Advertisement

European Journal of Epidemiology

, Volume 27, Issue 9, pp 689–693 | Cite as

Cancer survival in Eastern and Western Germany after the fall of the iron curtain

  • Lina Jansen
  • Adam Gondos
  • Andrea Eberle
  • Katharina Emrich
  • Bernd Holleczek
  • Alexander Katalinic
  • Hermann Brenner
  • GEKID Cancer Survival Working Group
CANCER

Abstract

Prior to the German reunification, cancer survival was much lower in East than in West Germany. We compare cancer survival between Eastern and Western Germany in the early twenty-first century, i.e. the second decade after the German reunification. Using data from 11 population-based cancer registries covering a population of 33 million people, 5-year age-standardized relative survival for the time period 2002–2006 was estimated for the 25 most common cancers using model-based period analysis. In 2002–2006, 5-year relative survival was very similar for most cancers, with differences below 3 % units for 20 of 25 cancer sites. Larger, statistically significant survival advantages were seen for oral cavity, oesophagus, and gallbladder cancer and skin melanoma in the West and for leukemia in the East. Our study shows that within two decades after the assimilation of political and health care systems, the former major survival gap of cancer patients in Eastern Germany has been essentially overcome. This result is encouraging as it suggests that, even though economic conditions have remained difficult in Eastern Germany, comparable health care provision may nevertheless enable comparable levels of cancer survival within a relatively short period of time.

Keywords

Cancer survival Cancer registry Regional variation Germany 

Notes

Acknowledgments

This study was supported by the German Cancer Aid (Deutsche Krebshilfe) Grant No. 108257.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Brenner H, Francisci S, de Angelis R, Marcos-Gragera R, Verdecchia A, Gatta G, et al. Long-term survival expectations of cancer patients in Europe in 2000–2002. Eur J Cancer. 2009;45(6):1028–41.PubMedCrossRefGoogle Scholar
  2. 2.
    Verdecchia A, Francisci S, Brenner H, Gatta G, Micheli A, Mangone L, et al. Recent cancer survival in Europe: a 2000–02 period analysis of EUROCARE-4 data. Lancet Oncol. 2007;8(9):784–96.PubMedCrossRefGoogle Scholar
  3. 3.
    Möhner M, Stabenow R, Eisinger B. Atlas der Krebsinzidenz in der DDR 1961–1989. Munich: Urban and Fischer; 1999.Google Scholar
  4. 4.
    Gondos A, Holleczek B, Arndt V, Stegmaier C, Ziegler H, Brenner H. Trends in population-based cancer survival in Germany: to what extent does progress reach older patients? Ann Oncol. 2007;18(7):1253–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Stabenow R, Wilsdorf-Köhler H, Neumeyer-Gromen A, Streller B. Krebs in Mecklenburg–Vorpommern 2007–2008 (Landesbericht). Berlin: Gemeinsames Krebsregister; 1/2011.Google Scholar
  6. 6.
    Hiripi E, Gondos A, Emrich K, Holleczek B, Katalinic A, Luttmann S, et al. Survival from common and rare cancers in Germany in the early 21st century. Ann Oncol. 2011;23(2):472–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Brenner H, Hakulinen T. Up-to-date and precise estimates of cancer patient survival: model-based period analysis. Am J Epidemiol. 2006;164(7):689–96.PubMedCrossRefGoogle Scholar
  8. 8.
    Brenner H, Hakulinen T. Up-to-date long-term survival curves of patients with cancer by period analysis. J Clin Oncol. 2002;20(3):826–32.PubMedCrossRefGoogle Scholar
  9. 9.
    Brenner H, Soderman B, Hakulinen T. Use of period analysis for providing more up-to-date estimates of long-term survival rates: empirical evaluation among 370,000 cancer patients in Finland. Int J Epidemiol. 2002;31(2):456–62.PubMedCrossRefGoogle Scholar
  10. 10.
    Corazziari I, Quinn M, Capocaccia R. Standard cancer patient population for age standardising survival ratios. Eur J Cancer. 2004;40(15):2307–16.PubMedCrossRefGoogle Scholar
  11. 11.
    Ederer F, Heise H. Instructions to IBM 650 programmers in processing survival computations. Bethesda: National Cancer Institute; 1959.Google Scholar
  12. 12.
    Robert Koch Institute. 20 Jahre nach dem Fall der Mauer: Wie hat sich die Gesundheit in Deutschland entwickelt?. Berlin: Robert Koch Institute; 2010.Google Scholar
  13. 13.
    Razum O, Altenhoner T, Breckenkamp J, Voigtlander S. Social epidemiology after the German reunification: east vs. West or poor vs. rich? Int J Public Health. 2008;53(1):13–22.PubMedCrossRefGoogle Scholar
  14. 14.
    Coleman MP, Rachet B, Woods LM, Mitry E, Riga M, Cooper N, et al. Trends and socioeconomic inequalities in cancer survival in England and Wales up to 2001. Br J Cancer. 2004;90(7):1367–73.PubMedCrossRefGoogle Scholar
  15. 15.
    Rachet B, Ellis L, Maringe C, Chu T, Nur U, Quaresma M, et al. Socioeconomic inequalities in cancer survival in England after the NHS cancer plan. Br J Cancer. 2010;103(4):446–53.PubMedCrossRefGoogle Scholar
  16. 16.
    Bastiaannet E, de Craen AJ, Kuppen PJ, Aarts MJ, van der Geest LG, van de Velde CJ, et al. Socioeconomic differences in survival among breast cancer patients in the Netherlands not explained by tumor size. Breast Cancer Res Treat. 2011;127(3):721–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Lagerlund M, Bellocco R, Karlsson P, Tejler G, Lambe M. Socio-economic factors and breast cancer survival—a population-based cohort study (Sweden). Cancer Causes Control. 2005;16(4):419–30.PubMedCrossRefGoogle Scholar
  18. 18.
    Berrino F, Micheli A, Sant M, Capocaccia R. Interpreting survival differences and trends. Tumori. 1997;83(1):9–16.PubMedGoogle Scholar
  19. 19.
    Brenner H, Hakulinen T. Population-based monitoring of cancer patient survival in situations with imperfect completeness of cancer registration. Br J Cancer. 2005;92(3):576–9.PubMedGoogle Scholar
  20. 20.
    Kogevinas M, Porta M. Socioeconomic differences in cancer survival: a review of the evidence. IARC Sci Publ. 1997;138:177–206.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Lina Jansen
    • 1
  • Adam Gondos
    • 1
  • Andrea Eberle
    • 2
  • Katharina Emrich
    • 3
  • Bernd Holleczek
    • 4
  • Alexander Katalinic
    • 5
  • Hermann Brenner
    • 1
  • GEKID Cancer Survival Working Group
  1. 1.Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
  2. 2.Cancer Registry of Bremen, BIPS—Bremen Institute for Epidemiology and Prevention ResearchUniversity of BremenBremenGermany
  3. 3.Cancer Registry of Rhineland-Palatinate, Institute for Medical Biostatistics, Epidemiology and InformaticsUniversity Medical Center, Johannes Gutenberg University MainzMainzGermany
  4. 4.Saarland Cancer RegistrySaarbrückenGermany
  5. 5.Institute of Cancer EpidemiologyUniversity of LübeckLübeckGermany

Personalised recommendations