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Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities
BACKGROUND: Cancer of unknown primary (CUP) is the fourth most common cause of cancer death. With advanced diagnostics and treatments, we investigated the proportion of cancers diagnosed as CUP, treatment outcomes and association with socioeconomic disparities. METHODS: We analysed trends in CUP dia...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778275/ https://www.ncbi.nlm.nih.gov/pubmed/23860528 http://dx.doi.org/10.1038/bjc.2013.386 |
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author | Urban, D Rao, A Bressel, M Lawrence, Y R Mileshkin, L |
author_facet | Urban, D Rao, A Bressel, M Lawrence, Y R Mileshkin, L |
author_sort | Urban, D |
collection | PubMed |
description | BACKGROUND: Cancer of unknown primary (CUP) is the fourth most common cause of cancer death. With advanced diagnostics and treatments, we investigated the proportion of cancers diagnosed as CUP, treatment outcomes and association with socioeconomic disparities. METHODS: We analysed trends in CUP diagnosis and outcome within the Surveillance, Epidemiology, and End Results registry between 1973 and 2008. RESULTS: The percentage of all cancers diagnosed as CUP has decreased over time comprising <2% of cancers since 2007. A higher proportion of CUP was diagnosed in the elderly, females, blacks and residents of less affluent or less educated counties. Median survival of all CUP patients was 3 months, with no improvement over time. The 5-year survival significantly improved in those with squamous histology (squamous cell carcinoma; SCC) but only marginally in non-SCC. Factors associated with a longer survival on multivariate analysis included white race; female; <65 years old; most recent decade at diagnosis; SCC; married; a histological diagnosis; and treatment with radiotherapy (all P<0.001). Despite the improvement in survival with radiotherapy, its use was less frequent in females and blacks. CONCLUSION: The percentage of cancers diagnosed as CUP is decreasing but prognosis remains poor, particularly in non-SCC CUP. However, significant socioeconomic disparities exist in diagnosis and survival, suggesting inequalities in access to diagnostic investigations and treatment. |
format | Online Article Text |
id | pubmed-3778275 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-37782752014-09-03 Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities Urban, D Rao, A Bressel, M Lawrence, Y R Mileshkin, L Br J Cancer Epidemiology BACKGROUND: Cancer of unknown primary (CUP) is the fourth most common cause of cancer death. With advanced diagnostics and treatments, we investigated the proportion of cancers diagnosed as CUP, treatment outcomes and association with socioeconomic disparities. METHODS: We analysed trends in CUP diagnosis and outcome within the Surveillance, Epidemiology, and End Results registry between 1973 and 2008. RESULTS: The percentage of all cancers diagnosed as CUP has decreased over time comprising <2% of cancers since 2007. A higher proportion of CUP was diagnosed in the elderly, females, blacks and residents of less affluent or less educated counties. Median survival of all CUP patients was 3 months, with no improvement over time. The 5-year survival significantly improved in those with squamous histology (squamous cell carcinoma; SCC) but only marginally in non-SCC. Factors associated with a longer survival on multivariate analysis included white race; female; <65 years old; most recent decade at diagnosis; SCC; married; a histological diagnosis; and treatment with radiotherapy (all P<0.001). Despite the improvement in survival with radiotherapy, its use was less frequent in females and blacks. CONCLUSION: The percentage of cancers diagnosed as CUP is decreasing but prognosis remains poor, particularly in non-SCC CUP. However, significant socioeconomic disparities exist in diagnosis and survival, suggesting inequalities in access to diagnostic investigations and treatment. Nature Publishing Group 2013-09-03 2013-07-16 /pmc/articles/PMC3778275/ /pubmed/23860528 http://dx.doi.org/10.1038/bjc.2013.386 Text en Copyright © 2013 Cancer Research UK http://creativecommons.org/licenses/by-nc-sa/3.0/ From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/ |
spellingShingle | Epidemiology Urban, D Rao, A Bressel, M Lawrence, Y R Mileshkin, L Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities |
title | Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities |
title_full | Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities |
title_fullStr | Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities |
title_full_unstemmed | Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities |
title_short | Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities |
title_sort | cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778275/ https://www.ncbi.nlm.nih.gov/pubmed/23860528 http://dx.doi.org/10.1038/bjc.2013.386 |
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