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1. Protocol for a feasibility study of a cancer symptom awareness campaign to support the rapid diagnostic centre referral pathway in a socioeconomically deprived area: Targeted Intensive Community-based campaign To Optimise Cancer awareness (TIC-TOC)

Author

Adrian Edwards, Daniel Jones, Fiona V Lugg-Widger, Julia Hiscock, Gareth Newton, Sara Thomas, Ann Maria Thomas, Kate Brain, Rebecca Cannings-John, Bernadette Sewell, Pamela Smith, Julia Townson, Harriet D Quinn-Scoggins, Grace M McCutchan, Dyfed Huws, Helen Stanton, Dawn Casey, Gwenllian Moody, Eleanor Clarke, Christina Lloydwin, Catherine Lloyd-Bennett, and Angela Watkins

Subjects
Medicine
Abstract

Introduction Rapid diagnostic centres (RDCs) are being implemented across the UK to accelerate the assessment of vague suspected cancer symptoms. Targeted behavioural interventions are needed to augment RDCs that serve socioeconomically deprived populations who are disproportionately affected by cancer, have lower cancer symptom awareness and are less likely to seek help for cancer symptoms. The aim of this study is to assess the feasibility and acceptability of delivering and evaluating a community-based vague cancer symptom awareness intervention in an area of high socioeconomic deprivation.Methods and analysis Intervention materials and messages were coproduced with local stakeholders in Cwm Taf Morgannwg, Wales. Cancer champions will be trained to deliver intervention messages and distribute intervention materials using broadcast media (eg, local radio), printed media (eg, branded pharmacy bags, posters, leaflets), social media (eg, Facebook) and attending local community events. A cross-sectional questionnaire will include self-reported patient interval (time between noticing symptoms to contacting the general practitioner), cancer symptom recognition, cancer beliefs and barriers to presentation, awareness of campaign messages, healthcare resource use, generic quality of life and individual and area-level deprivation indicators. Consent rates and proportion of missing data for patient questionnaires (n=189) attending RDCs will be measured. Qualitative interviews and focus groups will assess intervention acceptability and barriers/facilitators to delivery.Ethics and dissemination Ethical approval for this study was given by the London—West London & GTAC Research Ethics (21/LO/0402). This project will inform a potential future controlled study to assess intervention effectiveness in reducing the patient interval for vague cancer symptoms. The results will be critical to informing national policy and practice regarding behavioural interventions to support RDCs in highly deprived populations.

Published
2022
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2. Primary liver cancer in the UK: Incidence, incidence-based mortality, and survival by subtype, sex, and nation

Author

Anya Burton, Daniela Tataru, Robert J. Driver, Thomas G. Bird, Dyfed Huws, David Wallace, Timothy J.S. Cross, Ian A. Rowe, Graeme Alexander, Aileen Marshall, Ian Rowe, Vinay Kumar, Tim Cross, Katherine Cullen, Rhys Pockett, Tom Bird, Dyfed W. Huws, Anna Gavin, Lizz Paley, and Guruprasad Aithal

Subjects
Primary liver cancer, Hepatocellular carcinoma, Intrahepatic cholangiocarcinoma, Incidence, Mortality, Survival, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background & Aims: The incidence of primary liver cancer (PLC) is increasing in Western Europe. To understand trends over time and the current burden in the UK, a detailed analysis of the epidemiology of PLC and its subtypes was conducted. Methods: Data on PLCs diagnosed during 1997–2017 were obtained from population-based, nationwide registries in the UK. European age-standardised incidence (ASR) and incidence-based mortality rates (ASMR) per 100,000 person-years were calculated overall and by sex and UK-nation. Annual percentage change in rates was estimated using Joinpoint regression. One-, 2-, and 5-year age-standardised net survival was estimated. Results: A total of 82,024 PLCs were diagnosed. Both hepatocellular carcinoma (HCC) incidence and mortality rates trebled (ASR 1.8–5.5 per 100,000, ASMR 1.3–4.0). The rate of increase appeared to plateau around 2014/2015. Scottish men consistently had the highest HCC incidence rates. PLC survival increased, driven by a substantial increase in the proportion that are HCC (as prognosis is better than other PLCs) and in HCC survival (change in 1-year survival 24–47%). Intrahepatic cholangiocarcinoma was the most common PLC in women and 1-year survival improved from 22.6% to 30.5%. Conclusions: PLC incidence has been increasing rapidly but, as most risk factors are modifiable, it is largely a preventable cancer. This rate of increase has slowed in recent years, possibly attributable to effective treatment for hepatitis C. As other risk factors such as obesity and diabetes remain prevalent in the UK, it is unlikely the considerable burden of this disease will abate. While improvements in survival have been made, over half of patients are not alive after 1 year, therefore further progress in prevention, early detection, and treatment innovation are needed. Lay summary: Many more people are getting liver cancer, particularly the subtype hepatocellular carcinoma, than 20 years ago. Men in Scotland are most likely to get liver cancer and to die from it. Survival after liver cancer diagnosis is getting longer but still less than half are alive after 1 year.

