TAILIEUCHUNG - Cancer survival in five continents: a worldwide population-based study (CONCORD)

The algorithm for programmes to treat women with precancerous lesions should be chosen based on the resources and health systems infrastructure in the country. A screen-and- treat approach with VIA followed by cryotherapy for treatment (by minimizing delay and the number of visits between screening and treatment) may be suitable for most low- resources settings. Screening with VIA can be provided at all levels of health care, including at the primary health care level. Linkages to services providing LEEP (Loop Electrosurgical Excision Procedure) or cold knife conization with or without colposcopy should be provided when cryotherapy is not indicated, based on the. | Articles Cancer survival in five continents a worldwide population-based study CONCORD Michel P Coleman Manuela Quaresma Franco Berrino Jean-Michel Lutz Roberta De Angelis Riccardo Capocaccia Paolo Baili Bernard Rachet Gemma Gatta Timo Hakulinen Andrea Micheli Milena Sant Hannah K Weir J Mark Elwood Hideaki Tsukuma Sergio Koifman Gulnar Azevedo e Silva Silvia Francisci Mariano Santaquilani Arduino Verdecchia Hans H Storm John L Young and the CONCORD Working Group Summary Background Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1-9 million adults aged 15-99 years diagnosed with a first primary invasive cancer of the breast women colon rectum or prostate during 1990-94 and followed up to 1999 by use of individual tumour records from 101 populationbased cancer registries in 31 countries on five continents. This is to our knowledge the first worldwide analysis of cancer survival with standard quality-control procedures and identical analytic methods for all datasets. Methods To compensate for wide international differences in general population background mortality by age sex country region calendar period and in the USA ethnic origin we estimated relative survival the ratio of survival noted in the patients with cancer and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Findings Global variation in cancer survival was very wide. 5-year relative survival for breast colorectal and prostate cancer was generally higher in North America Australia Japan and northern western and southern Europe and lower in Algeria Brazil and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries NPCR and the study covers 42 of the .

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