Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems

Transient droplet behavior and droplet breakup during bulk and confined shear flow in blends with one viscoelastic component: experiments, modelling and simulations

The transient droplet deformation and droplet orientation after inception of shear, the shape relaxation after cessation of shear and droplet breakup during shear, are microscopically studied, both under bulk and confined conditions. The studied blends contain one viscoelastic Boger fluid phase. A counter rotating setup, based on a Paar Physica MCR300, is used for the droplet visualisation. For bulk shear flow, it is shown that the droplet deformation during startup of shear flow and the shape relaxation after cessation of shear flow are hardly influenced by droplet viscoelasticity, even at moderate to high capillary and Deborah numbers. The effects of droplet viscoelasticity only become visible close to the critical conditions and a novel break-up mechanism is observed. Matrix viscoelasticity has a more pronounced effect, causing overshoots in the deformation and significantly inhibiting relaxation. However, different applied capillary numbers prior to cessation of shear flow, with the Deborah number fixed, still result in a single master curve for shape retraction, as in fully Newtonian systems. The long tail in the droplet relaxation can be qualitatively described with a phenomenological model for droplet deformation, when using a 5-mode Giesekus model for the fluid rheology. It is found that the shear flow history significantly affects the droplet shape evolution and the breakup process in blends with one viscoelastic component. Confining a droplet between two plates accelerates the droplet deformation kinetics, similar to fully Newtonian systems. However, the increased droplet deformation, due to wall effects, causes the steady state to be reached at a later instant in time. Droplet relaxation is less sensitive to confinement, leading to slower relaxation kinetics only for highly confined droplets. For the blend with a viscoelastic droplet, a non-monotonous trend is found for the critical capillary number as a function of the confinement ratio. Finally, experimental data are compared with 3D simulations, performed with a volume-of-fluid algorithm

Rotation of a sphere in a viscoelastic fluid under flow

The rotation speed of spherical particles in a shear flow is studied experimentally in rheologically different fluids. The fluids, selected to highlight specific constitutive features, include a Newtonian fiuid, a Boger fluid, a wormhke micellar surfactant solution, and a shear thinning elastic polymer solution. It is shown experimentally that particle rotation slows down, when compared to the Newtonian case, as elasticity increases. This is in qualitative agreement with TFEM simulation studies. Furthermore, the dimensionless rotation speed of the spheres in the different fluids as function of the elasticity of the medium scales onto a single curve. This scaling with the Weissenberg number was somewhat unexpected given simulation results for different rheological models, where significant differences are observed for selected single relaxation time differential models

A comparative study of the effects of cone-plate and parallel-plate geometries on rheological properties under oscillatory shear flow

In this study, the effects of cone-plate (C/P) and parallel-plate (P/P) geometries were investigated on the rheological properties of various complex fluids, e.g. single-phase (polymer melts and solutions) and multiphase systems (polymer blend and nanocomposite, and suspension). Small amplitude oscillatory shear (SAOS) tests were carried out to compare linear rheological responses while nonlinear responses were compared using large amplitude oscillatory shear (LAOS) tests at different frequencies. Moreover, Fourier-transform (FT)-rheology method was used to analyze the nonlinear responses under LAOS flow. Experimental results were compared with predictions obtained by single-point correction and shear rate correction. For all systems, SAOS data measured by C/P and P/P coincide with each other, but results showed discordance between C/P and P/P measurements in the nonlinear regime. For all systems except xanthan gum solutions, first-harmonic moduli were corrected using a single horizontal shift factor, whereas FT rheology-based nonlinear parameters (I3/1, I5/1, Q3, and Q5) were corrected using vertical shift factors that are well predicted by single-point correction. Xanthan gum solutions exhibited anomalous corrections. Their first-harmonic Fourier moduli were superposed using a horizontal shift factor predicted by shear rate correction applicable to highly shear thinning fluids. The distinguished corrections were observed for FT rheology-based nonlinear parameters. I3/1 and I5/1 were superposed by horizontal shifts, while the other systems displayed vertical shifts of I3/1 and I5/1. Q3 and Q5 of xanthan gum solutions were corrected using both horizontal and vertical shift factors. In particular, the obtained vertical shift factors for Q3 and Q5 were twice as large as predictions made by single-point correction. Such larger values are rationalized by the definitions of Q3 and Q5. These results highlight the significance of horizontal shift corrections in nonlinear oscillatory shear data