Improvements in Cancer Survival Better for Younger Patients


Survival has improved for patients with cancers of the colon or rectum, breast, prostate, lung and liver, and those improvements were better among younger patients, according to a study published online by JAMA Oncology.

Cancer is a leading cause of death in the United States and many other countries although progress has been made during the past few decades with significant advances in surgery, radiotherapy, chemotherapy and targeted therapies. Those improvements, along with better cancer screening and diagnosis, have led to steady improvements in survival, according to the study background.

Wei Zheng, M.D., Ph.D., of the Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, Tenn., and coauthors analyzed cancer follow-up data from 1990 to 2010 from more than 1 million patients. The patients were diagnosed with cancer of the colon or rectum, breast, prostate, lung, liver, pancreas or ovary from 1990 to 2009 and were included in registries of the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) program.

Study results indicate that the improvement in survival was substantially greater in younger than elderly patients. For example, patients 50 to 64 years old diagnosed with colon and rectum cancer from 2005 to 2009 had a 43 percent lower risk of death, compared with the same age groups diagnosed this cancer from 1990 to 1994. The reduction in risk of death for patients with breast, liver, and prostate cancer was 52 percent, 39 percent, and 68 percent, respectively from 1990 – 1994 to 2005 – 2009, for this age group of patients.

However, for older patients (75 to 85 years old) the risk of death was not reduced as much with a 12 percent lower risk for patients with cancer of the colon, rectum or breast, 24 percent lower for patients with liver cancer and 35 percent lower for patients with prostate cancer, according to the results.

According to the study results, improvement in cancer survival over the past 20 years has been slower in older patients. The authors note that this age-related gap was most pronounced for cancers with the largest diagnosis and treatment advances during the study period, including colorectal, breast and prostate cancers. Authors saw a widening gap in survival by race only in ovarian cancer. They also found that African American prostate cancer patients had larger improvements in survival over time than did white patients.

“Our data suggest that age- and race-related differences in survival improvements over time may be explained, at last in part, by differences in cancer care across these subpopulations,” the study concludes.

(JAMA Oncol. Published online February 19, 2015. doi:10.1001/jamaoncol.2014.161.