Published
2021
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3. People with cancer living in deprived areas of Wales are more likely to have another serious condition at diagnosis than those in the least deprived areas

Author

Dyfed Huws, Rebecca Thomas, Julie Howe, Adele Oddy, Tomos Smith, David Egan, Tamsin Long, and Kelly Shiell-Davis

Subjects
Demography. Population. Vital events, HB848-3697
Abstract

Background People diagnosed with cancer are living longer and whilst cancer survival is improving for many cancers, there is not the same parity for all social groups - older people and people living in more deprived areas often have more chronic health conditions. We examined the association between those other health conditions and cancer incidence, prevalence and survival for all Welsh patients, for the four most common cancers and all malignant cancer cases (excluding non-melanoma skin cancer). Methods We extracted data on all malignant cancer cases from the WCISU’s population-based cancer registry for diagnosis periods 1995-2015. Cases were linked to a Cluster Network and to Patient Episode Database for Wales hospital data for the preceding year to establish pre-existing health conditions. From this, a Charlson score was calculated for each case - this is a validated score to predict risk of death and disease burden. For incidence and prevalence, we calculated the proportion of patients with Charlson score 0, 1 and 2+, and proportions with each health condition examined. We calculated one-year net survival by Charlson score or condition. Where possible, analysis was by cancer type, age-band, area deprivation, rurality, sex and stage at diagnosis. Results One in four people were already living with another serious condition. Patients diagnosed in more deprived areas of Wales were more likely to have an existing condition at diagnosis. Survival worsened as the severity or number of existing conditions increased. Conclusion Patients diagnosed with cancer in more deprived areas of Wales were more likely to be already living with another serious condition, showing a significant decrease in their projected survival at Charlson score 1 and 2+ compared to the least deprived areas. This work will enable acute, primary and community care, and other organisations to understand the overall burden of ill health in the cancer population in Wales.

Published
2019
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4. Improving the quality of care pathways for sarcoma patients and the advantages of using WCISU’s (Welsh Cancer Intelligence Surveillance Unit) national cancer registry

Author

Rowena Griffiths, Ashley Akbari, Dyfed Huws, Ronan Lyons, Martin Rolles, and Johanne Vass

Subjects
Demography. Population. Vital events, HB848-3697
Abstract

Introduction Soft Tissue Sarcoma (STS) diagnosis is difficult due to its nature and the variability of its occurrence on the body. To improve patient outcomes a better understanding was needed of the care pathways experienced by the patient from initial presentation to final treatment. Objectives and Approach Several items of information are necessary, within the data, to identify a care pathway. A correct STS diagnosis, a presentation date or first investigation date, a diagnosis date and any subsequent treatment dates. Identifying cases in hospital data, using International Classification of Diseases (ICD10) codes - C40, C41, C47 and C49 - based on cancer site - can miss cases and cause difficulties when trying to distinguish the difference between the investigation and treatment stages. Having access to WCISU’s national cancer registry, proved advantageous and enabled the routine data to be validated. Results Attempts to identify differences between investigative and treatment procedures using the procedure codes available in hospital data was unhelpful due to variations in coding. However, WCISU’s national cancer registry records all cases of cancer diagnosed in Wales using both ICD10 and International Classification of Diseases for Oncology codes to record cancer morphology. In addition, it records the date of diagnosis and treatment start dates. Using the cancer registry it was possible to cross-check the cases extracted from the hospital data and identify the diagnosis and treatment dates. By matching the treatment dates back to the hospital data it then became possible to analyse the procedure codes to see how many treatments were being delivered, the type of treatment and the periods covered. Conclusion/Implications Once accurate diagnosis and treatments dates were identified, it was possible to drill further into the hospital data to see the finer detail of the procedures the patient received. Utilising independent data sources made it possible to develop an enriched view of patient care pathways from diagnosis through to treatment.

