Changes in life expectancy for cancer patients over time since diagnosis

Abstract

The aims of this study were to provide life expectancy (LE) estimates of cancer patients at diagnosis and LE changes over time since diagnosis to describe the impact of cancer during patients' entire lives. Cancer patients' LE was calculated by standard period life table methodology using the relative survival of Italian patients diagnosed in population-based cancer registries in 1985-2011 with follow-up to 2013. Data were smoothed using a polynomial model and years of life lost (YLL) were calculated as the difference between patients' LE and that of the age- and sex-matched general population. The YLL at diagnosis was highest at the youngest age at diagnosis, steadily decreasing thereafter. For patients diagnosed at age 45 years, the YLL was above 20 for lung and ovarian cancers and below 6 for thyroid cancer in women and melanoma in men. LE progressively increased in patients surviving the first years, decreasing thereafter, to approach that of the general population. YLL in the long run mainly depends on attained age. Providing quantitative data is essential to better define clinical follow-up and plan health care resource allocation. These results help assess when the excess risk of death from tumour becomes negligible in cancer survivors.

Keywords: (ICD-10), international classification of diseases tenth revision; (ICD-O-3), international classification of diseases for oncology, third revision; Cancer; Cancer survivors; ISTAT, national institute of statistics; Italy; LE, life expectancy; Life expectancy; NHL, non-Hodgkin lymphoma; Population-based cancer registry; RS, relative survival; Relative survival; YLL, years of life lost.

Graphical abstract

Fig. 1

Life expectancy of the general population (black) and of each age class at diagnosis by age for all cancers; colon, rectum, and anus; lung; and breast, Italy, females.

Fig. 2

Life expectancy of the general population (black) and of each age class at diagnosis by age for all cancers; colon, rectum, and anus; lung; and prostate, Italy, males.