Japanese Journal of Clinical Oncology

doi: 10.1093/jjco/hyaf114pmid: 41859890

BackgroundBreast, cervical and ovarian cancers significantly affect young and middle-aged women, both physically and socially. However, relevant comprehensive stratified analyses are limited. Using Japanese data from CONCORD-3, a global cancer survival surveillance program, we analyzed long-term survival trends.MethodsData from 16 Japanese population-based cancer registries were analyzed for women diagnosed aged 15–99 years during 2000–2014 with a tumor originating in the breast, cervix uteri or ovaries. Follow-up was extended to five years post-diagnosis or until December 31st, 2014. In situ tumors and death-certificate-only registrations were excluded. Five-year net survival was estimated with the Pohar Perme estimator by calendar period of diagnosis, morphology and stage, and age-standardized with International Cancer Survival Standard weights.ResultsDuring 2000–2014, 5-year net survival improved for breast cancer from 85.9% (95% CI, 85.2–86.6%) to 89.4% (88.9–89.9%), for cervical cancer from 67.5% (66.3–68.7%) to 71.4% (70.4–72.3%), and for ovarian cancer from 35.5% (33.8–37.2%) to 46.3% (44.9–47.7%). Five-year survival for tumors diagnosed at a localized stage remained consistently high (>98% for breast cancer and > 90% for cervical cancer). Ovarian cancer survival varied greatly according to morphology.ConclusionsFive-year net survival for women with cancers of the breast, cervix, and ovary) in Japan improved during 2000–2014, and remained at a globally high level throughout this period. These gains are probably attributable to earlier detection of breast and cervical cancers and advances in multimodal treatment for all cancers. Survival for distant-stage cervical and ovarian cancers remains a challenge, underscoring the need for enhanced screening and treatment strategies.

doi: 10.1093/jjco/hyaf165pmid: 41859878

BackgroundBrain tumors are a serious health issue, and survival is an effective indicator of how the healthcare system manages them. We examined net survival trends for patients diagnosed with a primary brain tumor during 2000–2014 in Japan, using data from 16 regional population-based cancer registries participating in the CONCORD-3 study.MethodsWe included patients aged 15–99 years, with follow-up completed either 5 years after diagnosis or up to 31 December, 2014. We estimated 5-year net survival by age group and morphological subtype using the Pohar Perme estimator, and age-standardized with International Cancer Survival Standard weights.ResultsFive-year net survival for brain tumors increased from 27.9% for patients diagnosed during 2000–2004 to 46.3% in 2010–2014. During 2010–2014, 5-year net survival for astrocytic tumors was 22.3%, but ~90% for neuronal and mixed neuro-glial tumors, germ cell tumors, and other specified tumors. Five-year net survival reached 62.1% for oligodendroglial and oligoastrocytic tumors.ConclusionsFive-year net survival for brain tumors in Japan improved during 2000–2014, with remarkable variations by morphologic type. Survival improved for all age groups, and particularly for younger patients, highlighting the need for enhanced survivorship care. Japan’s focus on comprehensive data collection and supportive care for longer-term survivors remains key for further progress. When comparedinternationally, Japan’s gains sit at the higher end of reported survival ranges, underscoring how robust registry infrastructure and equitable access to care could inform strategies for brain tumor care.

doi: 10.1093/jjco/hyaf203pmid: 41859880

BackgroundIn 2018, CONCORD-3 updated long-term surveillance of cancer survival trends worldwide. In this monograph, we conducted further analyses and examined trends in net survival using the Japanese data during 2000–14.MethodsSixteen population-based cancer registries in Japan contributed data to CONCORD-3 with anonymized individual records on 2 237 861 patients diagnosed with one of 15 adult cancers (15–99 years), and brain tumors and hematological malignancies in children (0–14 years). Five-year net survival was estimated with the Pohar Perme estimator and age-standardized with International Cancer Survival Standard weights. We estimated survival for three calendar periods, by age group, sex, anatomic site or morphology, and by stage at diagnosis.ResultsFive-year net survival improved between 2000–04 and 2010–14 for several cancers, including brain tumors (27.9%–46.3%), ovarian cancer (35.5%–46.3%), stomach cancer (50.5%–60.3%), lymphoid malignancies (47.5%–57.3%), myeloid malignancies (24.8%–33.3%), and esophageal cancer (27.7%–36.0%). Breast cancer, childhood lymphoma, and prostate cancer showed consistently high or improving survival (85.9%–93.0%). In contrast, survival for melanoma remained unchanged. Net survival was low for pancreatic cancer (6.9%–8.3%). Among selected countries, survival was higher in Japan for esophageal (36.0%), liver (30.1%), and lung cancers (32.9%). Survival for melanoma, hematologic malignancies, and childhood cancers was lower in Japan than in Western countries.ConclusionsNet survival in Japan improved substantially for several cancers, but survival for pancreatic cancer remained low. International collaboration is crucial to accelerate the development of effective cancer control strategies.