Published
2018
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5. Contribution of avoidable mortality to life expectancy inequalities in Wales: a decomposition by age and by cause between 2002 and 2020

Author

Jonny Currie, Hayden T Schilling, Lloyd Evans, Tammy Boyce, Nathan Lester, Giles Greene, Kirsty Little, Ciarán Humphreys, Dyfed Huws, Andrew Yeoman, Sally Lewis, and Shantini Paranjothy

Subjects
Public Health, Environmental and Occupational Health, General Medicine
Abstract

Objectives To explore the contribution of avoidable mortality to life expectancy inequalities in Wales during 2002–2020. Design Observational study. Setting Wales, 2002–20, including early data from the COVID-19 pandemic. Methods We used routine statistics for 2002–2020 on population and deaths in Wales stratified by age, sex, deprivation quintile and cause of death. We estimated the contribution of avoidable causes of death and specific age-categories using the Arriaga decomposition method to highlight priorities for action. Results Life expectancy inequalities rose 2002–20 amongst both sexes, driven by serial decreases in life expectancy amongst the most deprived quintiles. The contributions of amenable and preventable mortality to life expectancy inequalities changed relatively little between 2002 and 2020, with larger rises in non-avoidable causes. Key avoidable mortality conditions driving the life expectancy gap in the most recent period of 2018–2020 for females were circulatory disease, cancers, respiratory disease and alcohol- and drug-related deaths, and also injuries for males. Conclusions Life expectancy inequalities widened during 2002–20, driven by deteriorating life expectancy in the most deprived quintiles. Sustained investment in prevention post-COVID-19 is needed to address growing health inequity in Wales; there remains a role for the National Health Service in ensuring equitable healthcare access to alongside wider policies that promote equity.

Published
2022
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6. Protocol for a feasibility study of a cancer symptom awareness campaign to support the rapid diagnostic centre referral pathway in a socioeconomically deprived area: Targeted Intensive Community-based campaign To Optimise Cancer awareness (TIC-TOC)

Author

Pamela Smith, Gwenllian Moody, Eleanor Clarke, Julia Hiscock, Rebecca Cannings-John, Julia Townson, Adrian Edwards, Harriet D Quinn-Scoggins, Bernadette Sewell, Daniel Jones, Christina Lloydwin, Sara Thomas, Dawn Casey, Catherine Lloyd-Bennett, Helen Stanton, Fiona V Lugg-Widger, Dyfed Huws, Angela Watkins, Gareth Newton, Ann Maria Thomas, Grace M McCutchan, and Kate Brain

Subjects
Cross-Sectional Studies, Neoplasms, Quality of Life, Feasibility Studies, Humans, General Medicine, Referral and Consultation
Abstract

IntroductionRapid diagnostic centres (RDCs) are being implemented across the UK to accelerate the assessment of vague suspected cancer symptoms. Targeted behavioural interventions are needed to augment RDCs that serve socioeconomically deprived populations who are disproportionately affected by cancer, have lower cancer symptom awareness and are less likely to seek help for cancer symptoms. The aim of this study is to assess the feasibility and acceptability of delivering and evaluating a community-based vague cancer symptom awareness intervention in an area of high socioeconomic deprivation.Methods and analysisIntervention materials and messages were coproduced with local stakeholders in Cwm Taf Morgannwg, Wales. Cancer champions will be trained to deliver intervention messages and distribute intervention materials using broadcast media (eg, local radio), printed media (eg, branded pharmacy bags, posters, leaflets), social media (eg, Facebook) and attending local community events. A cross-sectional questionnaire will include self-reported patient interval (time between noticing symptoms to contacting the general practitioner), cancer symptom recognition, cancer beliefs and barriers to presentation, awareness of campaign messages, healthcare resource use, generic quality of life and individual and area-level deprivation indicators. Consent rates and proportion of missing data for patient questionnaires (n=189) attending RDCs will be measured. Qualitative interviews and focus groups will assess intervention acceptability and barriers/facilitators to delivery.Ethics and disseminationEthical approval for this study was given by the London—West London & GTAC Research Ethics (21/LO/0402). This project will inform a potential future controlled study to assess intervention effectiveness in reducing the patient interval for vague cancer symptoms. The results will be critical to informing national policy and practice regarding behavioural interventions to support RDCs in highly deprived populations.

