PMID- 29758491
OWN - NLM
STAT- MEDLINE
DCOM- 20190403
LR  - 20190403
IS  - 1877-783X (Electronic)
IS  - 1877-7821 (Linking)
VI  - 55
DP  - 2018 Aug
TI  - Has cancer survival improved for older people as for younger people? New South 
      Wales, 1980-2012.
PG  - 23-29
LID - S1877-7821(18)30154-1 [pii]
LID - 10.1016/j.canep.2018.04.014 [doi]
AB  - BACKGROUND: Cancer survival has improved markedly in Australia for all ages but 
      it is still lower in older patients. We hypothesize that the survival gap by age 
      has increased. Our rationale is that treatment constraints in older people and 
      potentially their limited participation in trials may have limited opportunities 
      for survival gain. METHODS: Post-diagnostic five-year cancer-specific mortality 
      rates were analysed by age group for cancers recorded on the NSW Cancer Registry. 
      Live cases were censored on December 31st, 2012. Hazards ratios (HRs) were 
      obtained from proportional hazards regression for 1990-99 and 2000-12 diagnostic 
      periods, using 1980-89 as the reference, adjusting for socio-demographic factors, 
      degree of cancer spread, and for all cancers combined, for cancer sites. RESULTS: 
      Five-year mortality reduced by diagnostic period for all cancers collectively 
      from 53% in 1980-89 to 33% in 2000-12, with decreases for separate cancer sites. 
      Adjusted HRs (95% confidence intervals) were 0.78 (0.77, 0.80) for 1990-99 and 
      0.61 (0.58, 0.63) for 2000-12 for all cancers combined. The downward trend in HRs 
      was smaller for the 80+ year age group, leading to significantly higher HRs of 
      0.83 (0.81, 0.87) and 0.73 (0.70, 0.76) for 1990-99 and 2000-12 respectively. 
      Results were similar using competing risk regression and 5-year rather than 
      10-year age strata. CONCLUSION: The reduction in cancer mortality was smaller in 
      older people, as seen in the USA. Research is needed to achieve the best 
      trade-offs between cancer control and harm avoidance in older people. 
      Multidisciplinary teams have an important contribution to make.
CI  - Copyright (c) 2018 Elsevier Ltd. All rights reserved.
FAU - Li, Ming
AU  - Li M
AD  - Cancer Epidemiology and Population Health, University of South Australia, GPO Box 
      2471, Adelaide, SA, 5001, Australia. Electronic address: ming.li@unisa.edu.au.
FAU - Morrell, Stephen
AU  - Morrell S
AD  - Cancer Information and Analysis Unit, Cancer Institute NSW, GPO Box 41, 
      Alexandria, Sydney, NSW, 1435, Australia. Electronic address: 
      Stephen.morrell@cancerinstitute.org.au.
FAU - Creighton, Nicola
AU  - Creighton N
AD  - Cancer Information and Analysis Unit, Cancer Institute NSW, GPO Box 41, 
      Alexandria, Sydney, NSW, 1435, Australia. Electronic address: 
      Nicola.creighton@cancerinstitute.org.au.
FAU - Tervonen, Hanna
AU  - Tervonen H
AD  - Cancer Information and Analysis Unit, Cancer Institute NSW, GPO Box 41, 
      Alexandria, Sydney, NSW, 1435, Australia. Electronic address: 
      hanna.tervonen@cancerinstitute.org.au.
FAU - You, Hui
AU  - You H
AD  - Cancer Information and Analysis Unit, Cancer Institute NSW, GPO Box 41, 
      Alexandria, Sydney, NSW, 1435, Australia. Electronic address: 
      hui.you@cancerinstitute.org.au.
FAU - Roder, David
AU  - Roder D
AD  - Cancer Epidemiology and Population Health, University of South Australia, GPO Box 
      2471, Adelaide, SA, 5001, Australia. Electronic address: 
      david.roder@unisa.edu.au.
FAU - Currow, David
AU  - Currow D
AD  - Chief Executive Officer, Cancer Institute NSW, GPO Box 41, Alexandria, Sydney, 
      NSW, 1435, Australia. Electronic address: david.currow@cancerinstitute.org.au.
LA  - eng
PT  - Journal Article
DEP - 20180525
PL  - Netherlands
TA  - Cancer Epidemiol
JT  - Cancer epidemiology
JID - 101508793
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*epidemiology/mortality
MH  - New South Wales/epidemiology
MH  - Proportional Hazards Models
MH  - Registries
MH  - Survival Rate
MH  - Young Adult
OTO - NOTNLM
OT  - Age disparity
OT  - Cancer mortality post diagnosis
OT  - NSW cancer registry
EDAT- 2018/05/15 06:00
MHDA- 2019/04/04 06:00
CRDT- 2018/05/15 06:00
PHST- 2017/11/07 00:00 [received]
PHST- 2018/04/11 00:00 [revised]
PHST- 2018/04/30 00:00 [accepted]
PHST- 2018/05/15 06:00 [pubmed]
PHST- 2019/04/04 06:00 [medline]
PHST- 2018/05/15 06:00 [entrez]
AID - S1877-7821(18)30154-1 [pii]
AID - 10.1016/j.canep.2018.04.014 [doi]
PST - ppublish
SO  - Cancer Epidemiol. 2018 Aug;55:23-29. doi: 10.1016/j.canep.2018.04.014. Epub 2018 
      May 25.