doi: 10.1093/jjco/hyaf021pmid: 41859886

BackgroundWe aimed at assessing 15-year trends in 5-year net survival for men diagnosed with prostate cancer during 2000–2014 and registered by 16 Japanese regional population-based cancer registries included in the CONCORD-3 study.MethodsWe included data on adult men (15–99 years) diagnosed with prostate cancer during 2000–2014 and followed-up to 31 December 2014. We grouped patients into five age groups (15–54, 55–64, 65–74, 75–84, and 85–99 years) and four morphology groups according to the ICD-O-3 classification (epithelial, neuroendocrine, other specified morphologies, and malignant neoplasm, not otherwise specified). We grouped patients by stage at diagnosis into localized, regional, and advanced disease. We estimated 5-year net survival by age group, morphological subtype and stage using the Pohar Perme estimator, correcting for background mortality. All-ages estimates were standardized with the International Cancer Survival Standard weights.ResultsAge-standardized 5-year net survival increased over time, from 85.9% in 2000–2004 to 93.0% in 2010–2014. Survival was higher than 90% for epithelial tumors, and for localized and regional disease. Five-year net survival for patients with distant metastasis was poor at 47.3% (95% CI. 39.4–55.1%) during 2010–2014.ConclusionsThe improvement in survival for prostate cancer may be due to the high and increasing proportion of patients with localized disease and with epithelial tumors, for which 5-year survival approaches 100%. A comprehensive analysis of long-term survival over a longer period of time would be essential to investigate further the factors contributing to the increasing trend in survival.

doi: 10.1093/jjco/hyaf130pmid: 41859881

BackgroundWe estimated net survival trends for patients with stomach cancer registered in 16 regional population-based cancer registries in Japan that participated in the CONCORD-3 study.MethodsWe included data on adults (15–99 years) diagnosed with stomach cancer between 2000 and 2014 and followed-up for their vital status until 31 December 2014. We grouped cancer patients into three anatomic groups (proximal, distal, and overlapping regions and stomach cancer, not otherwise specified) with the International Classification of Disease for Oncology, Third edition topography codes. We estimated 5-year net survival with the Pohar Perme estimator for three calendar periods (2000–2004, 2005–2009, 2010–2014), by age group (15–44, 45–54, 55–64, 65–74, and 75–99 years), anatomic group, and stage at diagnosis. All-ages survival estimates were age-standardized using the International Cancer Survival Standard weights.ResultsFive-year net survival improved over time, from 50.5% in 2000–2004 to 57.6% and 60.3% in 2005–2009 and 2010–2014, respectively. Survival for patients with proximal stomach cancer improved from 49.7% in 2000–2004 to 53.5% 2005–2009 and plateaued to 53.1% in 2010–2014. Survival for distal stomach cancer increased from 64.8% in 2000–2004 to 67.6% and 68.2% in 2005–2009 and 2010–2014, respectively. In 2010–2014, 5-year net survival for patients with localized disease (94.8%) was much higher than survival for regional (53.7%) and distant (6.4%) disease.ConclusionsFive-year net survival for stomach cancer improved noticeably during 2000–2014. This improvement might be due to advances in systemic chemotherapy. Although survival in distal stomach cancer had improved, no such improvement was seen in proximal stomach cancer. Standardizing esophagogastric junction cancer treatment may improve its outcomes and contribute to better survival in proximal stomach cancer overall. Scientific evaluation of screening programs is also needed to enhance the efficacy of stomach cancer control initiatives in Japan.

doi: 10.1093/jjco/hyaf159pmid: 41859887

BackgroundWe assessed trends and international comparisons of net survival for patients with esophageal cancer using data from Japanese regional population-based cancer registries participating in the CONCORD-3 study.MethodsThe analysis included 63 631 patients aged 15–99 years diagnosed with esophageal cancer during 2000–14, with follow-up completed either 5 years after diagnosis or by 31 December 2014. Five-year net survival was estimated using the Pohar Perme estimator, by sex, anatomical subsite, calendar period of diagnosis, and extent of disease. Survival estimates were age-standardized using the International Cancer Survival Standard weights.ResultsDuring 2000–14, the age-standardized 5-year net survival for esophageal cancer improved from 27.7% (95% CI: 26.4%–29.0%) in 2000–04 to 36.0% (34.8%–37.3%) in 2010–14. This increase corresponded with a higher proportion of patients with localized disease. In 2010–14, survival was notably higher among women, at 42.6% (39.7%–45.5%), than among men, at 36.0% (34.8%–37.3%), and among patients aged 45–54 years at 39.7% (35.5%–44.0%), 55–64 years at 38.9% (37.0%–40.8%), and 65–74 years at 39.4% (37.8%–41.1%). Survival remained lower among the oldest patients, aged 75–99 years, at 29.0% (27.0%–31.0%). By anatomical subsite, survival was highest for the “abdominal, or lower third” segment of the esophagus, followed by the “thoracic, or middle third,” while the “cervical, or upper third” showed the lowest survival.ConclusionSurvival for esophageal cancer in Japan has improved, largely attributable to early detection. Variations by sex, age, and subsite were evident. Detailed analyses using population-based registry data will provide evidence to aid the development of effective cancer control strategies.