Published
2022

7. Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

Author

Naomi Ssenyonga, Charles Stiller, Kayo Nakata, Jaime Shalkow, Shelagh Redmond, Jean-Luc Bulliard, Fabio Girardi, Christine Fowler, Rafael Marcos-Gragera, Audrey Bonaventure, Nathalie Saint-Jacques, Pamela Minicozzi, Prithwish De, Miguel Rodríguez-Barranco, Siri Larønningen, Veronica Di Carlo, Margit Mägi, Mikhail Valkov, Karri Seppä, Dyfed Wyn Huws, Michel P Coleman, Claudia Allemani, Sabiha Bouzbid, Mokhtar Hamdi-Chérif, Lamia Kara, Kaouel Meguenni, Derbali Regagba, Sine Bayo, Traore Cheick Bougadari, Shyam Shunker Manraj, Karima Bendahhou, Akinade Ladipo, Olufemi Ogunbiyi, Nontuthuzelo Somdyala, María Agustina Chaplin, Florencia Moreno, Gladis Calabrano, Silvia Espinola, Beatriz Carballo Quintero, Rosalba Fita, Walter Laspada, Susana Ibañez, Carlos Lima, Allini Mafra Da Costa, Paulo César De Souza, Juliana Chaves, Cyntia Laporte, Maria Paula Curado, Jose Carlos de Oliveira, Claudia Veneziano, Donaldo Veneziano, Ana Beatriz Almeida, Maria Latorre, Gulnar Azevedo e Silva, Marise Rebelo, Marceli Santos, Juan Galaz, Mackarena Aparicio Aravena, Jocelyn Sanhueza Monsalve, Denise Herrmann, Solange Vargas, Victor Herrera, Claudia Uribe, Luis Eduardo Bravo, Luz Stella Garcia, Nelson Arias-Ortiz, Daniela Morantes, Daniel Jurado, María Yépez Chamorro, Sandra Delgado, Melissa Ramirez, Yaima Galán Alvarez, Priscila Torres, Fray Martínez-Reyes, Leyda Jaramillo, Rina Quinto, Jhoanna Castillo, Mariela Mendoza, Patricia Cueva, José Yépez, Bernard Bhakkan, Jacqueline Deloumeaux, Clarisse Joachim, Jonathan Macni, Rodolfo Carrillo, Jaime Shalkow Klincovstein, Rebeca Rivera Gomez, Patricia Perez, Ebert Poquioma, Guillermo Tortolero-Luna, Diego Zavala, Rafael Alonso, Enrique Barrios, Angela Eckstrand, Cindy Nikiforuk, Ryan Woods, Gail Noonan, Donna Turner, Eshwar Kumar, Bin Zhang, Jeff Dowden, Gregory Doyle, Gordon Walsh, Aniq Anam, Carol McClure, Kim Vriends, Christine Bertrand, Agnihotram Ramanakumar, Serena Kozie, Heather Stuart-Panko, Tara Freeman, Justin George, Rosa Avila, David O'Brien, Abby Holt, Lyn Almon, Kevin Ward, Sandy Kwong, Cyllene Morris, Randi Rycroft, Lloyd Mueller, Cathryn Phillips, Heather Brown, Betsy Cromartie, Julie Ruterbusch, Ann Schwartz, Gary Levin, Brad Wohler, Rana Bayakly, Scarlett Gomez, Meg McKinley, Rosemary Cress, Joni Davis, Brenda Hernandez, Christopher Johnson, Bozena Morawski, Laura Ruppert, Suzanne Bentler, Mary Charlton, Bin Huang, Thomas Tucker, Dennis Deapen, Lihua Liu, Mei-Chin Hsieh, Xiao-Cheng Wu, Molly Schwenn, Kimberly Stern, Susan Gershman, Richard Knowlton, Georgetta Alverson, Tamara Weaver, Jay Desai, Deirdre Rogers, Jeanette Jackson-Thompson, Debbi Lemons, Heather Zimmerman, Michelle Hood, Jenifer Roberts-Johnson, Whitney Hammond, Judith Rees, Karen Pawlish, Antoinette Stroup, Charles Key, Charles Wiggins, Amy Kahn, Maria Schymura, Soundarya Radhakrishnan, Chandrika Rao, Lynn Giljahn, Roberta Slocumb, Christy Dabbs, Raffaella Espinoza, Karen Aird, Todd Beran, Jim Rubertone, Stephen Slack, Junhie Oh, Tiffany Janes, Stephen Schwartz, Stephanie Chiodini, Deborah Hurley, Martin Whiteside, Saroj Rai, Melanie Williams, Kim Herget, Carol Sweeney, Alison Johnson, Mahesh Keitheri Cheteri, Patti Migliore Santiago, Steven Blankenship, Shawn Farley, Robert Borchers, Robin Malicki, Julia Espinoza, Joseph Grandpre, Brenda Edwards, Angela Mariotto, Hannah Weir, Reda Wilson, Ning Wang, Lei Yang, Jian-Shun Chen, Yu-Tong