Objective: To gain insight into the survival of cancer patients in order to evaluate any improvement in cancer care.
Design: A retrospective population-based cohort study.
Method: Data from the Netherlands Cancer Registry were used for this study. For all patients diagnosed with cancer in the Netherlands between 1989 and 2008, information on vital status was obtained from hospitals, municipalities and the Municipal Personal Records Database. Age-standardised, relative survival rates per cancer type were calculated.
Results: The 5-year relative survival for all types of cancer combined increased from 47% in 1989-1993 to 59% in 2004-2008. This increase was greater in males than in females (from 40% to 55% and from 55% to 62%, respectively). The most striking improvements in survival were observed in breast, prostate and colorectal cancers, probably for reasons differing for each cancer type. Patients with chronic myeloid leukaemia showed the greatest gain in survival (43%). Survival rates in older patients were generally worse in comparison to those in younger patients, especially in case of head and neck cancer, ovarian cancer and haematological malignancies. The survival gap between older and younger patients has increased over the last 20 years. The 10-year survival rate for most cancer types was not much lower than the 5-year rate, except in chronic and indolent haematological malignancies and cancers that may reoccur after a long time, such as breast and prostate cancer.
Conclusion: The increase in survival rates of cancer patients in the Netherlands, attributed to early detection and improved treatment, could represent either an increase in the number of patients cured or to cancer patients living longer lives. A potential area for further improvement is especially notable in the elderly. This is even more important given the ageing population.