Cancer survival in Lithuania after the restoration of independence: Rapid improvements, but persisting major gaps

Figures & data

Table I. Number of cases (N), median age at diagnosis (MA), proportion of morphologically verified cases (V), and proportionate change in case numbers versus the preceding period, 24 most common cancers in Lithuania, 1995–1999 to 2005–2009.

		1995–1999			2000–2004				2005–2009
Site	ICD-10	N	MA	V (%)	N	MA	V (%)	Change (%)*	N	MA	V (%)	Change (%)*
Oral cavity	C00-C14	1812	60	94.3	2028	61	94.0	+ 11.9	1820	60	93.1	− 10.3
Esophagus	C15	754	63	75.1	807	63	80.4	+ 7.0	820	62	81.5	+ 1.6
Stomach	C16	5343	67	76.5	4997	68	82.9	− 6.5	4240	69	86.6	− 15.1
Colorectal	C18-C21	6159	68	78.3	6975	69	84.6	+ 13.2	7065	70	86.7	+ 1.3
Liver	C22	632	68	42.7	612	69	65.5	− 3.2	640	70	65.0	+ 4.6
Gallbladder	C23,C24	573	70	68.6	620	71	69.7	+ 8.2	470	73	73.0	− 24.2
Pancreas	C25	2010	68	41.6	2118	69	53.3	+ 5.4	2007	69	65.6	− 5.2
Larynx	C32	1032	60	92.8	991	61	92.8	− 4.0	969	62	93.6	− 2.2
Lung	C33,C34	7868	65	66.6	7725	67	72.0	− 1.8	6716	67	71.4	− 13.1
Skin melanoma	C43	987	58	97.1	1122	60	98.0	+ 13.7	1289	63	96.7	+ 14.9
Breast (female)	C50	5740	59	90.2	6438	61	92.0	+ 12.2	7033	61	93.4	+ 9.2
Cervix uteri	C53	2198	53	91.9	2489	51	91.1	+ 13.2	2416	51	93.6	− 2.9
Corpus uteri	C54	2176	62	95.4	2515	63	95.3	+ 15.6	2623	64	96.1	+ 4.3
Ovary	C56	2055	62	84.7	2032	63	85.8	− 1.1	1950	62	88.1	− 4.0
Prostate	C61	3493	72	76.4	7038	72	92.1	+ 101.5	15348	68	95.5	+ 118.1
Testis	C62	159	33	95.6	187	35	97.9	+ 17.6	189	33	95.8	+ 1.1
Kidney	C64	2398	64	66.3	2886	65	74.7	+ 20.4	3135	65	79.8	+ 8.6
Bladder	C67	2013	69	78.8	2312	70	84.0	+ 14.9	1938	71	82.2	− 16.2
Brain and nervous system	C71,C72	1017	56	78.6	1083	58	83.4	+ 6.5	1153	61	83.3	+ 6.5
Thyroid	C73	712	55	95.1	1316	54	96.8	+ 84.8	1767	54	99.1	+ 34.3
Hodgkin’s lymphoma	C81	490	33	100.0	376	35	100.0	− 23.3	371	33	99.7	− 1.3
Non-Hodgkin’s lymphoma	C82-C85	832	63	100.0	1290	65	99.3	+ 55.0	1547	68	99.3	+ 19.9
Multiple myeloma	C90	526	67	100.0	696	67	99.4	+ 32.3	720	68	98.6	+ 3.4
Leukemia	C91-C95	1927	66	99.6	1924	68	99.4	− 0.2	1822	69	98.1	− 5.3

*Percent change in the number of cases compared to the previous period.

Table II. Period survival estimates and changes in age-adjusted 5-year relative survival of common cancers in Lithuania between 1995–1999 and 2005–2009.