He, Guo-Hui Song, Xiao-Ping Gu, Dan Mei, Heng-Ming Ge, Tong-Hao Wu, Yan-Yan Li, De-Li Zhao, Feng Jin, Jian-Hua Zhang, Feng-Dong Zhu, Qian Junhua, Yan Lei Yang, Chun-Xiao Jiang, Wang Biao, Jian Wang, Qi-Long Li, He Yi, Xin Zhou, JianMei Dong, WeiWei Li, Fang-Xian Fu, Jian-Guo Chen, Jian Zhu, Yan-Hua Li, Yu-Qiang Lu, Min Fan, Su-Qin Huang, Guo-Ping Guo, Hua Zhaolai, Kuangrong Wei, Wan-Qing Chen, Wenqiang Wei, Hongmei Zeng, Anna Demetriou, Wai Kong Mang, Kai Cheong Ngan, Amal Kataki, Manigreeva Krishnatreya, Padmavathi Amma Jayalekshmi, Paul Sebastian, Preethi George, Aleyamma Mathew, Ambakumar Nandakumar, Reza Malekzadeh, Gholamreza Roshandel, Lital Keinan-Boker, Barbara Silverman, Hidemi Ito, Yuriko Koyanagi, Masako Sato, Fumio Tobori, Ichiro Nakata, Norihiro Teramoto, Masakazu Hattori, Yasuharu Kaizaki, Fumitaka Moki, Hiromi Sugiyama, Mai Utada, Makiko Nishimura, Keiichi Yoshida, Katsuki Kurosawa, Yuji Nemoto, Hiroto Narimatsu, Masahiko Sakaguchi, Seiki Kanemura, Michiko Naito, Rintaro Narisawa, Isao Miyashiro, Daisuke Mori, Mayuko Yoshitake, Izumi Oki, Norimasa Fukushima, Akiko Shibata, Keiichiro Iwasa, Chie Ono, Tomohiro Matsuda, Omar Nimri, Kyu-Won Jung, Young-Joo Won, Eiman Alawadhi, Amani Elbasmi, Azizah Ab Manan, Farzaana Adam, Erdenekhuu Nansalmaa, Undarmaa Tudev, Chimedsuren Ochir, Al Hareth Al Khater, Mufid El Mistiri, Gek Hsiang Lim, Yik Ying Teo, Chun-Ju Chiang, Wen-Chung Lee, Rangsiya Buasom, Suleeporn Sangrajrang, Krittika Suwanrungruang, Patravoot Vatanasapt, Karnchana Daoprasert, Donsuk Pongnikorn, Atit Leklob, Somphob Sangkitipaiboon, Sarayut Geater, Hutcha Sriplung, Okan Ceylan, Iskender Kög, Oya Dirican, Tülay Köse, Tulın Gurbuz, Füsun Emine Karašahin, Duygu Turhan, Umut Aktaş, Yakup Halat, Sultan Eser, Cankut Yakut, Merve Altinisik, Yasar Cavusoglu, Ayşe Türkköylü, Nuršen Üçüncü, Monika Hackl, Anna Zborovskaya, Olga Aleinikova, Kris Henau, Liesbet Van Eycken, Trayan Atanasov, Zdravka Valerianova, Mario Šekerija, Ladislav Dušek, Miroslav Zvolský, Lina Steinrud Mørch, Hans Storm, Charlotte Wessel Skovlund, Kaire Innos, Nea Malila, Jérémie Jégu, Michel Velten, Edouard Cornet, Xavier Troussard, Anne-Marie Bouvier, Anne-Valérie Guizard, Véronique Bouvier, Guy Launoy, Sandrine Dabakuyo Yonli, Marie-Laure Poillot, Marc Maynadié, Morgane Mounier, Lina Vaconnet, Anne-Sophie Woronoff, Mélanie Daoulas, Michel Robaszkiewicz, Jacqueline Clavel, Claire Poulalhon, Emmanuel Desandes, Brigitte Lacour, Isabelle Baldi, Camille Pouchieu, Brice Amadeo, Gaëlle Coureau, Alain Monnereau, Magali Audoin, Tania D'Almeida, Séverine Boyer, Karima Hammas, Brigitte Trétarre, Marc Colonna, Patricia Delafosse, Sandrine Plouvier, Anne Cowppli-Bony, Florence Molinié, Simona Bara, Olivier Ganry, Bénédicte Lapôtre-Ledoux, Laetitia Daubisse-Marliac, Nadine Bossard, Jacques Estève, Zoé Uhry, Roland Stabenow, Heide Wilsdorf-Köhler, Andrea Eberle, Sabine Luttmann, Imma Löhden, Alice Nennecke, Joachim Kieschke, Eunice Sirri, Christina Justenhoven, Sylke Zeissig, Bernd Holleczek, Nora Eisemann, Alexander Katalinic, Rachelle Asquez, Vijay Kumar, Eleni Petridou, Elínborg Ólafsdóttir, Laufey Tryggvadóttir, Deirdre Murray, Paul Walsh, Hildrun Sundseth, Guido Mazzoleni, Fabio Vittadello, Enzo Coviello, Francesco Cuccaro, Rocco Galasso, Giuseppe Sampietro, Michele Magoni, Antonino Ardizzone, Angelo D'Argenzio, Alessia Anna Di Prima, Antonella Ippolito, Anna Maria Lavecchia, Antonella Sutera Sardo, Gemma Gola, Paola Ballotari, Erica