Abstract:
IMPORTANCE:Substantial progress has been made in cancer diagnosis and treatment, resulting in a steady improvement in cancer survival. The degree of improvement by age, race, and sex remains unclear. OBJECTIVE:To quantify the degree of survival improvement over time by age, race, and sex in the United States. DESIGN, SETTING, AND PARTICIPANTS:Longitudinal analyses of cancer follow-up data from 1990 to 2010, from 1.02 million patients who had been diagnosed as having cancer of the colon or rectum, breast, prostate, lung, liver, pancreas, or ovary from 1990 to 2009 and who were included in 1 of 9 population-based registries of the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program. MAIN OUTCOMES AND MEASURES:Hazard ratios (HRs) and 95% CIs for cancer-specific death were estimated for patients diagnosed as having any of these cancers during 1995 to 1999, 2000 to 2004, and 2005 to 2009, compared with those diagnosed in 1990 to 1994. RESULTS:Significant improvements in survival were found for cancers of the colon or rectum, breast, prostate, lung, and liver. Improvements were more pronounced for younger patients. For patients aged 50 to 64 years and diagnosed from 2005 to 2009, adjusted HRs (95% CIs) were 0.57 (95% CI, 0.55-0.60), 0.48 (95% CI, 0.45-0.51), 0.61 (95% CI, 0.57-0.69), and 0.32 (95% CI, 0.30-0.36), for cancer of the colon or rectum, breast, liver, and prostate, respectively, compared with the same age groups of patients diagnosed during 1990 to 1994. However, the corresponding HRs (95% CIs) for elderly patients (those 75-85 years old) were only 0.88 (95% CI, 0.84-0.92), 0.88 (95% CI, 0.82-0.95), 0.76 (95% CI, 0.69-0.84), and 0.65 (95% CI, 0.61-0.70), for the same 4 cancer sites, respectively. A similar, although weaker, age-related period effect was observed for lung and pancreatic cancers. The adjusted HRs (95% CIs) for lung cancer were 0.75 (95% CI, 0.73-0.77) and 0.84 (95% CI, 0.81-0.86), respectively, for patients aged 50 to 64 years and 75 to 85 years diagnosed between 2005 and 2009, compared with the same age groups of patients diagnosed between 1990 and 1994 (0.73 [95% CI, 0.69-0.77] and 0.90 [95% CI, 0.85-0.95], respectively. Compared with whites or Asians, African Americans experienced greater improvement in prostate cancer survival. From 1990 to 2009, ovarian cancer survival declined among African Americans but improved among whites. No apparent sex difference in the degree of improvement for any non-sex-specific cancer was noted. CONCLUSIONS AND RELEVANCE:Younger patients experienced greater benefit from recent oncology advances than elderly patients. African Americans experienced poorer survival than whites for all cancers, and the racial difference decreased for prostate cancer but increased for ovarian cancer. Identifying factors associated with varied improvement in cancer survival can inform future improvements in cancer care for all.
journal_name
JAMA Oncoljournal_title
JAMA oncologyauthors
Zeng C,Wen W,Morgans AK,Pao W,Shu XO,Zheng Wdoi
10.1001/jamaoncol.2014.161subject
Has Abstractpub_date
2015-04-01 00:00:00pages
88-96issue
1eissn
2374-2437issn
2374-2445pii
2118568journal_volume
1pub_type
杂志文章相关文献
JAMA Oncology文献大全abstract:IMPORTANCE:BRCA testing is recommended for young women diagnosed as having breast cancer, but little is known about decisions surrounding testing and how results may influence treatment decisions in young patients. OBJECTIVES:To describe the use of BRCA testing and to evaluate how concerns about genetic risk and use o...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.5941
更新日期:2016-06-01 00:00:00
abstract:Importance:Multiparametric magnetic resonance imaging (MRI) in conjunction with MRI-transrectal ultrasound (TRUS) fusion-guided biopsies have improved the detection of prostate cancer. It is unclear whether MRI itself adds additional value to multivariable prediction models based on clinical parameters. Objective:To d...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2017.5667
更新日期:2018-05-01 00:00:00
abstract:Importance:Evidence for application of stereotactic and other conformal radiotherapy techniques in treating brain tumors is largely based on data derived from dosimetric, retrospective, or small prospective studies. Therefore, we conducted a randomized clinical trial of stereotactic conformal radiotherapy (SCRT) compar...
