Sabine Luttmann

Krebs in Deutschland 2011/2012

Gesundheitsberichterstattung des Bundes Für das Jahr 2012 wurde die Zahl der Krebsneuerkrankungen in Deutschland vom Zentrum für Krebsregisterdaten (ZfKD) auf rund 478.000 geschätzt, davon 252.100 bei Männern und 225.900 bei Frauen. Damit hat die absolute Zahl der Krebsneuerkrankungen zwischen 2002 und 2012 bei Männern um 13 %, bei Frauen um 10 % zugenommen. Dies ist überwiegend auf den kontinuierlich steigenden Anteil älterer Menschen in der Bevölkerung Deutschlands zurückzuführen. Berücksichtigt man diese demografischen Veränderungen durch Berechnung altersstandardisierter Raten, zeigt sich bei Männern ein leichter Rückgang der Erkrankungsraten (um 4 %), bei Frauen ein Anstieg von etwa 5 %. Nach derzeitigem Stand erkrankt jeder zweite Mann (51 %) und 43 % aller Frauen im Laufe des Lebens an Krebs.

Up-to-date results on survival of patients with melanoma in Germany

Background  Prior analyses of survival of patients with primary cutaneous malignant melanoma from Germany were based only on small populations and need to be updated.

Survival of stomach and esophagus cancer patients in Germany in the early 21st century

Abstract Background. Esophagus and stomach cancers are associated with poor prognosis. But most published population-based cancer survival estimates for stomach and esophagus cancer refer to survival experience of patients diagnosed in the 1990s or earlier years. The aim of this study was to provide up-to-date survival estimates and trends for patients with stomach and esophagus cancer in Germany. Material and methods. Our analysis is based on data from 11 population-based cancer registries, covering 33 million inhabitants. Patients diagnosed with stomach and esophagus cancer in 1997–2006 were included. Period analysis was used to derive five-year relative survival estimates and trends by age, sex, cancer subsite, and stage for the time period of 2002–2006. German and US survival estimates were compared utilizing the SEER 13 database. Results. Overall age-standardized five-year relative survival was 31.8% and 18.3% for stomach and esophagus cancer, respectively, compared to 27.2% and 17.4% in the US. Survival was somewhat higher among female than among male patients for both cancer sites (33.6% vs. 30.6% and 21.5% vs. 17.5%, respectively) and much higher for non-cardia stomach cancer (40.4%) than for cardia cancer (23.4%). From 2002 to 2006, a moderate increase in five-year relative survival by 2.7 percent units was observed for non-cardia stomach cancer patients in Germany (p < 0.001). Conclusion. Five-year relative cancer survival has reached levels around 40% for patients with non-cardia stomach cancer in Germany in the early 21st century, whereas it remained at lower levels around 20% for patients with esophagus and cardia cancer.

Survival among adolescents and young adults with cancer in Germany and the United States: An international comparison

Serious concern arose in the scientific literature about the state of and progress in cancer survival among adolescent and young adult (AYA) patients in the recent years. We provide an up‐to‐date international comparison of survival among AYA patients. Using population‐based cancer data from 11 German cancer registries and the SEER Program of the United States (covering populations of 39 and 33 million people, respectively), standardized tumor group classifications, period analysis and modeling, we compared the 5‐year relative survival of AYA patients in the age groups 15–29 and 30–39 to survival seen among adults aged 40–49 for the 2002–2006 period. Additionally, we also provide an age‐specific survival comparison between the two countries. In 2002–2006, for the overwhelming majority of the more than 30 types of cancer examined, AYA patients aged both 15–29 and 30–39 years had higher or similar survival than patients in the age group 40–49 in both countries. A numerically large and statistically significant survival deficit among AYA patients was only found for breast carcinomas in both populations, and colorectal and stomach carcinoma in the United States for the age group 15–29. Overall, results of the country‐specific comparisons did not indicate systematic differences. With very few exceptions, no survival deficit between AYA patients and adults aged 40–49 years was found in either of the examined countries in the first decade of the 21st century.

Survival of ovarian cancer patients in Germany in the early 21st century: a period analysis by age, histology, laterality, and stage.

Population-based studies on ovarian cancer providing survival estimates by age, histology, laterality, and stage have been sparse. We aimed to derive the most up-to-date and detailed survival estimates for ovarian cancer patients in Germany. We used a pooled German national dataset including data from 11 cancer registries covering 33 million populations. A total of 21 651 patients diagnosed with ovarian cancer in 1997–2006 were included. Period analysis was carried out to calculate the 5-year relative survival (RS) for the years 2002–2006. Trends in survival between 2002 and 2006 were examined using model-based period analysis. Age adjustment was performed using five age groups (15–44, 45–54, 55–64, 65–74, and 75+ years). Overall, the age-adjusted 5-year RS in 2002–2006 was 41%. A strong age gradient was observed, with a decrease in the 5-year RS from 67% in the age group 15–49 years to 28% in the age group 70+ years. Furthermore, the prognosis varied markedly by histology, laterality, and stage, with the age-adjusted 5-year RS ranging from 25% (for carcinoma not otherwise specified) to 81% (for stromal cell carcinoma), reaching 46% for unilateral and 32% for bilateral carcinoma and reaching 82% for Federation of Gynecology and Obstetrics (FIGO) stages I and II, 36% for FIGO stage III, and 18% for FIGO stage IV. No improvement in survival could be observed for any of the subgroups in the period between 2002 and 2006. Our analyses suggest that an improvement in the 5-year RS for ovarian cancer may have stagnated in the early 21st century and underline the need for a more effective translation of therapeutic innovation into clinical practice.

