The EUROCARE-6 Publication Plan is structured in two different phases:
- Phase-1 – Higher priority
- Phase-2 – Additional papers
Phase 1 papers
| Topic |
Objectives |
|
| 1 | Adult hematological CML |
Paper comparing CML survival results in Randomised Clinical Trials and population-based cancer registries data in Europe by country. “Clear improvement in real world CML survival: a comparison with randomised controlled trials”, Front Oncol. 2022 Jul 14;12:892684. doi: 10.3389/fonc.2022.892684. |
| 2 | Childhood cancers |
We present new data showing progress in survival for CC cases diagnosed during the period 2000-2013 and geographical differences for the most recent period of diagnosis. In addition, we assess for the first time long-term survival (up to 15 years) and cure fraction (CF) for paediatric cancers in the European population. “Long-term survival and cure fraction estimates for childhood cancer in Europe (EUROCARE-6): results from a populationbased study”. Lancet Oncol. 2022 Dec;23(12):1525-1536. https://doi.org/10.1016/S1470-2045(22)00637-4 |
| 3 | Cancer prevalence in Europe | Objective: to provide a comprehensive overview of country-specific cancer prevalence in Europe 2020 by gender, age and cancer site. Complete and by disease duration (2,5,10,20, and >20) prevalence is presented. Time trends 2010-2020 are discussed in terms of main determinants (population ageing, incidence and survival) |
| 4 | Empirical vs model-based methods to estimate complete prevalence | Complete prevalence estimates are not routinely available at the population level in most European countries. Prevalence completeness indexes based on retrospective modelling of incidence and survival are challenging to apply in many contexts. Long term time series of observed prevalence are increasingly available and can be used to derive empirical completeness indexes. The paper will compare and assess pros and cons of applying empirical versus model-based approaches by using the EUROCARE-6 dataset. |
| 5 | Adult solid cancers | Objectives: to present long term survival estimates (period analysis 2010-2014 up to 10 years) for main cancer entities (revised list to increase comparability and to cover clinically relevant entities based on morphology). Estimates by: Country (and area), age, gender, relevance of TNHE (Total National Health Expenditure) to explain geographical differences. Survival time trends at 5y,10y with model-based projections to 2020 in Europe and by area |
| 6 | Adult haematological cancers (Lymphoid) | Lymphoid malignancies: 5-year and long term survival estimates (10- or 15-year) for main lymphoid, defined according to the updated EUROCARE-6 list of HM grouping. Survival will be estimated by country, age, gender; changes in survival over time will also be analysed. The role of Total National Health Expenditure (TNHE) to explain geographical differences will be examined. |
| 7 | Adult haematological cancers (Myeloid) | Myeloid malignancies: 5-year and long term survival estimates (10- or 15-year) for main myeloid malignancies, defined according to the updated EUROCARE-6 list of HM grouping. Survival will be estimated by country, age, gender; changes in survival over time will also be analysed.The role of Total National Health Expenditure (TNHE) to explain geographical differences will be examined. |
| 8 | Adolescents and young adults (AYA) with cancer |
Objectives: to compare survival differences across geographic areas and to report on survival trends for AYA. The EUROCARE 5 paper compared survival and survival trends between AYA and children and between AYA and adults (+40 years) thus there is a need now to assess also the differences across geographic areas considering that AYA-dedicated programmes are increasingly available in different MS. |
| 9 | Interregional survival differences between rare and common cancers |
Objectives: to assess whether survival differences across European (EU) regions for rare cancers are higher than for common cancers. Because rare cancers require specific expertise and clinical networking, the hypothesis is that health care organisation may have a higher impact on the survival for rare cancers compared to the impact it has on common ones. Survival of major families of rare cancers will be estimated for the different EU regions and the differences across areas will be compared to the differences observed for major common cancers across the EU regions |
| 10 | Head and neck cancers |
Sublocalisation and morphology to interpret regional survival differences. Test whether availability of stage increases with respect to past EU-5 analyses. |
| 11 | Survival differences by gender |
With a few exceptions, cancer survival is better for women than men. Objective: to investigate the influence of life expectancy, age and morphology (RARECAREnet entities) on the gender survival differences. The impact of stage will be analysed depending on its availability |
Phase 2 papers
| Topic | Objectives | |
| 1 | Cured cancer survivors |
Survival models taking into account the possibility of complete remission for cancer patients (so called cure-mixture models) are applied to the EUROCARE-6 dataset to derive informative indicators on cancer survivorship. Companion paper with the one on cancer prevalence in Europe, it combines prevalence by duration and model-based survival estimates (time to cure) to derive numbers and proportions of cured prevalent cases |
| 2 | Methodological comparisons of statistical methods: net vs. relative survival |
Objective: Estimating net vs. relative survival in elderly patients. The quality and completeness of life tables data have a varying impact on the estimation of cancer survival in elderly patients depending on the method used (net vs. relative). The EUROCARE-6 dataset allows to assess the impact of the two methods in a wide variety of neoplasms and populations. |