journal_title:JAMA oncology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamaoncol.2017.0997
更新日期:2017-10-01 00:00:00
abstract:Importance:Tumor-treating fields (TTFields) therapy improves both progression-free and overall survival in patients with glioblastoma. There is a need to assess the influence of TTFields on patients' health-related quality of life (HRQoL). Objective:To examine the association of TTFields therapy with progression-free ...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaoncol.2017.5082
更新日期:2018-04-01 00:00:00
abstract:Importance:To date, the benefit of genome-driven cancer therapy has not been quantified. Objective:We sought to estimate the annual percentage of patients in the United States with advanced or metastatic cancer who could be eligible for and benefit from US Food and Drug Administration (FDA)-approved genome-driven ther...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2018.1660
更新日期:2018-08-01 00:00:00
abstract:Importance:Consensus is lacking as to the optimal radiotherapy dose and fractionation schedule for treating bone metastases. Objective:To assess the relative efficacy of high-dose, single-fraction stereotactic body radiotherapy (SBRT) vs standard multifraction radiotherapy (MFRT) for alleviation of pain in patients wi...
journal_title:JAMA oncology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamaoncol.2019.0192
更新日期:2019-06-01 00:00:00
abstract:Importance:Pathologic nodal stage is the most significant prognostic factor in resectable non-small cell lung cancer (NSCLC). The International Association for the Study of Lung Cancer NSCLC staging project revealed intercontinental differences in N category-stratified survival. These differences may indicate differenc...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaoncol.2017.2993
更新日期:2018-01-01 00:00:00
abstract:Importance:Osteosarcoma, the most common malignant bone tumor in children and adolescents, occurs in a high number of cancer predisposition syndromes that are defined by highly penetrant germline mutations. The germline genetic susceptibility to osteosarcoma outside of familial cancer syndromes remains unclear. Object...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2020.0197
更新日期:2020-05-01 00:00:00
abstract:Importance:In clinical practice, patients with primary metastatic renal cell carcinoma (mRCC) have been offered cytoreductive nephrectomy (CN) followed by targeted therapy, but the optimal sequence of surgery and systemic therapy is unknown. Objective:To examine whether a period of sunitinib therapy before CN improves...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaoncol.2018.5543
更新日期:2019-02-01 00:00:00
abstract:IMPORTANCE:Hepatocellular carcinoma (HCC) has the second-highest cancer-related mortality rate in the world because most patients are diagnosed at an intermediate to advanced stage when surgery is not suitable. Transcatheter arterial chemoembolization (TACE) is currently considered a first-line therapy for unresectable...
journal_title:JAMA oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamaoncol.2015.2189
更新日期:2015-09-01 00:00:00
abstract:Importance:Esophageal adenocarcinoma and its precursor lesion Barrett esophagus have seen a dramatic increase in incidence over the past 4 decades yet marked genetic heterogeneity of this disease has precluded advances in understanding its pathogenesis and improving treatment. Objective:To identify novel disease susce...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2016.2054
更新日期:2016-10-01 00:00:00
abstract:Importance:While adjuvant hormonal therapy (HT) reduces mortality for women with nonmetastatic breast cancer, nonadherence to HT is common. Objective:We investigated the association between patterns of prior nonadherence to medications for chronic conditions with HT nonadherence. Design, Setting, and Participants:For...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2016.1291
更新日期:2016-10-01 00:00:00
abstract:IMPORTANCE:E-cadherin (CDH1) is a cancer predisposition gene mutated in families meeting clinically defined hereditary diffuse gastric cancer (HDGC). Reliable estimates of cancer risk and spectrum in germline mutation carriers are essential for management. For families without CDH1 mutations, genetic-based risk stratif...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaoncol.2014.168
更新日期:2015-04-01 00:00:00
abstract:IMPORTANCE:Statin use has been associated with improved prostate cancer outcomes. Dehydroepiandrosterone sulfate (DHEAS) is a precursor of testosterone and a substrate for SLCO2B1, an organic anionic transporter. We previously demonstrated that genetic variants of SLCO2B1 correlated with time to progression (TTP) durin...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.0829
更新日期:2015-07-01 00:00:00
abstract:Importance:Capecitabine is not considered a standard agent in the adjuvant treatment of early breast cancer. The results of this study suggest that addition of adjuvant capecitabine to a regimen that contains docetaxel, epirubicin, and cyclophosphamide improves survival outcomes of patients with triple-negative breast ...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaoncol.2016.6120
更新日期:2017-06-01 00:00:00
abstract:Importance:Checkpoint blockade therapy targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death protein 1 pathways (PD-1/PD-L1) have achieved success in treating a number of malignancies. However, only a subset of patients responds to these therapies, and optimization of patient sele...
journal_title:JAMA oncology
pub_type: 杂志文章,评审
doi:10.1001/jamaoncol.2016.2214
更新日期:2016-11-01 00:00:00
abstract:IMPORTANCE:Multiple myeloma has been classified as exhibiting "limited or suggestive evidence" of an association with exposure to herbicides in Vietnam War veterans. Occupational studies have shown that other pesticides (ie, insecticides, herbicides, fungicides) are associated with excess risk of multiple myeloma and i...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.2938
更新日期:2015-11-01 00:00:00
abstract:Importance:A high 21-gene recurrence score (RS) by breast cancer assay is prognostic for distant recurrence of early breast cancer after local therapy and endocrine therapy alone, and for chemotherapy benefit. Objective:To describe clinical outcomes for women with a high RS who received adjuvant chemotherapy plus endo...
