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  • br Changes in life expectancy for cancer

    2021-03-10


    Changes in life expectancy for cancer patients over time since diagnosis
    Laura Botta,1* Luigino Dal Maso,2* Stefano Guzzinati,3 Chiara Panato,2 Gemma Gatta,1 Annalisa Trama,1 Massimo Rugge,3 Giovanna Tagliabue,4 Claudia Casella,5 Bianca Caruso,6 Maria Michiara,7 Stefano Ferretti,8 Flavio Sensi,9 Rosario Tumino,10 Federica Toffolutti,2 Antonio Giampiero Russo,11 Anna Luisa Caiazzo,12 Lucia Mangone,13 Walter Mazzucco,14 Silvia Iacovacci,15 Paolo Ricci,16 Gemma Gola,17 Giuseppa Candela,18 Antonella Sutera Sardo,19 Roberta De Angelis,20 Carlotta Buzzoni,21,22 Riccardo Capocaccia,23 and Mitomycin C AIRTUM Working Group24
    Running Head: Life expectancy of cancer patients
    1Evaluative Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy 2 Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, 33081 Aviano (PN), Italy
    3Veneto Tumor Registry, Azienda Zero, 35131 Padua, Italy
    4Lombardy Cancer Registry, Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
    5Liguria Cancer Registry, Clinical Epidemiology, Ospedale Policlinico San Martino IRCCS, 16132 Genova, Italy
    6Modena Cancer Registry, Public Health Department, AUSL di Modena, 41126 Modena, Italy
    7Parma Cancer Registry, Oncology Unit, Azienda Ospedaliera Universitaria di Parma, 43100 Parma, Italy 8Ferrara Cancer registry, University of Ferrara, Local Health Authority Ferrara, 44121 Ferrara, Italy 9North Sardinia Cancer Registry, Azienda Regionale per la Tutela della Salute, 07100 Sassari, Italy
    10Cancer Registry for the Provinces of Caltanisetta and Ragusa, Dipartimento di Prevenzione Medica, Azienda Sanitaria Provinciale (ASP) Ragusa, 97100 Ragusa, Italy
    11Cancer Registry of Milan, Epidemiology Unit, Agency for Health Protection of Milan, 20122 Milan, Italy
    12Cancer Registry of Salerno Province, Azienda Sanitaria Provinciale (ASP) Salerno, 84014 Nocera Inferiore, Italy
    13Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42100 Reggio Emilia, Italy
    14Sciences for Health Promotion (PROSAMI) Department, University of Palermo, and Clinical Epidemiology and Cancer Registry Unit, Palermo University Hospital "P. Giaccone" 90127 Palermo, Italy
    15Cancer Registry of Latina Province, Direzione Azienda AUSL, Centro Direzionale Latina Fiori, 04100 Latina, Italy
    16Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana,
    17Como Cancer Registry, UOC Epidemiologia-ATS Insubria, 21100 Varese, Italy
    18Trapani Cancer Registry, Dipartimento di Prevenzione della Salute, Servizio Sanitario Regionale Sicilia, Azienda Sanitaria Provinciale (ASP) 91100 Mitomycin C Trapani, Italy
    19Catanzaro Cancer Registry, Servizio di Epidemiologia e Statistica Sanitaria, Azienda Sanitaria Provinciale (ASP) Catanzaro, 88100 Catanzaro, Italy
    20Centro Nazionale per la Prevenzione delle Malattie e Promozione della Salute, Istituto Superiore di Sanità (ISS), 00161 Rome, Italy
    21Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPRO), 50139 Florence, Italy
    22AIRTUM Database, Registro Tumori Toscano, Istituto per lo Studio e la Prevenzione Oncologica, SC Epidemiologia Clinica, 50139 Florence, Italy
    23Editorial Board “Epidemiologia & Prevenzione,” 20148 Milano, Italy
    24AIRTUM Working Group: Emanuele Crocetti and Fabio Falcini (Romagna Cancer Registry-CR), Fortunato Bianconi (Umbria CR), Salvatore Sciacca (Catania-Messina CR), Guido Mazzoleni (South Tyrol CR), Mario Fusco (Naples 3-South CR), Stefano Rosso (Biella CR), Francesco Tisano (Siracusa CR), Anna Clara Fanetti (Sondrio CR), Mario Usala (Nuoro CR)
    *Corresponding authors
    Laura Botta
    Abbreviations: life expectancy (LE); years of life lost (YLL); International Classification of Diseases, Tenth Revision (ICD-10); International Classification of Diseases for Oncology, Third Revision (ICD-O-3); relative survival (RS); National Institute of Statistics (ISTAT); non-Hodgkin lymphoma (NHL)
    Abstract
    The aims of this study were to provide life expectancy (LE) estimates of cancer patients at diagnosis and LE changes over time since diagnosis to describe the impact of cancer during patients' entire lives. Cancer patients' LE was calculated by standard period life table methodology using the relative survival of Italian patients diagnosed in population-based cancer registries in 1985-2011 with follow-up to 2013. Data were smoothed using a polynomial model and years of life lost (YLL) were calculated as the difference between patients' LE and that of the age- and sex-matched general population. The YLL at diagnosis was highest at the youngest age at diagnosis, steadily decreasing thereafter. For patients diagnosed at age 45 years, the YLL was above 20 for lung and ovarian cancers and below 6 for thyroid cancer in women and melanoma in men. LE progressively increased in patients surviving the first years, decreasing thereafter, to approach that of the general population. YLL in the long run mainly depends on attained age. Providing quantitative data is essential to better define clinical follow-up and plan health care resource allocation. These results help assess when the excess risk of death from tumour becomes negligible in cancer survivors.