Cancer survival
After cardiovascular disease, cancer care is the second cause of death in LAC (see Chapter 3). Bray et al. estimated that cancer was the cause of 670 000 deaths in 2018 in LAC (Bray et al., 2018[1]). While prostate, breast and colorectal cancer are the main cancers in the region, cancer types with low five-year survival rates are a good indicator of the quality of advanced cancer care in a country’s health system.
Lung (90 000, 7% of all cancers) and stomach (67 000, 5% of all cancers) cancer were the fourth and fifth most common cancers in the region in 2018 (Jemal et al., 2019[2]). However, Lung cancer’s high mortality rate makes it the leading cause of death (81 000, 12% of all cancer deaths), while stomach cancer accounts for 8% of all cancer deaths (52 000 in 2018).
The average five-year survival rate of Lung cancer in OECD countries is 17.1% for patients diagnosed between 2010 and 2014. This rate is just 13.3% in LAC. Cuba has the highest survival rate among LAC countries with available data with 30.1% of lung cancer patients surviving after 5 years. Costa Rica (20.1%) is the only other country in the region with a higher than OECD average survival rate. Chile has the lowest recorded five-year survival rate with only 4.6%, half the LAC average survival rate and 73% lower than the OECD average (Figure 7.7).
For stomach cancer, the LAC average five-year survival rate stands at 23.7% of patients diagnosed between 2010 and 2014. The OECD average (29.6% of patients) is 25% higher. As with Lung cancer, Chile has the lowest five-year survival with only 16.7% of stomach cancer patients surviving after 5 years. Costa Rica (40.6%) and Cuba (35.7%) lead the region and again are the only two countries with five-year survival rates higher than the OECD average (Figure 7.8).
Colorectal cancer causes almost 65 000 deaths per year in LAC (Bray et al., 2018[1]). While the term colorectal includes cancer starting both in the Colon and the Rectum, five-year survival rates are importantly higher for Colon cancers. Costa Rica leads the group of five LAC countries with available data with 93.5% of patients surviving after 5 years. Together with Brazil (88.2%), they are above the OECD average of 85.7%. Ecuador has the lowest survival rate for Colon cancer among those with data, with 67.3% (Figure 7.9).
Melanoma of skin accounts for 18 881 new cancer cases in LAC every year, and about 5 650 deaths (Bray et al., 2018[1]). Figure 7.10 presents the five-year survival rate of patients diagnosed with melanoma of the skin. The LAC six countries with available data are below the OEDC average rate of 83%. Costa Rica has the highest five-year survival in the group with 77.2%, while Ecuador has the lowest with 57.9%.
Five-year net survival refers to the cumulative probability of cancer patients surviving five years after diagnosis, after correction for the risk of death from other causes, which varies widely between countries, over time, by age and sex. Net survival is expressed as a percentage in the range 0-100%. The period approach is used to allow estimation of five-year survival where five years of follow-up are not available for all patients. Cancer survival estimates for all ages combined are age-standardised with the International Cancer Survival Standard weights. Data collection, quality control and analysis were performed centrally as part of the CONCORD programme for the global surveillance of cancer survival, led by the London School of Hygiene and Tropical Medicine (Allemani et al., 2018[3]). Where national data were not available, the CONCORD programme analysed the available data from regional registries, but in most countries the analyses were based on national coverage, facilitating international comparison.
References
[3] Allemani, C. et al. (2018), “Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries”, The Lancet, Vol. 391/10125, pp. 1023-1075, https://doi.org/10.1016/S0140-6736(17)33326-3.
[1] Bray, F. et al. (2018), “Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries”, CA: A Cancer Journal for Clinicians, Vol. 68/6, pp. 394-424, https://doi.org/10.3322/caac.21492.
[2] Jemal, A. et al. (eds.) (2019), The Cancer Atlas, 3rd edition, American Cancer Society, Atlanta, http://www.cancer.org/canceratlas.
Note: National coverage in Costa Rica and Cuba. Survival estimates are considered less reliable for Colombia: see Allemani et. al. (2018[3]) for more information.
Source: CONCORD programme, London School of Hygiene and Tropical Medicine.
Note: National coverage in Costa Rica, Cuba and Uruguay. Survival estimates are considered less reliable for Colombia: see Allemani et. al. (2018[3]) for more information.
Source: CONCORD programme, London School of Hygiene and Tropical Medicine.
Note: National coverage in Costa Rica, Cuba and Uruguay. Survival estimates are considered less reliable for Colombia: see Allemani et. al. (2018[3]) for more information.
Source: CONCORD programme, London School of Hygiene and Tropical Medicine.
Note: National coverage in Costa Rica, Cuba and Uruguay. Survival estimates are considered less reliable for Colombia: see Allemani et. al. (2018[3]) for more information.
Source: CONCORD programme, London School of Hygiene and Tropical Medicine.