Lung cancer survival in Germany: A population-based analysis of 132,612 lung cancer patients

OBJECTIVES Lung cancer is the most common cancer-related death worldwide. In Germany it accounts for 25% of cancer deaths in men, and 14% in women. The aim of this study is to provide an overview of 5-year relative survival by sex, age, histology, and tumour stage in Germany representing a population of 26.7 million people. MATERIALS AND METHODS The study is based on a pooled German dataset including data from 12 population-based cancer registries covering around one third of the German population. A total of 132,612 patients diagnosed with lung cancer from 2002 to 2010 were included in the analysis. Survival estimates for the time period 2007-2010 were calculated using period analysis. Differences in survival between sexes were tested for statistical significance by model-based period analysis (poisson regression model). The relative excess risk (RER) of death (women vs. men) was extracted from the model with the p value for the difference in RER. RESULTS The overall age adjusted 5-year relative survival was 15.5% (standard error (SE) 0.2) for men and 20.3% (SE 0.3) in women. Survival differed markedly according to age (men: <60 years 18.5% vs. 80+ years 8.4% and women 23.7% vs. 10.6%, respectively), histology (largest difference between histological groups: men 25.7 and women 44.4% points) and stage (men: UICC Ia 62.9%, vs. UICC IV 4.6% and women 75.2% vs. 7.0%, respectively). Our study showed survival advantages for women compared to men, most notably in younger aged patients (RER 0.83, p<0.0001), patients with adenocarcinoma (RER 0.80, p<0.0001), and patients with lower stage cancer (RER 0.62, p<0.0001). CONCLUSIONS This study presents up-to-date survival estimates for lung cancer in Germany. Compared to other European countries survival was relatively high. Women showed higher survival than men independent of age, histology and stage. The reasons for the survival differences require further clarification.

Survival in patients with acute myeloblastic leukemia in Germany and the United States: Major differences in survival in young adults

Previous epidemiologic studies on AML have been limited by the rarity of the disease. Here, we present population level data on survival of patients with AML in Germany and the United States (US). Data were extracted from 11 population‐based cancer registries in Germany and the Surveillance, Epidemiology, and End Results (SEER13) database in the US. Patients diagnosed with AML in 1997–2011 were included. Period analysis was used to estimate 5‐year relative survival (RS) and trends in survival in the early 21st century. Overall 5‐year age‐adjusted RS for patients with AML in 2007–2011 was greater in Germany than in the US at 22.8% and 18.8%, respectively. Five‐year RS was higher in Germany than in the US at all ages, with particularly large differences at ages 15–24 for whom 5‐year RS was 64.3% in Germany and 55.0% in the US and 35–44, with 5‐year RS estimates of 61.8% in Germany and 46.6% in the US. Most of the difference in 5‐year RS was due to higher 1‐year RS, with overall 1‐year RS estimates of 47.0% in Germany and 38.5% in the US. A small increase in RS was observed between 2003–2005 and 2009–2011 in both countries, but no increase in survival was observed in either country for ages 75+. To our knowledge, this is the first detailed description of AML survival in Germany. Comparison to the US suggests that further analysis into risk factors for poor outcomes in AML in the US may be useful in improving survival.

Survival of patients with gastric lymphoma in Germany and in the United States.

This study aims to examine survival for gastric lymphomas and its main subtypes, mucosa‐associated lymphoid tissue lymphoma (MALT), and diffuse large B‐cell lymphoma (DLBCL), in Germany and in the United States.

Risk of second primary cancers in women diagnosed with endometrial cancer in German and Swedish cancer registries

Along with the increasing incidence and favorable prognosis, more women diagnosed with endometrial cancer may develop second primary cancers (SPCs). We aimed at investigating risk of SPCs after endometrial cancer in Germany and Sweden to provide insight into prevention strategies for SPCs. Endometrial cancer patients diagnosed at age ≥15 years in Germany during 1997–2011 and in Sweden nationwide during 1997–2012 were selected. Standardized incidence ratios (SIRs), calculated as the ratio of observed to expected numbers of cases, were used to assess the risk of a specific second cancer after endometrial cancer for both German and Swedish datasets. Among 46,929 endometrial cancer survivors in Germany and 18,646 in Sweden, overall 2,897 and 1,706 SPCs were recorded, respectively. Significantly elevated SIRs were observed in Germany for ovarian (SIR = 1.3; 95%CI:1.1–1.5) and kidney cancers [1.6 (1.3–1.8)], while in Sweden the SIRs were 5.4 (4.6–6.3) and1.4 (1.0–1.9), respectively. Elevated risk for second ovarian endometrioid carcinoma was pronounced after early (<55 years) onset endometrial cancer in Germany [9.0 (4.8–15)] and Sweden [7.7 (5.1–11)]. In Germany elevated risks were found for second ovarian endometrioid carcinoma after endometrioid histology of first endometrial cancer [6.3 (4.0–9.4)] and for second kidney cancer after clear cell histology of endometrial cancer [4.9 (1.6–11)]. We found exceptionally elevated risk of second ovarian endometrioid carcinoma after endometrial cancer of the same histology or of early onset. Risk for second kidney cancer was also increased, particularly after endometrial cancer of clear cell histology. Cancer prevention strategies should focus on these cancers after endometrial cancer diagnosis.

Survival of patients with lymphoplasmacytic lymphoma and solitary plasmacytoma in Germany and the United States of America in the early 21st century

Population-level survival has increased for a number of hematologic malignancies.[1][1]–[3][2] Multiple myeloma, in particular, has seen improved survival both in clinical trials[4][3]–[8][4] and on the population level.[3][2],[9][5]–[11][6] However, it is not known whether the changes in