Sammanfattning
INTRODUCTION: Improved one- and three-year survival was seen after the initiation of the National Cancer Control Plan in year 2000. Short follow-up and lack of five-year survival called for an update with more data.
MATERIAL AND METHODS: All cancers from the period 1995-2006 were studied in four cohorts of three-year incident cases from 1995 to 2006 followed to death or to the end of 2008. Age-standardised one-, three- and five-year relative survival and excess mortality were computed.
RESULTS: The improved one- and three-year survival was confirmed. The five-year survival increased from 38% in 1995-1997 to 48% in 2004-2006 for men, but a five percentage point increase is owed to the incidence increase of prostate cancer without changed mortality. In women the increase in survival was from 50% to 55%, i.e. a five percentage point increase. Improved five-year survival was seen for cancers of the oesophagus, colon and rectum, lung, and for haematological cancers; for women, also pancreas, ovary, brain and melanoma, and for men prostate cancer survival improved.
DISCUSSION: The improved cancer survival was confirmed and it was also observed at the five-year follow-up. The excess mortality is largely present during the first year of follow-up and is a useful indicator of whether changes in diagnosis and care lead to the desired outcome. Overall survival should be interpreted in the context of major changes in recorded incidence due to the introduction of new diagnostic tools and biomarkers such as prostate-specific antigen, as such measures do not necessarily change mortality. Whether cancer care in Denmark has reached the highest international standard remains to be proven by survival comparison to countries with adequate data for a comparative analysis.