Giacomazzi, Stefano Ferretti, Luigino Dal Maso, Diego Serraino, Maria Vittoria Celesia, Rosa Angela Filiberti, Fabio Pannozzo, Anna Melcarne, Fabrizio Quarta, Anita Andreano, Antonio Giampiero Russo, Giuliano Carrozzi, Claudia Cirilli, Luca Cavalieri d'Oro, Magda Rognoni, Mario Fusco, Maria Francesca Vitale, Mario Usala, Rosanna Cusimano, Walter Mazzucco, Maria Michiara, Paolo Sgargi, Lorenza Boschetti, Giorgio Chiaranda, Pietro Seghini, Milena Maule, Franco Merletti, Eugenia Spata, Rosario Tumino, Pamela Mancuso, Massimo Vicentini, Tiziana Cassetti, Romano Sassatelli, Fabio Falcini, Stefania Giorgetti, Anna Luisa Caiazzo, Rossella Cavallo, Daniela Piras, Francesca Bella, Anselmo Madeddu, Anna Clara Fanetti, Sergio Maspero, Simona Carone, Antonia Mincuzzi, Giuseppa Candela, Tiziana Scuderi, Maria Adalgisa Gentilini, Roberto Rizzello, Stefano Rosso, Roberto Zanetti, Adele Caldarella, Teresa Intrieri, Fortunato Bianconi, Fabrizio Stracci, Paolo Contiero, Giovanna Tagliabue, Massimo Rugge, Manuel Zorzi, Simonetta Beggiato, Angelita Brustolin, Roberta De Angelis, Gemma Gatta, Anita Maurina, Marija Oniščuka, Mohsen Mousavi, Nadezda Lipunova, Ieva Vincerzevskienė, Dominic Agius, Neville Calleja, Sabine Siesling, Otto Visser, Tom Johannesen, Maciej Trojanowski, Tomasz Mierzwa, Jadwiga Rachtan, Kamila Kępska, Beata Kościańska, Joanna Wójcik-Tomaszewska, Marcin Motnyk, Anna Gos, Magdalena Bielska-Lasota, Joanna Didkowska, Urszula Wojciechowska, Gonçalo Forjaz de Lacerda, Raul Rego, Branca Carrito, Ana Pais, Maria José Bento, Jessica Rodrigues, Antonio Lourenço, Alexandra Mayer-da-Silva, Luminita Blaga, Daniela Coza, Lubov Gusenkova, Olga Lazarevich, Olga Prudnikova, Dmitri Mikhailovich Vjushkov, Alla Egorova, Andrey Orlov, Lidiya Pikalova, Lilia Zhuikova, Juraj Adamcik, Chakameh Safaei Diba, Vesna Zadnik, Tina Zagar, Marta De-La-Cruz, Arantza Lopez-de-Munain, Araceli Aleman, Dolores Rojas, Rosario Jiménez Chillarón, Ana Isabel Marcos Navarro, Montse Puigdemont, María-José Sánchez Perez, Paula Franch Sureda, Maria Ramos Montserrat, Maria Dolores Chirlaque López, Antonia Sánchez Gil, Eva Ardanaz, Marcela Guevara, Adela Cañete-Nieto, Rafael Peris-Bonet, Marià Carulla, Jaume Galceran, Fernando Almela, Consol Sabater, Staffan Khan, David Pettersson, Paul Dickman, Katharina Staehelin, Benjamin Struchen, Christian Herrmann, Seyed Mohsen Mousavi, Céline Egger Hayoz, Christine Bouchardy, Robin Schaffar, Philip Went, Manuela Maspoli-Conconi, Claudia Kuehni, Andrea Bordoni, Laura Ortelli, Arnaud Chiolero, Isabelle Konzelmann, Sabine Rohrmann, Miriam Wanner, John Broggio, Jem Rashbass, Deirdre Fitzpatrick, Anna Gavin, David Morrison, Catherine Thomson, Giles Greene, Dyfed Huws, Michel Coleman, Melissa Matz, Natalia Sanz, Richard Stephens, Elizabeth Chalker, Mirka Smith, Jessica Gugusheff, Hui You, Shu Qin Li, Sarah Dugdale, Julie Moore, Shoni Philpot, Rhonda Pfeiffer, Helen Thomas, Bruna Silva Ragaini, Alison Venn, Sue Evans, Luc Te Marvelde, Vedrana Savietto, Richard Trevithick, David Currow, Chris Lewis, Ssenyonga, Naomi, Stiller, Charle, Nakata, Kayo, Shalkow, Jaime, Redmond, Sheilagh, Bulliard, Jean-Luc, Girardi, Fabio, Fowler, Christine, Marcos-Gragera, Raphael, Bonaventure, Audrey, Saint-Jacques, Nathalie, Minicozzi, Pamela, De, Prithwish, Rodríguez-Barranco, Miguel, Larønningen, Siri, Di Carlo, Veronica, Mägi, Margit, Valkov, Mikhail, Seppä, Karri, Wyn Huws, Dyfed, Coleman, Michel P, Allemani, Claudia, and Mazzucco, Walter

