incidence; Mortality; Myelodysplastic syndromes; Population based cancer registries; Survival