Diverging trends in recent population-based survival rates in oesophageal and gastric cancer

Abstract

Background: Survival trends in oesophageal and gastric cancer need to be updated. A nationwide Swedish population-based study in 1961-2009 was based on registry data.

Methodology/principal findings: Relative survival rate, i.e. the ratio of the observed to the expected survival, adjusted for age, sex, and calendar period, and presented with 95% confidence intervals (CI), was the main outcome measure. The expected survival was calculated using the corresponding Swedish general population with no exclusions. The relative survival rates in oesophageal and gastric cardia adenocarcinoma have improved since the 1990s (p for trend <0.001), but not in oesophageal squamous cell carcinoma or gastric non-cardia adenocarcinoma. The relative 5-year survival rates during the two recent periods 1990-1999 and 2000-2008 were 12.5% (95%CI 10.1%-14.9%) and 10.3% (95%CI 8.5-12.0%) for oesophageal squamous cell carcinoma, 12.5% (95%CI 10.1%-14.9%) and 14.6% (95%CI 12.6-16.6%) for oesophageal adenocarcinoma, 11.1% (95%CI 9.6%-12.6%) and 14.3% (95%CI 12.3-16.3%) for gastric cardia adenocarcinoma, and 20.2% (95%CI 19.2%-21.1%) and 19.0% (95%CI 17.7-20.2%) for gastric non-cardia adenocarcinoma. The 3-year survival in tumour stage III in 2004-2008 was about 25% for all four tumour types.

Conclusions/significance: The survival in oesophageal and cardia adenocarcinoma is increasing, but the lack of such increase in oesophageal squamous cell carcinoma and gastric non-cardia adenocarcinoma is a concern.

Figure 1. Relative survival rates (%) in defined calendar year periods of diagnosis in oesophageal squamous cell carcinoma and oesophageal adenocarcinoma in 1961–2008, and cardia adenocarcinoma and gastric non-cardia adenocarcinoma in 1970–2008, and follow-up until 2009 in Sweden.