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Long-term Cancer Survival Trends by Updated Summary Stage.

Gonçalo Forjaz1, Lynn Ries2, Theresa P Devasia3

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Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
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Cancer survival trends improved across most sites and stages, particularly for localized pancreatic and esophageal cancers, and distant skin melanoma. These advances highlight progress in clinical management for cancers with historically poor prognoses.

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Area of Science:

  • Oncology
  • Cancer Epidemiology
  • Biostatistics

Background:

  • Cancer staging is crucial for prognosis, but evolving systems complicate long-term trend analysis.
  • Summary Stage (SS) classifies cancer spread (In situ, Localized, Regional, Distant).
  • Consistent staging is needed for accurate survival trend comparisons.

Purpose of the Study:

  • To analyze cancer survival trends using a consistent summary stage classification across multiple cancer sites.
  • To present survival trends using the joinpoint survival (JPSurv) model for 25 cancer sites.

Main Methods:

  • Developed a Long-Term Site-Specific Summary Stage variable for consistent staging.
  • Applied the JPSurv model to relative survival data from 1975-2018 (SEER-8), followed through 2019.
  • Analyzed incidence and mortality trends using the joinpoint model to aid survival trend interpretation.

Main Results:

  • Five-year relative survival rates improved for most cancer sites and stages.
  • Significant annual survival improvements observed for localized pancreatic cancer, distant skin melanoma, and localized esophagus cancer.
  • Specific annual percentage point increases reported for key cancer types and stages.

Conclusions:

  • This study provides the first multi-site analysis of survival trends by summary stage.
  • The most substantial survival gains were in cancers with poor prognoses and lacking organized screening, suggesting clinical management advances.
  • Findings are valuable for assessing population-level impacts of treatments and identifying health disparity trends.