Michel Philippe Coleman

Background: We assessed survival trends and international comparisons of patients with cutaneous melanoma from Japanese regional population-based cancer registries participating in the CONCORD-3 study. Methods: Subjects were patients aged 15–99 years diagnosed with cutaneous melanoma during 2000–2014, with follow-up completed either 5 years after diagnosis or through 31 December 2014. Five-year net survival was estimated by morphological type and calendar period of diagnosis, using the Pohar Perme estimator, and age-standardized using the International Cancer Survival Standard weights. Results: Age-standardized 5-year net survival for cutaneous melanoma remained stable among 4018 eligible subjects as follows: 68.9% during 2000–2004 (862 patients), 68.3% during 2005–2009 (1819 patients), and 69.0% during 2010–2014 (1337 patients). Five-year net survival in 2010–2014 was highest for lentigo maligna melanoma (89.0%, 64 patients, not age-standardized), followed by superficial spreading melanoma (88.4%, 91 patients) and acral lentiginous melanoma (83.7%, 163 patients, not age-standardized). However, survival for malignant melanoma not otherwise specified (68.0%, 1120 patients) and nodular melanoma was lower (56.5%, 58 patients). Five-year net survival for all types of cutaneous melanoma combined during 2010–2014 was lower in Japan (69.0%) and South Korea (59.9%) than in Australia, France, Germany, Italy, UK, Canada and the US (>85.7%). Conclusions: International disparities in net survival for cutaneous melanoma may be attributable to differences in the distribution of histological sub-types of melanoma and to variation in the availability and utilization of treatment modalities. Continuous monitoring of cancer survival is crucial for developing effective cancer control strategies.

Background: In 2018, CONCORD-3 updated long-term surveillance of cancer survival trends worldwide. In this monograph, we conducted further analyses and examined trends in net survival using the Japanese data during 2000–14. Methods: Sixteen population-based cancer registries in Japan contributed data to CONCORD-3 with anonymized individual records on 2 237 861 patients diagnosed with one of 15 adult cancers (15–99 years), and brain tumors and hematological malignancies in children (0–14 years). Five-year net survival was estimated with the Pohar Perme estimator and age-standardized with International Cancer Survival Standard weights. We estimated survival for three calendar periods, by age group, sex, anatomic site or morphology, and by stage at diagnosis. Results: Five-year net survival improved between 2000–04 and 2010–14 for several cancers, including brain tumors (27.9%–46.3%), ovarian cancer (35.5%–46.3%), stomach cancer (50.5%–60.3%), lymphoid malignancies (47.5%–57.3%), myeloid malignancies (24.8%–33.3%), and esophageal cancer (27.7%–36.0%). Breast cancer, childhood lymphoma, and prostate cancer showed consistently high or improving survival (85.9%–93.0%). In contrast, survival for melanoma remained unchanged. Net survival was low for pancreatic cancer (6.9%–8.3%). Among selected countries, survival was higher in Japan for esophageal (36.0%), liver (30.1%), and lung cancers (32.9%). Survival for melanoma, hematologic malignancies, and childhood cancers was lower in Japan than in Western countries. Conclusions: Net survival in Japan improved substantially for several cancers, but survival for pancreatic cancer remained low. International collaboration is crucial to accelerate the development of effective cancer control strategies.

Background: We aimed to assess 15-year trends in the 5-year net survival for patients with colon or rectal cancer from 2000 to 2014 and registered in the 16 Japanese regional population-based cancer registries included in the CONCORD-3 study. Methods: Data were included for adults (15–99 years) diagnosed with a cancer of the colon or rectum from 2000 to 2014 and followed up until 31 December 2014. We estimated the 5-year net survival by anatomic site, age, and stage using the Pohar Perme estimator. Age-standardized net survival was estimated using the International Cancer Survival Standard weights. Results: We analyzed data on 247 682 and 102 776 patients with colon and rectal cancer, respectively. Age-standardized 5-year net survival increased from 63.4% (95% CI: 62.7%–64.0%) in 2000–2004 to 67.8% (67.3%–68.4%) in 2010–2014 for colon cancer and from 58.6% (57.6%–59.5%) to 64.8% (64.0%–65.7%) for rectal cancer over the same period. For both cancers, survival was lower for older patients (75–99 years) than other age groups. Five-year net survival was lower for right-sided than left-sided colon cancer. Five-year net survival was higher than 90% for localized cancers of both the colon and rectum throughout 2000–2014. Survival for regional and distant disease for both cancers improved. Conclusions: For both colon and rectal cancers, the 5-year net survival improved from 2000 to 2014. However, no improvement was noted for older patients. These results may serve as evidence for developing new cancer control measures and treatment strategies, with a focus on older patients.