	1995–1999		2000–2004		2005–2009
Site	PE	SE	PE	SE	PE	SE	Change^4	p-value
Oral cavity	37.8	1.9	35.1	1.7	35.5	1.6	− 2.3	0.054
Esophagus	7.9	1.4	4.0	0.7	5.2	1.0	− 2.6	0.197
Stomach	18.0	0.6	19.3	0.6	21.6	0.7	+ 3.6	< 0.001
Colorectal	34.0	0.8	41.2	0.7	45.9	0.7	+ 12.0	< 0.001
Liver	2.4	0.6	5.4	0.9	7.4	1.2	+ 5.0	< 0.001
Gallbladder	9.5	1.3	10.7	1.6	16.8	2.0	+ 7.4	< 0.001
Pancreas	4.0	0.4	5.4	0.5	4.4	0.5	+ 0.4	< 0.001
Larynx	34.2	2.6	42.8	2.7	44.7	2.6	+ 10.5	< 0.001
Lung	8.3	0.4	8.0	0.3	7.9	0.4	− 0.4	< 0.001
Skin melanoma	63.8	2.0	65.9	1.7	69.2	1.6	+ 5.4	0.001
Breast	53.0	1.1	63.2	0.9	69.0	0.9	+ 16.0	< 0.001
Cervix uteri	49.4	1.2	51.3	1.1	59.2	1.2	+ 9.7	< 0.001
Corpus uteri	66.4	1.7	70.3	1.4	75.1	1.3	+ 8.7	< 0.001
Ovary	25.2	1.2	29.0	1.0	32.0	1.1	+ 6.8	< 0.001
Prostate^1	44.2	1.5	63.3	1.3	90.7	0.7	+ 46.6	< 0.001
Testis^2	64.5	5.0	76.2	4.6	76.7	4.6	+ 12.2	< 0.001
Kidney	43.4	1.6	52.1	1.3	62.1	1.2	+ 18.7	< 0.001
Bladder	48.6	1.5	54.6	1.3	56.4	1.4	+ 7.8	< 0.001
Brain and nervous system^3	17.7	1.3	19.0	1.1	20.6	1.2	+ 2.8	0.145
Thyroid	72.7	1.5	82.2	1.5	92.3	1.2	+ 19.7	< 0.001
Hodgkin’s lymphoma	58.4	2.2	68.6	2.3	74.6	2.3	+ 16.2	< 0.001
Non-Hodgkin’s lymphoma	35.0	2.3	39.1	1.8	49.5	1.5	+ 14.5	< 0.001
Multiple myeloma	19.5	1.9	20.5	1.9	34.9	2.2	+ 15.4	< 0.001
Leukemia	33.8	1.3	31.5	1.2	41.8	1.4	+ 8.0	< 0.001

PE, period estimate; SE, standard error.

¹15–59, 60–74 and 75 + age groups were used for age adjustment; ²15–29, 30–44, 45 + age groups were used for age adjustment; ³15–44, 45–59 and 60 + age groups were used for age adjustment; ⁴Percent units change in survival between 1995–1999 and 2005–2009.

Table III. Period survival estimates in age-adjusted 1-year and conditional 5|1-year relative survival of common cancers in Lithuania between 1995–1999 and 2005–2009.

