PCN35 Survival Estimates of Six Major Advanced and Metastatic Solid Tumors in Europe: A Cancer Registry and Literature Review

Survival is a key index of the overall effectiveness of health services in the management of patients with cancer. Epidemiological data on cancer survival in unselected patient populations in Europe are sparse and incomplete. Prognosis is directly related to staging of cancer at diagnosis. Our objective is to evaluate variations in survival by using country registry data and published population-based studies for six tumors: lung, bladder, colorectal, ovarian, pancreatic and gastric. Cancer data from nine registries (in France, Italy, Germany, The Netherlands, Austria, Norway, Ireland, Finland, UK) in Europe were used along with literature review using Embase for the period 2000-2012. Relative survival (RS) estimates for various time periods were summarized for stage III and IV for each tumor type. Marked differences in population based survival across Europe were found which could be explained in part by variation in terms of time period and staging definition but also by other factors such as clinical practice, histological type, age, death ascertainment and co-morbidities. 5-year relative survival (RS) in stage III varies greatly according to tumor site with improvement observed over time. 5-year RS rates ranged from 4-24% for lung, 20-45% for bladder, 40-66% for colorectal, 20-61% for ovary, 8% for pancreas and 13-35% for gastric. Survival in metastatic cancer remains low. 1 year RS rates for Stage IV cancers were 7-38% for lung, 24-56% for bladder, 19-81% for colorectal, 34-77% for ovary, 6-16% for pancreas and 6-34% for gastric. Variations of survival in unselected patient populations are due to differences in patient characteristics, diagnostic codification, and treatment modalities. Future work should validate these findings as registry data is inherent with limitations such as variation in follow up time periods, disease coding and definition of survival. More efforts should focus on standardization of data capturing processes across European cancer registries.