Ann Oncol. 2014 Aug 22.

Long-term survival, prevalence, and cure of cancer: A population-based estimation for 818,902 Italian patients and 26 cancer types.

Dal Maso L1, Guzzinati S2, Buzzoni C3, Capocaccia R4, Serraino D1, Caldarella A5, Dei Tos AP6, Falcini F7, Autelitano M8, Masanotti G9, Ferretti S10, Tisano F11, Tirelli U12, Crocetti E5, De Angelis R4; the AIRTUM Working group.
Author information 1Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.2Veneto Region Cancer Registry, Padua, Italy.3AIRTUM database, Florence, Italy Tuscany Cancer Registry, Clinical and descriptive epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy.4National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), National Institute of Health (ISS), Rome, Italy.5Tuscany Cancer Registry, Clinical and descriptive epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy.6Veneto Region Cancer Registry, Padua, Italy Department of Oncology, Anatomic Pathology Unit, General Hospital of Treviso, Italy.7Romagna Cancer Registry, Cancer Institute of Romagna (IRCSS), Meldola, Italy.8Milan Cancer Registry, Milan Health Authority, Epidemiology Unit, Milan, Italy.9Umbria Cancer Registry, Department of Medical and Surgical Specialties, and Public Health, Section of Public Health, Perugia University, Perugia, Italy.10Ferrara Cancer Registry, Ferrara University, Ferrara, Italy.11Siracusa Cancer Registry, ASP of Siracusa, Siracusa, Italy.12Medical Oncology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.

Abstract
BACKGROUND: Persons living after a cancer diagnosis represent 4% of the whole population in high income Countries. The study aim was to provide estimates of indicators of long-term survival and cure for 26 cancer types, presently lacking.

PATIENTS AND METHODS: Data on 818,902 Italian cancer patients diagnosed at age 15-74 years in 1985-2005 were included. Proportions of patients with the same death rates of the general population (cure fractions) and those of prevalent patients who were not at risk of dying as a result of cancer (cure prevalence) were calculated, using validated mixture cure models, by cancer type, sex, and age group. We also estimated complete prevalence, conditional relative survival (CRS), time to reach five- and ten-year CRS>95%, and proportion of patients living longer than those thresholds.

RESULTS: The cure fractions ranged from >90% for patients aged <45 years with thyroid and testis cancers to <10% for liver and pancreatic cancers of all ages. Five- or ten-year CRS>95% were both reached in less than ten years by patients with cancers of the stomach, colon-rectum, pancreas, corpus and cervix uteri, brain, and Hodgkin lymphoma. For breast cancer patients, five- and ten-years CRSs reached >95% after 19 and 25 years, respectively, and in 15 and 18 years for prostate cancer patients. Five-year CRS remained <95% for >25 years after cancer diagnosis in patients with liver and larynx cancers, non-Hodgkin lymphoma, myeloma, and leukaemia. Overall, the cure prevalence was 67% for men and 77% for women. Therefore, 21% of male and 31% of female patients had already reached five-year CRS>95%, while 18% and 25% had reached ten-year CRS>95%.

CONCLUSIONS: A quarter of Italian cancer patients can be considered cured. This observation has a high potential impact on health planning, clinical practice, and patients perspective.

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