Cancer outcomes research-a European challenge: measures of the cancer burden

Abstract

In a mission that aims to improve cancer control throughout Europe, the European Academy of Cancer Sciences has defined two key indicators of progress: within one to two decades, overall cancer-specific 10-year survival should reach 75%, and in each country, overall cancer mortality rates should be convincingly declining. To lay the ground for assessment of progress and to promote cancer outcomes research in general, we have reviewed the most common population-based measures of the cancer burden. We emphasize the complexities and complementary approaches to measure cancer survival and the novel opportunities for improved assessment of quality of life. We propose that: incidence and mortality rates are standardized to the European population; net survival is used as the measure of prognosis but with proper adjustments for confounding when temporal trends in overall cancer survival are assessed; and cancer-specific quality of life is measured by a combination of existing questionnaires and utilizes emerging communication technologies. We conclude that all measures are important and that a meaningful interpretation also requires a deep understanding of the larger clinical and public health context.

Keywords: cancer; health-related quality of life; incidence; mortality; outcomes; survival.

Fig. 1

Conceptual overview of the measures that describe the rate of transitioning from one health state to another. Competing risks are disregarded.

Fig. 2

Incidence and mortality rates and 5‐year relative survival. (A) Incidence rates, mortality rates, and 5‐year relative survival for thyroid cancer among Norwegian women from 1965 to 2019. (B) Incidence rates, mortality rates, and 5‐year relative survival for lung cancer for Norwegian men from 1967 to 2019.

Fig. 3

Conceptual overview of the measures that describe the rate of transitioning from one health state to another, competing risks are included.