journal_title:JAMA oncology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamaoncol.2019.4794
更新日期:2020-03-01 00:00:00
abstract:Importance:Why some triple-negative breast cancers (TNBCs) have high and others have low immune cell infiltration is unknown. Understanding how immune surveillance shapes the cancer genome could help in the selection of patients and the development of more effective immunotherapy strategies. Objective:To examine the a...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2017.2140
更新日期:2017-12-01 00:00:00
abstract:Importance:The androgen receptor inhibitor enzalutamide prolongs survival in men with metastatic castration-resistant prostate cancer (mCRPC). In controlled clinical studies, 0.5% (10 of 2051) of patients experienced seizure, but patients with a history of or risk factors for seizure were excluded. Men with mCRPC and s...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaoncol.2017.3361
更新日期:2018-05-01 00:00:00
abstract:Importance:Value-driven payment system reform is a potential tool for aligning economic incentives with the improvement of quality and efficiency of health care and containment of cost. Such a payment system has not been researched satisfactorily in full-cycle cancer care. Objective:To examine the association of outco...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2016.4549
更新日期:2017-03-01 00:00:00
abstract:Importance:Androgen-deprivation therapy (ADT) plus docetaxel is the standard of care in hormone-naive metastatic prostate cancer but is of uncertain benefit in a nonmetastatic, high-risk prostate cancer setting. Objective:To assess the benefit of ADT plus docetaxel in patients presenting with rising prostate-specific ...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaoncol.2018.6607
更新日期:2019-05-01 00:00:00
abstract:Importance:Primary tumor location is emerging as an important prognostic factor owing to distinct biological features. However, the side of origin of colon cancer (CC) still does not represent a prognostic parameter when deciding for adjuvant or palliative chemotherapy. Objective:To determine the prognostic role of le...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2016.4227
更新日期:2017-02-01 00:00:00
abstract:Importance:Novel intermediate end points may be useful to detect signals of early activity and prioritize new therapies to treat patients with advanced malignant neoplasms, including metastatic non-small cell lung cancer (mNSCLC). Objective:To explore milestone rate, a proposed intermediate end point for immunotherapy...
journal_title:JAMA oncology
pub_type: 杂志文章,meta分析
doi:10.1001/jamaoncol.2017.1029
更新日期:2017-08-10 00:00:00
abstract:IMPORTANCE:Time to events, or survival end points, are common end points in randomized clinical trials. They are usually analyzed under the assumption of proportional hazards, and the treatment effect is reported as a hazard ratio, which is neither an intuitive measure nor a meaningful one if the assumption of proporti...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.6359
更新日期:2016-07-01 00:00:00
abstract:IMPORTANCE:A recent randomized radiation dose-escalation trial in unresectable stage III non-small-cell lung cancer (NSCLC) (Radiation Therapy Oncology Group [RTOG] 0617) showed a lower survival rate in the high-dose radiation therapy (RT) arm (74 Gy) than in the low-dose arm (60 Gy) with concurrent chemotherapy. OBJE...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaoncol.2015.3969
更新日期:2016-03-01 00:00:00
abstract:Importance:Axicabtagene ciloleucel, an anti-CD19-CD28-CD3ζ chimeric antigen receptor T-cell therapy, was the first US Food and Drug Administration-approved, genetically engineered T-cell therapy for adults with relapsed or refractory large B-cell lymphoma (LBCL) after 2 or more lines of systemic therapy. There has not ...
journal_title:JAMA oncology
pub_type: 杂志文章,评审
doi:10.1001/jamaoncol.2019.3869
更新日期:2020-02-01 00:00:00
abstract:Importance:Chemoradiotherapy (CRT), followed by surgery, is the recommended approach for stage II and III rectal cancer. While CRT decreases the risk of local recurrence, it does not improve survival and leads to poorer functional outcomes than surgery alone. Therefore, new approaches to better select patients for CRT ...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2019.0186
更新日期:2019-07-01 00:00:00
abstract:Importance:Administration of anti-programmed cell death protein 1 (anti-PD-1) is now standard therapy in advanced non-small cell lung cancer (NSCLC). However, immune checkpoint inhibitors, including anti-PD-1, have not been assessed in patients with subclinical disease with advanced NSCLC, and no useful clinical biomar...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2018.5860
更新日期:2019-03-01 00:00:00
abstract:Importance:To date, there is no well-defined standard of care for early-stage pediatric Hodgkin lymphoma (HL), which may include chemotherapy alone or combined modality therapy (CMT) with chemotherapy followed by radiotherapy. Although the use of radiotherapy in pediatric HL is decreasing, this strategy remains controv...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2018.5911
更新日期:2019-05-01 00:00:00