AIMS: Global survival studies in cancer have generally shown favourable development, but studies over extended periods on populations for which medical care is essentially free of charge are lacking. METHODS: We analyse relative 1- and 5-year survival in all solid cancers in Denmark, Finland, Norway and Sweden through a 50-year period (1970-2019) using the NORDCAN database. RESULTS: The most recent survival results showed three types of patterns. Cancers of very good survival (5-year survival ∼90%) included common cancers of the breast and prostate, as well as melanoma. The second pattern, which included the largest number of cancers, showed 1-year survival of over 80% and a drop of 10-20 % units in 5-year survival. The third group consisted of eight fatal cancers, sharing poor 5-year survival (around 20%). The 50-year improvement in 1-year survival was largest (30-50 % units) in kidney, brain, gallbladder and liver cancers, and (∼30%) in colon, small intestinal, lung, pleural, pancreas and ovarian cancers. Improvements in 5-year survival were highest (40-50 % units) in prostate and kidney cancers but remained at 10-20 % units for the eight fatal cancers. Survival showed significant sex preferences for a few cancers. CONCLUSIONS: The analysis over a half-century confirms the progress in 'real-world' cancer control, and in 84% of patients 5-year survival was >60%. Metastases remain a challenge, placing the emphasis on early detection before metastasis occurs. Novel therapies, such as immunotherapy which has curative potential even against metastatic disease, are needed.

Biomedical Center Faculty of Medicine and Biomedical Center in Pilsen Charles University Prague 30605 Pilsen Czech Republic

Biomedical Center Faculty of Medicine and Biomedical Center in Pilsen Charles University Prague 30605 Pilsen Czech Republic; Division of Cancer Epidemiology German Cancer Research Center Im Neuenheimer Feld 580 D 69120 Heidelberg Germany

Cancer Gene Therapy Group Translational Immunology Research Program University of Helsinki Finland; Comprehensive Cancer Center Helsinki University Hospital Helsinki Finland

Hopp Children's Cancer Center Heidelberg Germany

Comment In

Eur J Cancer. 2023 Apr;183:190. doi: 10.1016/j.ejca.2023.01.012. PubMed

Comment In

Eur J Cancer. 2023 Apr;183:188-189. doi: 10.1016/j.ejca.2022.12.033. PubMed

References provided by Crossref.org

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