AIMS OF EUROCARE-5
Are:

1. To update the existing EUROCARE data bank, by including data of patients diagnosed up to 2007. Follow up will be updated to the most recent possible dates (e.g. on 31/12/2008) in order to analyse both long and short term survival rates of cases diagnosed more recently.
2. To analyse survival of cancer patients by means of conventional and more innovative methods: e.g. cohort relative survival; period survival analysis to estimate survival of patients with recent diagnosis; mixture survival model to estimate the proportion of patients cured.
3. To compare diagnostic and therapeutic procedures for cancer patients in Italy with those in other European countries at high survival by means of high resolution studies (HR).
4. To increase and promote the use of cancer survival registry data. The EUROCARE results will be diffused among the medical, public health and scientific communities, to the public in general, to tumour patients and to health planners.

   Expected Outcomes

   From survival analyses

• period survival analyses will be used to provide an estimate of survival time for patients diagnosed in recent years.
• the cohort method will be used for producing relative survival estimated by tumour site, age, country and gender. As in the past EUROCARE projects, relative survival will be computed by using the specific population life tables of the cancer registries.
• The proportion of cured patients estimated by mixture survival models will produce a complementary indicator to overall survival.
• Time trends of survival will provide information to the discussions on the effects of screening programmes and on the effectiveness of new treatments.
• Comparison of cancer survival between Europe and USA will be made available. Until now survival of the EUROCARE patients has been compared with that of patients included in the SEER (Surveillance, Epidemiology and End Results) network. This comparison will now be extended to the US registries of the NCP (National Cancer Registry).

   From the High Resolution studies

• Comparisons of the breakdown by tumour stage at diagnosis across regions, taking into account the type of diagnostic investigation.
• Development of Indicators of best practice and comparisons of their frequency across European regions. Examples of these indicators: hormonal treatment for breast cancer patients with ER positive; treatment with trastuzumab for breast cancer with HER2 over-expression; adjuvant chemotherapy in Dukes C colon cancer; frequency of sentinel lymph node examination. Multivariable analyses will be carried out for comparing across regions the odd of receiving a given treatment, by age, stage and other prognostic variables.
• Increase of the quality and availability of morphology data. A part of cancer survival differences could be explained by a difference in criteria that have been adopted to establish the tumour invasiveness. The feasibility to carry out studies which also review the microscopic slides on a sample basis is going to be explored.

   From both survival and HR studies

• Traditional publications such as scientific articles in biomedical journals or dedicated monographs and books.
• Electronic publications and Links with related cancer websites.
• Participation in national and international scientific meetings.
• Contacts with regional and national health planners and authorities.
• Communication with patient’s organisations and charities.
• Organization of seminars and courses.

   LONG TERM EXPECTED OUTCOMES FROM THE WHOLE EUROCARE PROJECT

• Reduce inequalities in cancer care and survival across Europe.
• Increase standards of cancer care in Europe.
• Provide information that is useful for health planners, doctors and citizens as well.