BACKGROUND: Gastric cancer (GC) and esophageal cancer (EC) are among the most fatal cancers and improving survival in them is a major clinical challenge. Nordic cancer data were recently released up to year 2019. These data are relevant for long-term survival analysis as they originate from high-quality national cancer registries from countries with practically free access to health care, thus documenting 'real-world' experience for entire populations. PATIENTS/METHODS: Data were obtained for Danish (DK), Finnish (FI), Norwegian (NO), and Swedish (SE) patients from the NORDCAN database from years 1970 through 2019. Relative 1- and 5-year survival were analyzed, and additionally the difference between 1- and 5-year survival was calculated as a measure of trends between years 1 and 5 after diagnosis. RESULTS: Relative 1-year survival for Nordic men and women in GC was 30% in period 1970-74 and it increased close to 60%. Early 5-year survival ranged between 10 and 15% and the last figures were over 30% for all women and NO men while survival for other men remain below 30%. Survival in EC was below that in GC, and it reached over 50% for 1-year survival only for NO patients; 5-year survival reached over 20% only for NO women. For both cancers, the difference between 1- and 5-year survival increased with time. Survival was worst among old patients. CONCLUSION: GC and EC survival improved over the 50-year period but the increase in 5-year survival was entirely explained by gains in 1-year survival, which improved at an accelerated pace in EC. The likely reasons for improvements are changes in diagnosis, treatment, and care. The challenges are to push survival past year 1 with attention to old patients. These cancers have a potential for primary prevention through the avoidance of risk factors.

Biomedical Center Faculty of Medicine Charles University Pilsen Czech Republic

Cancer Gene Therapy Group Translational Immunology Research Program University of Helsinki Helsinki Finland

Comprehensive Cancer Center Helsinki University Hospital Helsinki Finland

Department of Urology Helsinki University Hospital and University of Helsinki Helsinki Finland

Division of Cancer Epidemiology German Cancer Research Center Heidelberg Germany

Division of Pediatric Neurooncology German Cancer Research Center Heidelberg Germany

Hopp Children's Cancer Center Heidelberg Germany

Institute of Pathological Physiology Faculty of Medicine in Pilsen Charles University Pilsen Czech Republic

Zobrazit více v PubMed

Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. Lancet. 2020;396(10251):635‐648. PubMed

Arnold M, Abnet CC, Neale RE, et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology. 2020;159(1):335‐49.e15. PubMed PMC

Lu L, Mullins CS, Schafmayer C, Zeißig S, Linnebacher M. A global assessment of recent trends in gastrointestinal cancer and lifestyle‐associated risk factors. Cancer Commun (Lond). 2021;41(11):1137‐1151. PubMed PMC

Hemminki K, Sundquist K, Sundquist J, Försti A, Hemminki A, Li X. Familial risks and proportions describing population landscape of familial cancer. Cancer. 2021;13(17). PubMed PMC

Hemminki K, Sundquist K, Sundquist J, et al. Familial risks for liver, gallbladder and bile duct cancers and for their risk factors in Sweden, a low‐incidence country. Cancer. 2022;14(8). PubMed PMC

Arnold M, Morgan E, Bardot A, et al. International variation in oesophageal and gastric cancer survival 2012‐2014: differences by histological subtype and stage at diagnosis (an ICBP SURVMARK‐2 population‐based study). Gut. 2021;71:1532‐1543. PubMed

Riihimäki M, Thomsen H, Sundquist K, Sundquist J, Hemminki K. Clinical landscape of cancer metastases. Cancer Med. 2018;7(11):5534‐5542. PubMed PMC

Allum W, Lordick F, Alsina M, et al. ECCO essential requirements for quality cancer care: Oesophageal and gastric cancer. Crit Rev Oncol Hematol. 2018;122:179‐193. PubMed

Arnold M, Rutherford MJ, Bardot A, et al. Progress in cancer survival, mortality, and incidence in seven high‐income countries 1995‐2014 (ICBP SURVMARK‐2): a population‐based study. Lancet Oncol. 2019;20(11):1493‐1505. PubMed PMC

Hemminki J, Försti A, Hemminki A, Hemminki K. Survival trends in solid cancers in the Nordic countries through 50 years. Eur J Cancer. 2022;175:77‐85. PubMed

Tuo JY, Bi JH, Yuan HY, et al. Trends of stomach cancer survival: a systematic review of survival rates from population‐based cancer registration. J Dig Dis. 2022;23(1):22‐32. PubMed

Maret‐Ouda J, Markar SR, Lagergren J. Gastroesophageal reflux disease: a review. Jama. 2020;324(24):2536‐2547. PubMed

