https://orcid.org/0000-0001-7061-7178
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Abstract
Background
A recent overview of cancer survival trends 1990–2016 in the Nordic countries reported continued improvements in age-standardized breast cancer survival among women. The aim was to estimate age-specific survival trends over calendar time, including life-years lost, to evaluate if improvements have benefited patients across all ages in the Nordic countries.
Methods
Data on breast cancers diagnosed 1990–2016 in Denmark, Finland, Iceland, Norway, and Sweden were obtained from the NORDCAN database. Age-standardized and age-specific relative survival (RS) was estimated using flexible parametric models, as was reference-adjusted crude probabilities of death and life-years lost.
Results
Age-standardized period estimates of 5-year RS in women diagnosed with breast cancer ranged from 87% to 90% and 10-year RS from 74% to 85%. Ten-year RS increased with 15–18 percentage points from 1990 to 2016, except in Sweden (+9 percentage points) which had the highest survival in 1990. The largest improvements were observed in Denmark, where a previous survival disadvantage diminished. Most recent 5-year crude probabilities of cancer death ranged from 9% (Finland, Sweden) to 12% (Denmark, Iceland), and life-years lost from 3.3 years (Finland) to 4.6 years (Denmark). Although survival improvements were consistent across different ages, women aged ≥70 years had the lowest RS in all countries. Period estimates of 5-year RS were 94–95% in age 55 years and 84–89% in age 75 years, while 10-year RS were 88–91% in age 55 years and 69–84% in age 75 years. Women aged 40 years lost on average 11.0–13.8 years, while women lost 3.8–6.0 years if aged 55 and 1.9–3.5 years if aged 75 years.
Conclusions
Survival for Nordic women with breast cancer improved from 1990 to 2016 in all age groups, albeit with larger country variation among older women where survival was also lower. Women over 70 years of age have not had the same survival improvement as women of younger age.
Author Contributions
FEL: Conceptualization, Formal analysis, Methodology, Visualization, Writing-Original draft preparation (LEAD), Writing-Reviewing and Editing (LEAD). NK: Writing-Original draft preparation, Writing-Reviewing and Editing. ML: Writing-Reviewing and Editing. TMLA: Writing-Reviewing and Editing. GE: Data curation, Writing-Reviewing and Editing. TBJ: Writing-Reviewing and Editing. AV: Writing-Reviewing and Editing. DP: Writing-Reviewing and Editing. EJÓ: Writing-Reviewing and Editing. HB: Writing-Reviewing and Editing. PCL: Conceptualization, Funding acquisition, Writing-Reviewing and Editing. LSM: Writing-Original draft preparation, Writing-Reviewing and Editing. ALVJ: Conceptualization, Methodology, Writing-Original draft preparation (LEAD), Writing-Reviewing and Editing (LEAD).
Disclosure Statement
PCL received support from the Swedish Cancer Society and the Swedish Research Council for the submitted work; ML owns stock in Pfizer and Astra Zeneca; the authors have no other relationships or activities that could appear to have influenced the submitted work.
Data Availability Statement
The data underlying this article were provided by NORDCAN by permission. Data will be shared on request to the corresponding author with permission of the NORDCAN secretariat.