Prognosis and cure of long-term cancer survivors: A population-based estimation

Background: Increasing evidence of cure for some neoplasms has emerged in recent years. The study aimed to estimate population-based indicators of cancer cure. Methods: Information on more than half a million cancer patients aged 15-74 years collected by population-based Italian cancer registries and mixture cure models were used to estimate the life expectancy of fatal tumors (LEFT), proportions of patients with similar death rates of the general population (cure fraction), and time to reach 5-year conditional relative survival (CRS) >90% or 95% (time to cure). Results: Between 1990 and 2000, the median LEFT increased >1 year for breast (from 8.1 to 9.4 years) and prostate cancers (from 5.2 to 7.4 years). Median LEFT in 1990 was >5 years for testicular cancers (5.8) and Hodgkin lymphoma (6.3) below 45 years of age. In both sexes, it was <=0.5 years for pancreatic cancers and NHL in 1990 and in 2000. The cure fraction increased 10 percentage points between 1990 and 2000. It was 95% for thyroid cancer in women, 94% for testicular, 75% for pros- tate, 67% for breast cancers, and <20% for liver, lung, and pancreatic cancers. Time to 5-year CRS >95% was <10 years for testis, thyroid, colon cancers, and melanoma. For breast and prostate cancers, the 5-year CRS >90% was reached in <10 years but a small excess remained for >15 years. Conclusions: The study findings confirmed that several cancer types are curable. The awareness of the possibility of cancer cure has relevant clinical and social impacts. KEYWORDS cancer cure, Italy, population-based cancer registries, prevalence, survival