Strengthening health data on a rare and heterogeneous disease: sarcoma incidence and histological subtypes in Germany

Background: The population-based incidence of sarcoma and its histological subtypes in Germany is unknown. Up-to-date information on a disease with an incidence comparable to other cancer entities is of high public health relevance. The aim of this study was to determine this incidence and to detect significant changes in incidence trends using data from German epidemiological cancer registries. Methods: Pooled data from the German Centre for Cancer Registry Data with a primary diagnosis occurring in 2013 were used. To date, this is the latest data on cancer incidence available for Germany. All German cancer registries with sufficient completeness were included (10 out of 11), covering a population of 70.0 million people, representing 87% of the German population. All malignant sarcomas according to the RARECARE Project and the WHO classification 2002 were considered for analysis and, above all, gastrointestinal stromal tumours (GIST) of uncertain behaviour. Sensitivity analysis was performed excluding certain histologies. Results: The analysis included 3404 cases in men and 3442 cases in women diagnosed in 2013. The age adjusted sarcoma incidence (European standard) was 7.4 (men) and 6.6 (women) per 100,000 inhabitants. About 70% of sarcomas were soft tissue sarcomas, about 22% GIST, and about 9% bone sarcomas. The most common histological subtypes besides GIST were fibrosarcomas (14%) and liposarcomas (12%) in men and complex mixed and stromal neoplasms (22%), non-uterine leiomysarcomas (10%) and fibrosarcomas (9%) in women. Considering the trend for the years of diagnosis 2004 to 2013, there was a significant increase in incidence for GIST while the incidence of soft tissue sarcomas (only men) as well as of bone sarcoma stayed constant over time. As to soft tissue sarcoma in women, the incidence stayed constant up to the year 2009 and significantly decreased afterwards. Conclusion: This study is the first detailed analysis of a German-wide population-based sarcoma incidence showing results comparable to the incidence detected in the RARECARE Project

Survival of adults with acute lymphoblastic leukemia in Germany and the United States.

BACKGROUND: Adulthood acute lymphoblastic leukemia (ALL) is a rare disease. In contrast to childhood ALL, survival for adults with ALL is poor. Recently, new protocols, including use of pediatric protocols in young adults, have improved survival in clinical trials. Here, we examine population level survival in Germany and the United States (US) to gain insight into the extent to which changes in clinical trials have translated into better survival on the population level. METHODS: Data were extracted from the Surveillance, Epidemiology, and End Results database in the US and 11 cancer registries in Germany. Patients age 15-69 diagnosed with ALL were included. Period analysis was used to estimate 5-year relative survival (RS). RESULTS: Overall 5-year RS was estimated at 43.4% for Germany and 35.5% for the US (p = 0.004), with a decrease in survival with increasing age. Survival was higher in Germany than the US for men (43.6% versus 37.7%, p = 0.002) but not for women (42.4% versus 40.3%, p\u3e0.1). Five-year RS estimates increased in Germany and the US between 2002 and 2006 by 11.8 and 7.3 percent units, respectively (p = 0.02 and 0.04, respectively). CONCLUSIONS: Survival for adults with ALL continues to be low compared with that for children, but a substantial increase in 5-year survival estimates was seen from 2002 to 2006 in both Germany and the US. The reasons for the survival differences between both countries require clarification

Survival of endometrial cancer patients in Germany in the early 21st century: a period analysis by age, histology, and stage

<p>Abstract</p> <p>Background</p> <p>Population-based studies on endometrial cancer providing survival estimates by age, histology, and stage have been sparse. We aimed to derive most up-to-date and detailed survival estimates for endometrial cancer patients in Germany.</p> <p>Methods</p> <p>We used a pooled German national dataset including data from 11 cancer registries covering a population of 33 million people. 30,906 patients diagnosed with endometrial cancer in 1997-2006 were included. Period analysis was performed to calculate 5-year relative survival (RS) in 2002-2006. Trends in survival between 2002 and 2006 were examined using model-based period analysis. Age-adjustment was performed using five age groups (15-44, 45-54, 55-64, 65-74, and 75+ years).</p> <p>Results</p> <p>Overall, age-adjusted 5-year relative survival in 2002-2006 was 81%. A moderate age gradient was observed, with 5-year RS decreasing from 90% in the age group 15-49 years to 75% in the age group 70+ years. Furthermore prognosis varied strongly by histologic subtypes and stage, with age-adjusted 5-year RS ranging from 43% (for sarcoma) to 94% (for squamous metaplasia), and reaching 91% for localized, 51% for regional, and 20% for distant stage. Except for age group 65-74 years, no significant improvement in survival was seen during the recent 5-year period under investigation.</p> <p>Conclusion</p> <p>In this comprehensive population-based survival analysis of patients with endometrial cancer from Germany, prognosis of endometrial cancer moderately varied by age, and strongly varied by histology and stage. While prognosis is rather good overall, further improvement in 5-year relative survival of endometrial cancer patients has been stagnating in the early 21^stcentury.</p

Krebs in Rheinland-Pfalz, 2015

Das Krebsregister Rheinland-Pfalz informiert in seinen jährlichen Berichten sowohl Fachleute als auch die interessierte Öffentlichkeit über das aktuelle Krebsgeschehen in unserem Land. Die Daten zu Neuerkrankungen, Sterblichkeit, Überlebensraten und der Zahl derer, die von einer bis zu zehn Jahre zurückliegenden Krebserkrankung betroffen sind, werden für epidemiologische Studien und gesundheitspolitische Entscheidungen genutzt. Der vorliegende Bericht für das Diagnosejahr 2012 bestätigt einige positive Tendenzen des Vorjahres. So sind Neuerkrankungen für die häufigsten Tumoren bei Frauen und Männern, Brust- , Darm- und Prostatakrebs, weiterhin leicht rückläufig. Ebenso ist bei der Sterblichkeit an den genannten Erkrankungen ein Rückgang zu verzeichnen..

Krebs in Rheinland-Pfalz, 2014

Das Krebsregister Rheinland-Pfalz ist seit fast 20 Jahren ein kompetenter Ansprechpartner für Medizin, Wissenschaft und Politik. Es liefert Informationen zu Neuerkrankungen, Sterblichkeit und Überlebensraten. Seit dem letzten Jahr veröffentlicht es auch die Zahl der Menschen, die von einer bis zu zehn Jahren zurückliegenden Krebsdiagnose betroffen sind. Diese Daten bieten wichtige und wertvolle Informationen und werden sowohl im Rahmen von epidemiologischen Studien als auch als Grundlage gesundheitspolitischer Entscheidungen genutzt. Mit dem vorliegenden Bericht für das Diagnosejahr 2011 zeichnet das Krebsregister in bewährter Weise ein umfassendes Bild des Krebsgeschehens in Rheinland-Pfalz. Erfreulich sind einige positive Tendenzen: Neuerkrankungen für die häufigsten Tumoren bei Frauen und Männern, Brust- und Prostatakrebs, sind weiterhin leicht rückläufig. Der Trend gilt sowohl hinsichtlich der absoluten Fallzahlen als auch hinsichtlich der altersstandardisierten Raten, die das steigende Durchschnittsalter der Bevölkerung berücksichtigen. Beim Brustkrebs gilt dies auch für die Sterblichkeit..

Trends in survival of chronic lymphocytic leukemia patients in Germany and the USA in the first decade of the twenty-first century

Abstract 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