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Pulte D.,German Cancer Research Center | Pulte D.,Thomas Jefferson University | Jansen L.,German Cancer Research Center | Gondos A.,German Cancer Research Center | And 4 more authors.
Leukemia and Lymphoma

This study provides up-to-date and detailed cancer survival estimates of German patients with non-Hodgkin lymphoma (NHL, International Statistical Classification of Diseases 10th Revision [ICD-10] codes C82-C85) based on data from 11 cancer registries. Period analysis was used to calculate 5-year relative survival in 2002-2006, overall and by gender, age and histology. Comparison was made with patients with NHL in the United States (US) Surveillance, Epidemiology and End Results database in the same time period. Overall 5-year relative survival for patients with NHL in Germany in 2002-2006 was 62.8% and in the US was 65.1%. Survival decreased with age from 81.7% at age 15-49 to 46.5% at age 75+. Survival in the US was 75.3% at age 15-49 and 52% at age 75+. Survival was higher for women than for men, at 65.2% for women and 60.7% for men. Survivals for diffuse B-cell lymphoma and follicular lymphoma, the two most common subtypes of NHL, were 57.3% and 77.5%, respectively. Between 2002 and 2006, overall 5-year relative survival increased by 5.3 percentage points. We conclude that survival for NHL is increasing in Germany in recent years. Survival was higher in Germany than in the US for patients aged 15-49 but lower for older patients. © 2013 Informa UK, Ltd. Source

Eberle A.,Leibniz Institute for Prevention Research and Epidemiology BIPS | Jansen L.,German Cancer Research Center | Castro F.,German Cancer Research Center | Krilaviciute A.,German Cancer Research Center | And 16 more authors.
Lung Cancer

Objectives: Lung cancer is the most common cancer-related death worldwide. In Germany it accounts for 25% of cancer deaths in men, and 14% in women. The aim of this study is to provide an overview of 5-year relative survival by sex, age, histology, and tumour stage in Germany representing a population of 26.7 million people. Materials and methods: The study is based on a pooled German dataset including data from 12 population-based cancer registries covering around one third of the German population. A total of 132,612 patients diagnosed with lung cancer from 2002 to 2010 were included in the analysis. Survival estimates for the time period 2007-2010 were calculated using period analysis. Differences in survival between sexes were tested for statistical significance by model-based period analysis (poisson regression model). The relative excess risk (RER) of death (women vs. men) was extracted from the model with the p value for the difference in RER. Results: The overall age adjusted 5-year relative survival was 15.5% (standard error (SE) 0.2) for men and 20.3% (SE 0.3) in women. Survival differed markedly according to age (men: <60 years 18.5% vs. 80+ years 8.4% and women 23.7% vs. 10.6%, respectively), histology (largest difference between histological groups: men 25.7 and women 44.4% points) and stage (men: UICC Ia 62.9%, vs. UICC IV 4.6% and women 75.2% vs. 7.0%, respectively). Our study showed survival advantages for women compared to men, most notably in younger aged patients (RER 0.83, p< 0.0001), patients with adenocarcinoma (RER 0.80, p< 0.0001), and patients with lower stage cancer (RER 0.62, p< 0.0001). Conclusions: This study presents up-to-date survival estimates for lung cancer in Germany. Compared to other European countries survival was relatively high. Women showed higher survival than men independent of age, histology and stage. The reasons for the survival differences require further clarification. © 2015 Elsevier Ireland Ltd. Source

Rusner C.,Martin Luther University of Halle Wittenberg | Trabert B.,U.S. National Institutes of Health | Katalinic A.,Cancer Registry of Schleswig Holstein | Kieschke J.,Cancer Registry of Lower Saxony | And 3 more authors.
Cancer Epidemiology

