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)

A new article by researchers from the International Agency for Research on Cancer (IARC) and partners reports the international variation in oesophageal and gastric cancer survival by stage at diagnosis and histological subtype, in seven high-income countries in 2012–2014. The study is part of the International Cancer Benchmarking Partnership (ICBP) Cancer Survival in High-Income Countries (SURVMARK-2) project.

The scientists found that stage at diagnosis varied considerably across the countries included in the study (Australia, Canada, Denmark, Ireland, New Zealand, Norway, and the United Kingdom). However, most patients with oesophageal cancer and gastric cancer continue to be diagnosed with regional or distant disease (proportions ranged between 56% and 90% across countries), when outcomes are typically poor. Oesophageal cancer survival was highest in Ireland (50.3%) and lowest in Canada (41.3%) at 1 year after diagnosis. Gastric cancer survival was highest in Australia (55.2%) and lowest in the United Kingdom (44.8%) at 1 year after diagnosis.

The researchers also observed survival differences within cancer stage groups, especially in patients diagnosed with localized disease; this suggests potential differences in cancer management across countries. Differences in survival were also seen for the two main histological subtypes of oesophageal cancer: oesophageal adenocarcinoma and oesophageal squamous cell carcinoma. However, higher survival for oesophageal adenocarcinoma than for oesophageal squamous cell carcinoma was consistent across countries.

This study shows that international disparities in gastric cancer and oesophageal cancer survival could be partly explained by earlier diagnosis resulting in more favourable stage distributions, as well as by differences in the distribution of histological subtypes. Differences in treatment, cancer registration practices, and the use of different staging methods and systems across countries may have affected the comparisons.

These results are also accessible through a publicly available online tool.

Arnold M, Morgan E, Bardot A, Rutherford MJ, Ferlay J, Little L, 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, Published online 25 November 2021;
https://doi.org/10.1136/gutjnl-2021-325266

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