Subjects
Adolescent, Australia, 610 Medicine & health, lymphoma, Settore MED/42 - Igiene Generale E Applicata, survival, United States, Europe, Leukemia, Myeloid, Acute, Young Adult, children, population-based/cancer registry, 360 Social problems & social services, survival, leukemia, cancer registry, Hematologic Neoplasms, leukaemia, Pediatrics, Perinatology and Child Health, Developmental and Educational Psychology, cancer, Humans, Registries, haematological malignancy, Child
Abstract

BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). METHODS We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. FINDINGS 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010-14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010-14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000-14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. INTERPRETATION This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. FUNDING Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.

Published
2022
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8. A way to explore the existence of 'immortals' in cancer registry data - An illustration using data from ICBP SURVMARK-2

Author

Therese M.-L. Andersson, Mark J. Rutherford, Tor Åge Myklebust, Bjørn Møller, Melina Arnold, Isabelle Soerjomataram, Freddie Bray, Hazem Abd Elkader, Gerda Engholm, Dyfed Huws, Alana Little, Lorraine Shack, Paul M. Walsh, Ryan R. Woods, D.Maxwell Parkin, and Paul C. Lambert

Subjects
Survival Rate, Cancer Research, Oncology, Epidemiology, Colonic Neoplasms, Humans, Registries, Ireland, Aged, New Zealand
Abstract

Accurately recorded vital status of individuals is essential when estimating cancer patient survival. When deaths are ascertained by linkage with vital statistics registers, some may be missed, and such individuals will wrongly appear to be long-term survivors, and survival will be overestimated. Interval-specific relative survival that levels off above one indicates that the survival among the cancer patients is better than expected, which could be due to the presence of immortals.We included colon cancer cases diagnosed in 1995-1999 within the 19 jurisdictions in seven countries participating in ICBP SURVMARK-2, with follow-up information available until end-2015. Interval-specific relative survival was estimated for each year following diagnosis, by country and age group at diagnosis.The interval-specific relative survival levels off at 1 for all countries and age groups, with two exceptions: for the age group diagnosed at age 75 years and above in Ireland, and, to a lesser extent, in New Zealand.Overall, a subset of immortals are not apparent in the early years within the ICBP SURVMARK-2 study, except for possibly in Ireland. We suggest this approach as one strategy of exploring the existence of immortals, and to be part of routine checks of cancer registry data.

