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Cancer Survival

Key findings

The 5-year relative survival ratio for 3 of the most common cancers improved in Ontario between 2002 and 2016. The 5-year relative survival ratios increased from 86% to 89% for female breast cancer, from 63% to 69% for colorectal cancer and from 18% to 24% for lung cancer. There was a slight decrease in survival for prostate cancer since 2002, although the 5-year relative survival ratio remains high at 93%.

Why is this important to Ontarians?     

Survival statistics indicate the effectiveness of cancer treatment and control programs.[1] Relative survival ratios indicate the likelihood of surviving for a certain amount of time (e.g., 1, 3 or 5 years) after a cancer diagnosis compared with people of the same age and sex in the general population. Changes in relative survival ratios happen more slowly than changes in incidence and mortality because survival rates depend on the interplay of these measures.

The first 5 years after diagnosis are a critical period for examining survival because that is when patients are more likely to access healthcare services, including primary treatment and clinical assessment for recurrence. After the first 5 years, the use of the healthcare system and the chance of recurrence both decrease.[2]

See Cancer Survival Methodology for technical information.

Note: Estimates include only the first primary cancer case per person, coded using the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) recode site group. Subsequent primary cancers captured by the Ontario Cancer Registry's new National Cancer Institute’s SEER standards for counting multiple primary cancers (adopted for cases diagnosed in 2010 and beyond) were excluded.

Data Table 1. Age-standardized 5-year relative survival ratio for the 4 most commonly diagnosed cancers, Ontario, 2002 to 2006 versus 2012 to 2016
Type of Cancer 2002 to 2006 (%) 95% Confidence Interval (lower, upper) 2012 to 2016 (%) 95% Confidence Interval (lower, upper)
Breast (female) 86.1 85.5-86.6% 88.5 87.7-89.1%
Colorectal 63.2 62.6-63.8% 68.6 67.8-69.3%
Lung 17.8 17.4-18.3% 24.4 23.7-25.1%
Prostate 94.8 94.3-95.3% 93.1 92.4-93.7%

Note: Estimates include only the first primary cancer case per person, coded using the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) recode site group. Subsequent primary cancers captured by the Ontario Cancer Registry's new National Cancer Institute’s SEER standards for counting multiple primary cancers (adopted for cases diagnosed in 2010 and beyond) were excluded.

Table 1: Five-year relative survival ratio (from 2010 to 2014), by jurisdiction and type of cancer
Jurisdiction Female Breast
Five-year relative survival ratio (%)
Colorectal
Five-year relative survival ratio (%)
Lung
Five-year relative survival ratio (%)
Prostate
Five-year relative survival ratio (%)
Ontarioϴ 88.5 68.6 24.4 93.1
British Columbia 87.4 66.1 20.7 92.5
Alberta 88.8 65.7 20.7 91.5
Saskatchewan 87.2 66.9 19.6 89.9
Manitoba 88.0 65.2 21.6 90.8
Nova Scotia 86.7 63.3 18.4 93.1
New Brunswick 87.4 66.7 23.5 93.4
Prince Edward Island 88.3 61.1 14.0 92.3

Data source:  North American Association of Central Cancer Registries [Internet].Cancer in North America: 2012-2016, Volume Four: Cancer Survival in the United States and Canada 2009-2015; [cited on 2019 Sept 10]. Available from: https://www.naaccr.org/wp-content/uploads/2019/05/CINA2018.v4.survival.pdf

Note: ϴ Ontario data is from 2012 to 2016.

 

 

Table 2: Five-year relative survival ratio (from 2009 to 2015), by jurisdiction and type of cancer
Jurisdiction Colon
Five-year relative survival ratio (%)
Rectum
Five-year relative survival ratio (%)
Lung
Five-year relative survival ratio (%)
Ontario 68.3 68.6 22.3
New South Wales (Australia) 71.3 68.7 19.9
Victoria (Australia) 69.2 72.1 22.4
Western Australia 72.9 71.9 21.4
Alberta 65.6 65.1 20.9
British Columbia 66.0 67.3 21.3
Manitoba 64.2 65.0 22.7
New Brunswick 68.3 67.7 24.9
Nova Scotia 62.4 60.5 19.3
Prince Edward Island 60.1 68.5 13.1
Saskatchewan 65.4 66.5 20.6
Denmark 65.7 69.1 18.
Ireland 61.8 62.4 19.8
New Zealand 62.1 65.4 15.5
Norway 65.4 68.8 20.4
England 58. 62.2 15.0
Northern Ireland 62.5 60.6 13.5
Scotland 59.7 62.9 14.1
Wales 56.7 60.8 14.0

 

Data source: Arnold M, Rutherford MJ, Bardot A, et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 2019; published online Sept 11. http://dx.doi.org/10.1016/S1470-2045(19)30456-5. Available from: http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30456-5/fulltext

Results

  • The improvements in survival may be attributable to advances in treatment and detection, such as improvements in diagnostic technologies that help detect cancer earlier and the implementation of organized screening programs for some cancers. 
  • The 5-year relative survival ratios for breast and prostate cancers are high at 89% and 93% respectively.
  • The 5-year relative survival ratios for colorectal and lung cancers have improved since 2002. Colorectal cancer survival rates increased from 63% to 69% and lung cancer survival rates increased from 18% to 24%.

Comparisons

Getting comparable data and measures from other jurisdictions is a challenge. Be aware of the different data definitions, methodologies and years used in indicators measured outside of Ontario. Jurisdictional comparison is still useful to provide a rough indication of how well Ontario is doing relative to other provinces and countries.

  • Table 1 indicates that Ontario’s relative survival ratios for the 4 most common cancers are among the highest in Canada. Ontario has the best survival rates for colorectal and lung cancers, and the second-highest rates for both prostate and breast cancers.
  • The results are based on data from the North American Association of Central Cancer Registries, which has produced the Cancer in North America CiNA Survival Volume since March 2016 to provide cancer survival estimates on a wider population than was previously available.
  • The CiNA Survival publication includes diagnosis years 2009 to 2015, with follow-up through the end of 2015.
  • Another source for benchmarking survival is the International Cancer Benchmarking Partnership SURVMARK-2 study, which includes the most recent collection of survival statistics for 7 types of cancer in 7 countries from 1995 to 2014: Canada, Australia, Denmark, Ireland, New Zealand, Norway and the United Kingdom.
  • Highlights from the study indicate that Canada has among the highest 5-year survival rates for lung cancer (21.7%) and colon cancer (66.8%) compared with other participating countries.
  • Table 2 shows that, compared with other Canadian and international jurisdictions, Ontario ranked:
  • Fourth highest for lung cancer (22.3%), behind New Brunswick (24.9%), Manitoba (22.7%) and Victoria (Australia) (22.4%)
  • Fourth highest for colon cancer (68.3%), behind Western Australia (72.9%), New South Wales (71.3%) and Victoria (69.2%)
  • Differences in Ontario’s ranking for lung cancer between the CiNA Survival Volume and the SURVMARK-2 study may be due to differences in methodology between the 2 sources.

     

For more information

Find more information on cancer incidence, mortality, survival and prevalence in Ontario in the Ontario Cancer Statistics 2018 Report.

Find information on cancer statistics across Canada in Canadian Cancer Statistics.

References

  1. Dickman PW, Adami HO. Interpreting trends in cancer patient survival. J Intern Med. 2006;260(2):103-17
  2. Cancer Care Ontario. Ontario Cancer Statistics 2018. Toronto: Cancer Care Ontario; 2018.