“The survival of people with cancer is a key indicator for assessing the overall improvement in prognosis, resulting both from therapeutic advances, from actions implemented to diagnose cancers at an earlier stage and to improve their management. in charge” explains the National Cancer Institute (Inca), which has just published a new study on the “Survival of people with cancer in metropolitan France 1989-2018”. As with previous studies, this one presents survival figures at 1 year, 5 years and 10 years after diagnosis. But for the first time, it presents survival estimates 20 years after diagnosis and extends the analysis to 50 solid tumors and 23 hematological malignancies.
>> Solid tumors: survival ranging from 7% to 96%: the results show a wide disparity in 5-year survival probabilities ranging from a very favorable prognosis for thyroid cancer (96%), to the most unfavorable prognosis for glioblastoma (central nervous system tumor subtype) and small cell lung cancer (both 7%). “The fight against cancers with a poor prognosis is a priority of the ten-year strategy for the fight against cancer. Specific measures are deployed in order to improve their prevention, their detection and to propose new treatments” underlines the Inca.
>> Hematological malignancies: 80% survival for nearly half of new cases: 10 of hematological malignancies (corresponding to 44% of new cases diagnosed each year) have a 5-year net survival greater than 80%. Nearly 50% of incident cases of hematological malignancies have intermediate prognoses (33% to 65%). Acute myeloid leukemia (7% of new annual cases of hematological malignancies) presents the most unfavorable prognosis, with a 5-year survival rate of 27%.
A better prognosis for women
Whether for solid tumors or hematological malignancies, the study shows differences in survival in favor of women for almost all the cancers studied. The biggest difference concerns:
- cancers of the lip-mouth-pharynx complex (+ 15 percentage points in women)
- myelodysplastic syndrome (+ 10 points)
- chronic myelomonocytic leukemia (+ 10 points)
- stomach cancer (+ 8 points)
- lung cancer (+6 points)
Only cancers of the bladder and nasal cavities show less favorable survival in women (respectively – 6 points and – 5 points). These differences can be explained in particular by a greater awareness among women of prevention and screening allowing earlier diagnoses and greater exposure of men to the main risk factors for cancer (particularly tobacco and alcohol).
A better survival rate among the youngest
Analysis of net survival trends over the entire study period shows an improvement in net survival at 5 years for 35 solid tumor locations (out of 41 studied) and 10 hematological malignancies (out of 18 subtypes studied). These improvements are more or less marked according to age. The higher the age at the time of diagnosis, the lower the chances of survival, with a more marked difference for certain hematological malignancies. The largest difference concerns acute myeloid leukaemias, the 5-year survival rate of which is 69% for the youngest people (30 years old) compared to 6% for the oldest people (80 years old).
A diagnosis of the disease at a more advanced stage in older people may, in part, explain these differences by age. The presence of comorbidities in older people also limits access to certain curative treatments or can cause post-therapeutic complications and induce a reduction in survival. Regarding breast and prostate cancers, young people have a lower survival rate than people of intermediate age due to a greater frequency of more aggressive tumours.
Which cancers have improved their survival rate?
With regard to solid tumours, the greatest improvement in 5-year net survival since 1990 is observed for prostate cancer (+ 21 percentage points) which is the most common cancer in men, sarcoma (+ 17 points) or for cancers of the thyroid, ovary, rectum or even small intestine (+ 14 points).
Regarding myeloid hemopathies, a particularly significant improvement in 5-year net survival was observed for chronic myeloid leukemia, which rose from 47% in 1990 to 86% in 2015) regardless of age at diagnosis. It is also important for 3 lymphoid hemopathies: follicular lymphoma (from 64% to 89%), diffuse large B-cell lymphoma (from 39 to 63% regardless of age at diagnosis) and multiple myeloma/plasmoctyoma ( from 42% to 63% in particular among the youngest).
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