Background: Malignant gonadal (GGCT) and extragonal germ cell tumors [GCT (EGCT)] are thought to originate from primordial germ cells. In contrast to well reported population-based data of GGCTs in males, analyses of GGCTs in females and EGCTs in both sexes remain limited. Methods: In a pooling project of nine population-based cancer registries in Germany for the years 1998-2008, 16,883 malignant GCTs and their topographical sites were identified using ICD-O morphology and topography for persons aged 15 years and older. We estimated age-specific and age-standardized incidence rates. Results: Among males, the incidence of testicular GCTs increased over time. In contrast, there was no increase in the incidence of EGCTs. Among females, rates of ovarian GCTs were stable, while rates of EGCTs declined over time. The most frequent extragonadal sites were mediastinum among males and placenta among females. Conclusions: Our results underline different incidence trends and distinct age-specific incidence patterns of malignant GGCTs and EGCTs, as reported recently by several population-based registries. The differences suggest that GGCT and EGCT may have different etiologies. © 2013 Elsevier Ltd. Source

Nennecke A.,Hamburg Cancer Registry | Geiss K.,Population based Cancer Registry Bavaria | Hentschel S.,Hamburg Cancer Registry | Vettorazzi E.,University of Hamburg | And 15 more authors.
Cancer Epidemiology

Background: Cancer care services including cancer prevention activities are predominantly localised in central cities, potentially causing a heterogeneous geographic access to cancer care. The question of an association between residence in either urban or rural areas and cancer survival has been analysed in other parts of the world with inconsistent results. This study aims at a comparison of age-standardised 5-year survival of cancer patients resident in German urban and rural regions using data from 11 population-based cancer registries covering a population of 33 million people. Material and methods: Patients diagnosed with cancers of the most frequent and of some rare sites in 1997-2006 were included in the analyses. Places of residence were assigned to rural and urban areas according to administrative district types of settlement structure. Period analysis and district type specific population life tables were used to calculate overall age-standardised 5-year relative survival estimates for the period 2002-2006. Poisson regression models for excess mortality (relative survival) were used to test for statistical significance. Results: The 5-year relative survival estimates varied little among district types for most of the common sites with no consistent trend. Significant differences were found for female breast cancer patients and male malignant melanoma patients resident in city core regions with slightly better survival compared to all other district types, particularly for patients aged 65 years and older. Conclusion: With regard to residence in urban or rural areas, the results of our study indicate that there are no severe differences concerning quality and accessibility of oncological care in Germany among different district types of settlement. © 2014 Elsevier Ltd. Source

Pulte D.,German Cancer Research Center | Pulte D.,Thomas Jefferson University | Castro F.A.,German Cancer Research Center | Jansen L.,German Cancer Research Center | And 6 more authors.
Journal of Hematology and Oncology

Background: Recent population-based studies in the United States of America (USA) and other countries have shown improvements in survival for patients with chronic lymphocytic leukemia (CLL) diagnosed in the early twenty-first century. Here, we examine the survival for patients diagnosed with CLL in Germany in 1997-2011. Methods: Data were extracted from 12 cancer registries in Germany and compared to the data from the USA. Period analysis was used to estimate 5- and 10-year relative survival (RS). Results: Five- and 10-year RS estimates in 2009-2011 of 80.2 and 59.5 %, respectively, in Germany and 82.4 and 64.7 %, respectively, in the USA were observed. Overall, 5-year RS increased significantly in Germany and the difference compared to the survival in the USA which slightly decreased between 2003-2005 and 2009-2011. However, age-specific analyses showed persistently higher survival for all ages except for 15-44 in the USA. In general, survival decreased with age, but the age-related disparity was small for patients younger than 75. In both countries, 5-year RS was >80 % for patients less than 75 years of age but <70 % for those age 75+. Conclusions: Overall, 5-year survival for patients with CLL is good, but 10-year survival is significantly lower, and survival was much lower for those age 75+. Major differences in survival between countries were not observed. Further research into ways to increase survival for older CLL patients are needed to reduce the persistent large age-related survival disparity. © 2016 Pulte et al. Source

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