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

Unified formulation for inhomogeneity-driven instabilities in the lower-hybrid range

A local dispersion relation that describes inhomogeneity-driven instabilities in the lower-hybrid range is derived following a procedure that correctly describes energy exchange between waves and particles in inhomogeneous media, correcting some inherent ambiguities associated with the standard formalism found in the literature. Numerical solutions of this improved dispersion relation show that it constitutes a unified formulation for the instabilities in the lower-hybrid range, describing the so-called modified two-stream instability, excited by the ion cross-field drift, including the ion Weibel instability, and also describing the lower-hybrid drift instability, which is due to inhomogeneity effects on the electron population

Pattern Formation in Laser Induced Melting

A laser focussed onto a semiconductor film can create a disordered lamellae pattern of coexisting molten-solid regions. We present a continuum model based on the higher reflectivity of the molten regions. For large latent heat, this model becomes equivalent to a model of block copolymers. The characteristic wavenumber of the lamellae is that marginally stable to slow variations in the orientation (the zig-zag instability) and is obtained via systematic expansions from two limits. The lamellae can also be unstable to the zig-zag instability and Eckhaus instability simultaneously. This instability is a signal of dynamic steady states. We numerically study the behaviour after a quench. The lamellar size agrees with the analytic results and experiments. For shallow quenches, locally parallel stripes slowly straighten in time. For deep quenches, a disordered lamellae forms. We construct the director field and determine the orientational correlation length. Near onset the correlation is fixed by the system size. Far from onset the correlation length saturates at a finite value. We study the transition to the time-dependent asymptotic states with decreasing latent heat. postScript figures available on requestComment: 44 pages, revtex 3.