doi: 10.1093/jjco/hyaf019pmid: 41859879

BackgroundWe assessed survival trends and international comparisons of patients with cutaneous melanoma from Japanese regional population-based cancer registries participating in the CONCORD-3 study.MethodsSubjects were patients aged 15–99 years diagnosed with cutaneous melanoma during 2000–2014, with follow-up completed either 5 years after diagnosis or through 31 December 2014. Five-year net survival was estimated by morphological type and calendar period of diagnosis, using the Pohar Perme estimator, and age-standardized using the International Cancer Survival Standard weights.ResultsAge-standardized 5-year net survival for cutaneous melanoma remained stable among 4018 eligible subjects as follows: 68.9% during 2000–2004 (862 patients), 68.3% during 2005–2009 (1819 patients), and 69.0% during 2010–2014 (1337 patients). Five-year net survival in 2010–2014 was highest for lentigo maligna melanoma (89.0%, 64 patients, not age-standardized), followed by superficial spreading melanoma (88.4%, 91 patients) and acral lentiginous melanoma (83.7%, 163 patients, not age-standardized). However, survival for malignant melanoma not otherwise specified (68.0%, 1120 patients) and nodular melanoma was lower (56.5%, 58 patients). Five-year net survival for all types of cutaneous melanoma combined during 2010–2014 was lower in Japan (69.0%) and South Korea (59.9%) than in Australia, France, Germany, Italy, UK, Canada and the US (>85.7%).ConclusionsInternational disparities in net survival for cutaneous melanoma may be attributable to differences in the distribution of histological sub-types of melanoma and to variation in the availability and utilization of treatment modalities. Continuous monitoring of cancer survival is crucial for developing effective cancer control strategies.

doi: 10.1093/jjco/hyaf141pmid: 41859883

Lung cancer is the leading cause of cancer death worldwide. To aid the development of lung cancer control strategies, we analyzed trends in lung cancer survival using data from 16 population-based cancer registries in Japan that participated in the CONCORD-3 study. We included patients aged 15–99 years diagnosed with lung cancer between 2000 and 2014 and followed up until 31 December 2014. A total of 5-year net survival was estimated using the Pohar Perme estimator, stratified by calendar period, age group, sex, histological subtype, and stage. All-ages estimates were standardized with the International Cancer Survival Standard weights. Age-standardized 5-year net survival in 339 277 patients with lung cancer increased slightly over time, from 29.3% (95% confidence intervals 28.1%–30.5%) for patients diagnosed during 2000–2004 to 32.9% (32.3%–33.4%) in 2010–2014. Five-year net survival improved particularly for young patients (15–44 years), for women diagnosed with non-small cell lung cancer and with localized disease. We observed limited or no survival improvement for patients diagnosed with small-cell lung cancer or with distant disease. In Japan, 5-year net survival for patients with lung cancer improved slightly over the 15 years 2000–2014, but no improvement was observed for patients with small-cell lung cancer or with distant disease. Continued surveillance of cancer survival is essential to guide cancer control efforts and further improve treatment outcomes.

doi: 10.1093/jjco/hyaf145pmid: 41859889

BackgroundWe aimed at estimating trends in 5-year net survival for myeloid and lymphoid malignancies, by age group and morphological subtype, using data on patients diagnosed during 2000–2014 and registered by 16 Japanese population-based cancer registries participating in the CONCORD-3 study.MethodsWe analyzed data on adult patients (15–99 years) diagnosed with a myeloid or lymphoid malignancy during 2000–2014 and followed up to December 31, 2014. We estimated 5-year net survival by age group and morphological subtype with the Pohar Perme estimator, and age-standardized the estimates using International Cancer Survival Standard weights.ResultsSignificant improvements were observed in five-year net survival for myeloid malignancies among patients aged 15–44 years (from 57.3% in 2000–2004 to 72.3% in 2010–2014) and 45–54 years (from 41.9% to 61.3% over the same period). For lymphoid malignancies, 5-year net survival improved for all ages, but the improvement was less pronounced for older patients. Five-year net survival improved by 10% or more for myeloproliferative neoplasms, classic Hodgkin’s lymphoma, and follicular lymphoma. Moderate improvement was observed for diffuse B-cell lymphoma and acute myeloid leukemia.ConclusionsFive-year net survival for patients with hematological malignancies improved throughout 2000–2014 in Japan. The improvement was more pronounced in younger than older patients. Continuous and detailed monitoring of cancer survival trends is crucial for devising effective control strategies for hematological malignancies. [221/250 words].