Kalff MC, Gottlieb‐Vedi E, Verhoeven RHA, et al. Presentation, treatment, and prognosis of esophageal carcinoma in a Nationwide comparison of Sweden and The Netherlands. Ann Surg. 2021;274(5):743‐750. PubMed

Engholm G, Ferlay J, Christensen N, et al. NORDCAN–a Nordic tool for cancer information, planning, quality control and research. Acta Oncol. 2010;49(5):725‐736. PubMed

Larønningen S, Ferlay J, Beydogan H, et al. NORDCAN: cancer incidence, mortality. Prevalence and Survival in the Nordic Countries. Association of the Nordic Cancer Registries. Cancer Registry of Norway; 2022.

Pukkala E, Engholm G, Hojsgaard Schmidt LK, et al. Nordic cancer registries ‐ an overview of their procedures and data comparability. Acta Oncol. 2018;57:440‐455. PubMed

Lundberg FE, Andersson TM, Lambe M, et al. Trends in cancer survival in the Nordic countries 1990‐2016: the NORDCAN survival studies. Acta Oncol. 2020;59(11):1266‐1274. PubMed

Hemminki K, Försti A, Hemminki A. Survival in colon and rectal cancers in Finland and Sweden through 50 years. BMJ Open Gastroenterol. 2021;8(1):e000644. PubMed PMC

Hemminki K, Försti A, Hemminki A, Ljungberg B, Hemminki O. Progress in survival in renal cell carcinoma through 50 years evaluated in Finland and Sweden. PLoS One. 2021;16(6):e0253236. PubMed PMC

Ellis L, Woods LM, Estève J, Eloranta S, Coleman MP, Rachet B. Cancer incidence, survival and mortality: explaining the concepts. Int J Cancer. 2014;135(8):1774‐1782. PubMed

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans . Personal habits and indoor combustions. IARC Monogr Eval Carcinog Risks Hum. 2012;100:1‐538. PubMed PMC

Hemminki K, Försti A, Hemminki A, Ljungberg B, Hemminki O. Incidence trends in lung and bladder cancers in the Nordic countries before and after the smoking epidemic. Eur J Cancer Prev. 2022;31(3):228‐234. PubMed

Pukkala E, Martinsen JI, Lynge E, et al. Occupation and cancer ‐ follow‐up of 15 million people in five Nordic countries. Acta Oncol. 2009;48:646‐790. PubMed

Hemminki K, Försti A, Hemminki A, Ljungberg B, Hemminki O. Survival in bladder and upper urinary tract cancers in Finland and Sweden through 50 years. PLoS One. 2022;17(1):e0261124. PubMed PMC

Jeremiasen M, Linder G, Hedberg J, et al. Improvements in esophageal and gastric cancer care in Sweden‐population‐based results 2007‐2016 from a national quality register. Dis Esophagus. 2020;33(3):doz070. PubMed PMC

Lordick F, Carneiro F, Cascinu S, et al. Gastric cancer: ESMO clinical practice guideline for diagnosis, treatment and follow‐up. Ann Oncol. 2022;33(10):1005‐1020. PubMed

Obermannová R, Alsina M, Cervantes A, et al. Oesophageal cancer: ESMO clinical practice guideline for diagnosis, treatment and follow‐up. Ann Oncol. 2022;33(10):992‐1004. PubMed

Cheng Z, Johar A, Gottlieb‐Vedi E, Nilsson M, Lagergren J, Lagergren P. Impact of co‐morbidity on reoperation or death within 90 days of surgery for oesophageal cancer. BJS Open. 2021;5(1):zraa035. PubMed PMC

Probst HB, Hussain ZB, Andersen O. Cancer patient pathways in Denmark as a joint effort between bureaucrats, health professionals and politicians—a national Danish project. Health Policy. 2012;105(1):65‐70. PubMed

Lundberg FE, Birgisson H, Johannesen TB, et al. Survival trends in patients diagnosed with colon and rectal cancer in the Nordic countries 1990‐2016: the NORDCAN survival studies. Eur J Cancer. 2022;172:76‐84. PubMed

Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015. Br J Cancer. 2018;118(8):1130‐1141. PubMed PMC

Wilson LF, Antonsson A, Green AC, et al. How many cancer cases and deaths are potentially preventable? Estimates for Australia in 2013. Int J Cancer. 2018;142(4):691‐701. PubMed

Janjigian YY, Shitara K, Moehler M, et al. First‐line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro‐oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open‐label, phase 3 trial. Lancet. 2021;398(10294):27‐40. PubMed PMC

Survival improvements in esophageal and gastric cancers in the Nordic countries favor younger patients