	1995–1999		2000–2004		2005–2009		1-year		5|1-year
Site	1-year	5|1-year	1-year	5|1-year	1-year	5|1-year	Change^4	p-value	Change^4	p-value
Oral cavity	60.2	61.9	59.0	58.6	55.0	63.9	− 5.2	0.034	+ 2.0	0.756
Esophagus	22.1	34.6	17.0	23.2	20.2	26.1	− 1.9	0.327	− 8.5	0.379
Stomach	32.6	55.5	35.4	54.0	40.2	53.9	+ 7.5	< 0.001	− 1.5	0.462
Colorectal	57.3	58.4	62.9	65.6	68.2	67.3	+ 10.9	< 0.001	+ 8.9	< 0.001
Liver	5.7	45.5	11.6	45.0	20.3	36.6	+ 14.6	< 0.001	− 8.9	0.828
Gallbladder	18.5	47.9	23.9	44.1	32.9	47.2	+ 14.4	< 0.001	− 0.7	0.766
Pancreas	9.1	44.9	14.5	35.9	17.5	25.2	+ 8.4	< 0.001	− 19.7	< 0.001
Larynx	63.3	53.1	72.3	58.9	70.7	62.9	+ 7.4	0.099	+ 9.8	< 0.001
Lung	21.2	39.7	22.5	35.0	26.4	28.0	+ 5.2	< 0.001	− 11.7	< 0.001
Skin melanoma	85.2	75.0	86.0	76.4	89.7	77.2	+ 4.5	0.001	+ 2.3	0.069
Breast	82.3	64.0	85.2	74.4	90.0	76.6	+ 7.6	< 0.001	+ 12.5	< 0.001
Cervix uteri	73.7	66.7	74.3	68.1	79.4	73.7	+ 5.7	< 0.001	+ 7.0	< 0.001
Corpus uteri	80.6	81.0	85.5	81.6	89.2	83.8	+ 8.6	< 0.001	+ 2.8	0.413
Ovary	47.8	52.4	54.1	53.4	60.1	51.1	+ 12.3	< 0.001	− 1.3	0.113
Prostate^1	74.6	59.3	86.8	72.9	96.5	94.0	+ 21.9	< 0.001	+ 34.7	< 0.001
Testis^2	73.8	88.4	86.1	88.4	86.1	88.5	+ 12.3	0.002	+ 0.1	0.031
Kidney	61.5	69.4	65.9	78.2	75.5	81.9	+ 14.0	< 0.001	+ 12.5	< 0.001
Bladder	66.3	72.1	70.8	75.9	75.1	74.2	+ 8.8	< 0.001	+ 2.1	0.255
Brain and nervous system^3	38.6	41.4	42.2	34.7	45.2	35.7	+ 6.5	0.002	− 5.7	0.064
Thyroid	80.1	89.4	87.3	91.9	94.2	97.6	+ 14.0	< 0.001	+ 8.2	< 0.001
Hodgkin’s lymphoma	81.6	68.7	82.4	81.2	83.8	87.4	+ 2.2	0.458	+ 18.8	< 0.001
Non-Hodgkin’s lymphoma	56.0	62.0	61.7	61.2	68.8	70.1	+ 12.8	< 0.001	+ 8.1	0.002
Multiple myeloma	53.6	32.3	54.5	37.4	69.0	50.0	+ 15.4	< 0.001	+ 17.7	0.001
Leukemia	54.4	61.3	51.5	60.2	64.4	64.0	+ 10.1	< 0.001	+ 2.7	0.053

PE, period estimate; SE, standard error.

¹15–59, 60–74 and 75 + age groups were used for age adjustment; ²15–29, 30–44, 45 + age groups were used for age adjustment; ³15–44, 45–59 and 60 + age groups were used for age adjustment; ⁴Percent units change in survival between 1995–1999 and 2005–2009.

Table IV. Number and proportion of patients by stage (of those with known stage) and age-adjusted 5-year relative survival of patients with colorectal, lung and breast cancer in Lithuania, 2005–2009.

Number and proportion of patients by stage
	Localized		Locally advanced		Regional		Metastatic		Unknown		Total
	N	%	N	%	N	%	N	%	N	%	N
Colorectal	691	11.7	2110	35.6	1689	28.5	1433	24.2	1142	16.2	7065
Lung	526	10.7	378	7.7	1891	38.4	2132	43.3	1789	26.6	6716
Breast	2967	47.6	91	1.5	2610	41.9	565	9.1	800	11.4	7033

5-year period estimates and standard errors by stage*.
	Localized		Locally advanced		Regional		Metastatic		Unknown
	PE	SE	PE	SE	PE	SE	PE	SE	PE	SE
Colorectal	84.8	2.3	69.1	1.4	48.8	1.5	5.9	0.7	31.0	1.7
Lung	37.1	2.5	7.1	1.3	5.9	0.7	0.8	0.2	6.7	0.9
Breast	90.8	1.3	61.5	5.8	65.4	1.5	12.9	1.4	57.3	2.3

N, number; PE, period estimate; SE, standard error.

*for metastatic lung cancer, age adjustment was done using the age groups 15–59, 60–74 and 75+.