Breast cancer-specific survival by clinical subtype after 7 years follow-up of young and elderly women in a nationwide cohort

Age and tumor subtype are prognostic factors for breast cancer survival, but it is unclear which matters the most. We used population‐based data to address this question. We identified 21,384 women diagnosed with breast cancer at ages 20–89 between 2005 and 2015 in the Cancer Registry of Norway. Subtype was defined using estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor 2 (HER2) status as luminal A‐like (ER+PR+HER2‐), luminal B‐like HER2‐negative (ER+PR‐HER2‐), luminal B‐like HER2‐positive (ER+PR+/‐HER2+), HER2‐positive (ER‐PR‐HER2+) and triple‐negative (TNBC) (ER‐PR‐HER2‐). Cox regression estimated hazard ratios (HR) for breast cancer‐specific 7‐year survival by age and subtype, while adjusting for year, grade, TNM stage and treatment. Young women more often had HER2‐positive and TNBC tumors, while elderly women (70–89) more often had luminal A‐like tumors. Compared to age 50–59, young women had doubled breast cancer‐specific mortality rate (HR = 2.26, 95% CI 1.81–2.82), while elderly had two to five times higher mortality rate (70–79: HR = 2.25, 1.87–2.71; 80–89: HR = 5.19, 4.21–6.41). After adjustments, the association was non‐significant among young women but remained high among elderly. Young age was associated with increased breast cancer‐specific mortality among luminal A‐like subtype, while old age was associated with increased mortality in all subtypes. Age and subtype were strong independent prognostic factors. The elderly always did worse, also after adjustment for subtype. Tumor‐associated factors (subtype, grade and stage) largely explained the higher breast cancer‐specific mortality among young. Future studies should address why luminal A‐like subtype is associated with a higher mortality rate in young women

Stage‑specific survival has improved for young breast cancer patients since 2000: but not equally

Purpose The stage-specific survival of young breast cancer patients has improved, likely due to diagnostic and treatment advances. We addressed whether survival improvements have reached all socioeconomic groups in a country with universal health care and national treatment guidelines. Methods Using Norwegian registry data, we assessed stage-specific breast cancer survival by education and income level of 7501 patients (2317 localized, 4457 regional, 233 distant and 494 unknown stage) aged 30–48 years at diagnosis during 2000–2015. Using flexible parametric models and national life tables, we compared excess mortality up to 12 years from diagnosis and 5-year relative survival trends, by education and income as measures of socioeconomic status (SES). Results Throughout 2000–2015, regional and distant stage 5-year relative survival improved steadily for patients with high education and high income (high SES), but not for patients with low education and low income (low SES). Regional stage 5-year relative survival improved from 85 to 94% for high SES patients (9% change; 95% confidence interval: 6, 13%), but remained at 84% for low SES patients (0% change; − 12, 12%). Distant stage 5-year relative survival improved from 22 to 58% for high SES patients (36% change; 24, 49%), but remained at 11% for low SES patients (0% change; − 19, 19%). Conclusions Regional and distant stage breast cancer survival has improved markedly for high SES patients, but there has been little survival gain for low SES patients. Socioeconomic status matters for the stage-specific survival of young breast cancer patients, even with universal health care

Stable glioma incidence and increased patient survival over the past two decades in Norway: a nationwide registry-based cohort study

Background: Surveillance of incidence and survival of central nervous system tumors is essential to monitor disease burden and epidemiological changes, and to allocate health care resources. Here, we describe glioma incidence and survival trends by histopathology group, age, and sex in the Norwegian population. Material and methods: We included patients with a histologically verified glioma reported to the Cancer Registry of Norway from 2002 to 2021 (N = 7,048). Population size and expected mortality were obtained from Statistics Norway. Cases were followed from diagnosis until death, emigration, or 31 December 2022, whichever came first. We calculated age-standardized incidence rates (ASIR) per 100,000 person-years and age-standardized relative survival (RS). Results: The ASIR for histologically verified gliomas was 7.4 (95% CI: 7.3–7.6) and was higher for males (8.8; 95% CI: 8.5–9.1) than females (6.1; 95% CI: 5.9–6.4). Overall incidence was stable over time. Glioblastoma was the most frequent tumor entity (ASIR = 4.2; 95% CI: 4.1–4.4). Overall, glioma patients had a 1-year RS of 63.6% (95% CI: 62.5–64.8%), and a 5-year RS of 32.8% (95% CI: 31.6–33.9%). Females had slightly better survival than males. For most entities, 1- and 5-year RS improved over time (5-year RS for all gliomas 29.0% (2006) and 33.1% (2021), p Interpretation: The incidence of gliomas has been stable while patient survival has increased over the past 20 years in Norway. As gliomas represent a heterogeneous group of primary CNS tumors, regular reporting from cancer registries at the histopathology group level is important to monitor disease burden and allocate health care resources in a population