Background: Breast, cervical and ovarian cancers significantly affect young and middle-aged women, both physically and socially. However, relevant comprehensive stratified analyses are limited. Using Japanese data from CONCORD-3, a global cancer survival surveillance program, we analyzed long-term survival trends. Methods: Data from 16 Japanese population-based cancer registries were analyzed for women diagnosed aged 15–99 years during 2000–2014 with a tumor originating in the breast, cervix uteri or ovaries. Follow-up was extended to five years post-diagnosis or until December 31st, 2014. In situ tumors and death-certificate-only registrations were excluded. Five-year net survival was estimated with the Pohar Perme estimator by calendar period of diagnosis, morphology and stage, and age-standardized with International Cancer Survival Standard weights. Results: During 2000–2014, 5-year net survival improved for breast cancer from 85.9% (95% CI, 85.2–86.6%) to 89.4% (88.9–89.9%), for cervical cancer from 67.5% (66.3–68.7%) to 71.4% (70.4–72.3%), and for ovarian cancer from 35.5% (33.8–37.2%) to 46.3% (44.9–47.7%). Five-year survival for tumors diagnosed at a localized stage remained consistently high (>98% for breast cancer and > 90% for cervical cancer). Ovarian cancer survival varied greatly according to morphology. Conclusions: Five-year net survival for women with cancers of the breast, cervix, and ovary) in Japan improved during 2000–2014, and remained at a globally high level throughout this period. These gains are probably attributable to earlier detection of breast and cervical cancers and advances in multimodal treatment for all cancers. Survival for distant-stage cervical and ovarian cancers remains a challenge, underscoring the need for enhanced screening and treatment strategies.

Background: The Improving Population Outcomes for Renal Tumours of childhood (IMPORT) is a prospective clinical observational study capturing detailed demographic and outcome data on children and young people diagnosed with renal tumours in the United Kingdom and the Republic of Ireland. Methods: Data were extracted from the IMPORT database for all newly diagnosed cases of Wilms tumour (WT) registered between November 2012 and December 2022. Kaplan–Meier survival was estimated at one, three and five years. For children aged 0–14 years with unilateral WT, Cox proportional hazards models were used to examine patient/tumour characteristics in relation to the excess hazard of death. Results: Among 620 patients, 570 had unilateral and 50 (8%) bilateral disease; 582 (94%) patients received pre‐operative chemotherapy and 38 (6%) immediate surgery. Median age was 41 months (IQR: 41–65). Median tumour volume at diagnosis was 595 cm ³ (IQR: 348–914) and 228 cm ³ (IQR: 83–535) after pre‐operative chemotherapy, with 123/443 (28%) ≥500 cm ³ . Of 570 patients with unilateral WT, 419 (73.5%) had localised and 151 (26.5%) metastatic disease. Five‐year survival was highest for children aged 0–4 years (94.8%). Five‐year survival by Toronto stage (assessed at nephrectomy) was 97.0% (stage I/yI), 93.8% (stage II/yII), 85.2% (stage III/yIII) and 88.9% (stage IV), and by histology 74.6% (high risk), 95.2% (intermediate risk) and 100% (low risk). In univariate analysis, histological risk group, age (</≥ 4 years), stage and tumour volume ≥500 cm ³ after pre‐operative chemotherapy were significantly associated with excess risk of death. In multivariate modelling, only high‐risk histology (HR 10.8, 95% CI: 4.0–29.1) retained significance. Conclusions: Five‐year survival for children with WT in the United Kingdom and Ireland is generally above 90%, with high‐risk histology as the most important adverse prognostic factor. However, median tumour volume at diagnosis and after pre‐operative chemotherapy remains large.

Childhood cancers are a heterogeneous group of rare diseases, accounting for less than 2% of all cancers diagnosed worldwide. Most countries, therefore, do not have enough cases to provide robust information on epidemiology, treatment, and late effects, especially for rarer types of cancer. Thus, only through a concerted effort to share data internationally will we be able to answer research questions that could not otherwise be answered. With this goal in mind, the US National Cancer Institute and the French National Cancer Institute co-sponsored the Paris Conference for an International Childhood Cancer Data Partnership in November 2023. This meeting convened more than 200 participants from 17 countries to address complex challenges in pediatric cancer research and data sharing. This Commentary delves into some key topics discussed during the Paris Conference and describes pilots that will help move this international effort forward. Main topics presented include: (1) the wide variation in interpreting the European Union’s General Data Protection Regulation among Member States; (2) obstacles with transferring personal health data outside of the European Union; (3) standardization and harmonization, including common data models; and (4) novel approaches to data sharing such as federated querying and federated learning. We finally provide a brief description of 3 ongoing pilot projects. The International Childhood Cancer Data Partnership is the first step in developing a process to better support pediatric cancer research internationally through combining data from multiple countries.