| 3 | Excess risk of dying of other causes of cured cancer patients by age and country |
Objectives: Estimate the excess risk of dying for other causes of cured cancer patients by country and by age and its impact on cure proportion and relative survival estimates. We will use the relative survival mixture model with additional parameters expressing the extra non-cancer death risk of patients [Botta et. al TJ 2019] |
| 4 | HPV related cancers |
Objective: to investigate the incidence and survival patterns of HNSCCs arising from sites, potentially related or unrelated to HPV and of HPV-related male and female genital HPV-related cancers (anal, cervical, vulvar, vaginal, penile) to provide clues on possible growing impact of HPV in the epidemiology of these cancers; on possible differences between males and females and across sites. Incidence and survival and incidence and survival trends will be analysed by gender, age groups, geographic areas or countries. |
| 5 | Breast cancer |
Five-year survival now approximates 100%, but relapses can occur also in the long term, and re-analyses of past clinical trials evidenced a continuing survival decrease even after 20-30 years. Accordingly, proportion cured is hardly estimable by mixture models. Objective. To investigate:
|
| 6 | Skin Melanoma |
In EUROCARE Skin Melanoma survival ranks among the highest figures, with a constant survival increase overtime. The overall good survival reflects the high proportion of lesion diagnosed in early stage, while the new immunotherapies are applied for stage III-IV.
|
| 7 | Colorectal cancer |
Aims: to estimate 5- and long term survival (10-, 15-year) by subsite, stage (localised, regional, metastatic), country, age, gender. The role of Total National Health Expenditure (TNHE) to explain geographical differences will be examined. Focus on exploring overtime changes in survival of patients with metastatic disease, possibly related to new treatments |
| 8 | Association of cancer survival and macroeconomic indicators (GDP, TNHE) |
Past EUROCARE analyses evidenced a direct association between the single countries’ total expenditure on health and all-cancers survival, and this relationship may partially explain the differences in survival across the countries. Objective: to explore variations with respect to past years, considering the aging of the European population and the availability of expensive new anticancer treatments (different access to these may potentially increase survival inequalities) |
| 9 | Sarcomas | Objective: to provide incidence and survival for sarcomas regardless of primary site. Routine tabulations of soft tissue sarcoma (STS) are not morphology-specific. Further, the lack of inclusion of sarcomas arising in all organs in most standard evaluations underestimates the true rates. This was reported by Toro et al in 2006 based on the SEER DB. In this paper in addition to estimating the underestimation of STS in Europe, the paper will assess the impact on survival. Furthermore, sarcomas will be divided in major groups (e.g. leiomyosarcoma, liposarcoma, fibrosarcoma etc). The sarcoma grouping has been discussed with sarcoma experts and will be used, instead of the C49 code, for comparing incidence and survival across geographic areas |
| 10 | Neuroendocrine tumors |
Objectives: to describe NET incidence and survival differences across geographic areas; to describe NET incidence and survival trends. The RARECAREnet list will be used to identify NET which will allow also to describe NET in different sites. The availability of data on stage will be assessed to consider studying major prognostic factors (i.e. stage, behaviour, age, sex, site |
| 11 | Survival of patients with metastatic cancer at diagnosis |
The cure of patients with metastatic disease is a relevant part of the whole oncological care. It is commonly perceived that survival is increasing also for patients with advanced tumour stage, and chronicisation of metastatic disease is presently pursued for several cancers. For some tumours (eg cutaneous melanoma) innovative therapies and related clinical research are more suitable for advanced than for localised stages. Patients with metastases at diagnosis have a better prognosis than that of patients developing metastases after first therapy cycle. A descriptive analysis of these cases can be a useful baseline for future research in the field |
| 12 | Bayesian approach for rare cancer survival |
Making use of EUROCARE 6 data in Europe, the aim is to assess whether the Bayesian approach could better estimate the country specific RS for rare cancers as we suspecting that scant data could affect the reliability of statistical analysis. In the line of the research and taking into account country-specific variability, a Bayesian relative survival model will be applied. We aim to show statistics such as annual excess hazard ratios (EHR) the 5-year relative survival; an indicator which rank the 5-year relative survival random effects and calculate the ratio of two units at opposite extremes (say 95% vs 5% percentile) We will investigate the methods only for a selection of entities defined using the Tier2 of the RARECARENet list. We will choose different combination of survival and incidence to better address the context in which the Bayesian approach could be beneficial |
| 13 | Unknown primary site |
Never studied in EUROCARE, despite its relatively high frequency. A part of these entities could reflect an incomplete registration |
| 14 | Incidence and survival of patients with retinoblastoma in Europe from 2000 to 2013 |
The aims of the study are:
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Eurocare
EUROCARE-6