Published
2021

9. Additional file 8: of Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar

Author

Lewis, Ruth, Hendry, Maggie, Nafees Din, Stanciu, Marian, Nafees, Sadia, Hendry, Annie, Teoh, Zhi, Lloyd, Thomas, Parsonage, Rachel, Neal, Richard, Collier, Gareth, and Dyfed Huws

Abstract

Appendix H. Summary of magnitude of effect for modifiable factors. Table H1. Summary effect estimates based on pooled data. Table H2. Summary effect estimates from individual studies included in reviews reporting narrative synthesis. (DOCX 23 kb)

Published
2019
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10. Additional file 7: of Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar

Author

Lewis, Ruth, Hendry, Maggie, Nafees Din, Stanciu, Marian, Nafees, Sadia, Hendry, Annie, Teoh, Zhi, Lloyd, Thomas, Parsonage, Rachel, Neal, Richard, Collier, Gareth, and Dyfed Huws

Abstract

Appendix G. Quality appraisal of reviews investigating modifiable factors using a modified AMSTAR checklist. AMSTAR questions. Table G1. Quality appraisal of included reviews assessing modifiable factors. (DOCX 18 kb)

Published
2019
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11. Additional file 4: of Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar

Author

Lewis, Ruth, Hendry, Maggie, Nafees Din, Stanciu, Marian, Nafees, Sadia, Hendry, Annie, Teoh, Zhi, Lloyd, Thomas, Parsonage, Rachel, Neal, Richard, Collier, Gareth, and Dyfed Huws

Abstract

Appendix D. Results of reviews in stage 2, overview of reviews. Table D1. ‘New’ biomarkers or biological factors not used in routine practice. Table D2. Tumour characteristics. Table D3. Metabolic criteria. Table D4. Clinical characteristics or routinely assessed biological variables. Table D5. Patient characteristics. Table D6. Healthcare provider and system. Table D7. Prognostic factors classified as ‘other’. (DOCX 96 kb)

Published
2019
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12. Additional file 6: of Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar

Author

Lewis, Ruth, Hendry, Maggie, Nafees Din, Stanciu, Marian, Nafees, Sadia, Hendry, Annie, Teoh, Zhi, Lloyd, Thomas, Parsonage, Rachel, Neal, Richard, Collier, Gareth, and Dyfed Huws

Subjects
digestive system diseases
Abstract

Appendix F. List of modifiable prognostic factors. Table F1: Modifiable prognostic factors evaluated by included reviews. (DOCX 14 kb)

Published
2019
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13. Additional file 3: of Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar

Author

Lewis, Ruth, Hendry, Maggie, Nafees Din, Stanciu, Marian, Nafees, Sadia, Hendry, Annie, Teoh, Zhi, Lloyd, Thomas, Parsonage, Rachel, Neal, Richard, Collier, Gareth, and Dyfed Huws

Abstract

Appendix C. Description of included reviews in stage 2, overview of reviews. Table C1. Summary of included reviews. Table C2. Reference details of included studies. (DOCX 93 kb)

Published
2019
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15. Additional file 2: of Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar

Author

Lewis, Ruth, Hendry, Maggie, Nafees Din, Stanciu, Marian, Nafees, Sadia, Hendry, Annie, Teoh, Zhi, Lloyd, Thomas, Parsonage, Rachel, Neal, Richard, Collier, Gareth, and Dyfed Huws

Abstract

Appendix B. Results of mapping review. Table B1. Summary of studies included in mapping review and their status in stage 2, overview of reviews. (DOCX 52 kb)

Published
2019
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16. Additional file 5: of Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar

Author

Lewis, Ruth, Hendry, Maggie, Nafees Din, Stanciu, Marian, Nafees, Sadia, Hendry, Annie, Teoh, Zhi, Lloyd, Thomas, Parsonage, Rachel, Neal, Richard, Collier, Gareth, and Dyfed Huws

Abstract

Appendix E. Description and results of reviews that aimed to evaluate any prognostic factor. Table E1. Summary of included reviews that considered the inclusion of any prognostic factor. Table E2. Modifiable prognostic factors evaluated by reviews that investigated â anyâ prognostic factor associated with survival. (DOCX 22 kb)

Published
2019
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