SUBMITTED 21 AUG 22 1

REVISION REQ. 25 SEPT 22; REVISION RECD. 24 NOV 22 2

ACCEPTED 15 DEC 22 3

ONLINE-FIRST: JANUARY 2023 4

DOI: https://doi.org/10.18295/squmj.1.2023.002 5

Long-Term Survival in Patients with Cancers 7

A SEER-based analysis 8

Rokia A. Sakr,1 Abdelrahman A. Nasr,2 *Eman I. Zineldin,3 Mohamed A. 9

Gouda4 10

Departments of 1Pathology and 2Hepatobiliary Surgery, National Liver Institute and 3Student 11

Research Unit and 4Department of Clinical Oncology, Faculty of Medicine, Menoufia 12

University, Menoufia, Egypt. 13

*Corresponding Author’s e-mail: eman.ibrahiem43@med.menofia.edu.eg 14

Abstract 16

Objectives: Long-term survival is an important endpoint in management of different 17

malignancies which is rarely assessed due to unfeasibility of follow-up for long duration of 18

time. In this study, we explored real-world data on cancer’s long-term survival using 19

historical records from the Surveillance, Epidemiology, and End Results (SEER) Program. 20

Besides reporting the 5-year relative survival, we analyzed the 10- and 20- year survival rates 21

for different types of cancers. Additionally, survival trends as a function of time, age, and 22

tumor type were reviewed and reported. Methods: We used SEER*Stat (version 8.3.6.1) for 23

data acquisition from the SEER 9 Regs (Nov 2019 Submission) database. Data of patients 24

diagnosed with cancer between 1975 and 2014 were retrieved and included in the analysis. 25

Results: For patients diagnosed with any malignant disease (n = 4,412,024), there was a 26

significant increase in median overall survival over time (p<0.001). The 20-, 10-, and 5-year 27

survival rates were higher in solid tumors compared to hematological malignancies (50.8% 28

vs. 38%, 57% vs. 47.4%, and 62.2% vs. 57.4%, respectively). The highest 20-year relative 29

survival rates were observed in thyroid cancer (95.2%), germ cell and trophoblastic 30

neoplasms (90.3%), melanoma (86.8%), Wilms’ tumor (86.2%), and prostate cancer (83.5%). 31

Conclusions: Long-term follow-up data were suggestive of high 20-year relative survival 32

rates for most tumor types. Relative survival showed an improving trend over time especially 33

in solid tumors. 34

Keywords: Survival; Neoplasms; SEER Program; Prognosis; United States. 35

Advances in Knowledge 37

• There was a significant increase in long-term survival rates in cancer patients over 38

the period between 1975 and 2014. 39

• The highest 20-year relative survival rate is seen in thyroid cancer, germ cell and 40

trophoblastic neoplasms, melanoma, Wilms’ tumor, and prostate cancer. 41

• Twenty-year relative survival rate is higher in solid cancers compared to 42

hematological malignancies. 43

Application to Patient Care 45

• Improved cancer diagnostics and therapeutic options have led to a substantial 46

increase in survival rates over time. This necessitates the development of long-47

term follow-up programs to accommodate the growing number of cancer 48

survivors. 49

• Twenty-year survival rates for some malignancies are high. Patients diagnosed 50

with those types of tumors should be aware of their probability of survival and 51

counseled about cancer survivorship. 52

Introduction 54

In the United States (US), nearly 609,360 persons are projected to die from cancer in the year 55

2022. In fact, cancer is currently considered the second most common cause of death in both 56

men and women in the US.1 This domination over other causes of death is a daunting fact for 57

cancer patients and their families that remains consistent among different races and variable 58

age groups.2 59

Although many researchers have studied cancer-related mortality, cancer survivorship usually 61

remains an underrepresented topic in literature despite growing interest in the concept in the 62

past decade. In 2019, more than 16.9 million Americans have survived cancer—a number that 63

is projected to reach more than 22.1 million by 2030.3 With recent advances in cancer 64

diagnostics and therapeutics, survival is expected to become even much better with a further 65

increase in the number of cancer survivors among the overall population.4,5 66

Cancer survival rates can vary according to tumor type and patients’ clinicodemographics.4,5 68

Exploring survival rates can not only provide insights into the natural history of different 69

cancers but also enlighten us about the changes that happened across time because of the 70

introduction of novel treatment options or incorporation of new preventive strategies including 71

screening programs. Most studies reporting on cancer survival, including clinical trials, have 72

addressed either 5-year or 10-year survival rates.6–9 However, looking into survival rates from 73

a more holistic approach that goes beyond 10 years is imperative; though this is usually 74

impractical to address in short-term studies or even in the context of prospective clinical trials. 75

In this study, we aimed to investigate long-term survival, including 20-year survival rates, of 77

different cancers in the US. We also tried to explore possible differences in survival rates across 78

tumor types, their association with different sociodemographic parameters, and their trends as 79

a function of time. 80

Methods 82

Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program.10 83

SEER is a program that was initiated in the early 1970s by the US National Cancer Institute to 84

collect data from nationwide cancer registries. Its current databases cover 47.9% of the US 85

population and are presumably generalizable to patients with cancer all over the US. The SEER 86

9 database (Nov 2019 Submission), which covers 9.4% of the population and includes historic 87

data that go back to 1973, was used as the data source in this study. The study was exempted 88

from institutional review board approval being a SEER-based study according to National 89

Bureau of Economic Research`s guidance.11 90

The case-listing function in SEER*Stat 8.3.6.1 was used to export data on cancer cases 92

diagnosed between 1975 and 2014. We included patients with known ages who had cancers 93

with malignant behavior at the time of initial data entry. The relative survival was calculated 94

in SEER*Stat using the Ederer II method. The probability of relative survival compares 95

survival in the patients included in the analysis with the expected survival of the general 96

population obtained from the US 1970–2017 Expected Survival Life Tables.12 For relative 97

survival, cases with a missing cause of death and/or survival time were excluded from the 98

analysis. 99

100

According to the third edition of the International Classification of Diseases for Oncology, we 101

classified tumors into either solid tumors (8000/3-9581/3) or hematological malignancies 102

(9590/3+). Age at diagnosis was categorized into five main categories (0–14, 15–24, 25–54, 103

55–64, and 65+ years). For comparing trends over time, we stratified years of diagnosis into 104

four groups with a 10-year interval for each group. 105

106

Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0. 107

(Armonk, NY: IBM Corp). Frequencies and percentages were used to describe categorical 108

variables. Survival analysis was performed using the Kaplan–Meier analysis method, where 109

the log-rank test was used to test for statistical difference. Cox regression analysis was 110

performed to adjust for potentially confounding factors. The p-value of 0.05 was used to 111

determine statistical significance. 112

113

Results 114

In this analysis, we included 4,412,024 cases diagnosed with cancer between 1975 and 2014. 115

Elderly population (65 years and over) was the largest age group in our study (55.6%; n = 116

2,452,512). The majority of the study cohort were male (51.3%; n=2,262,378) and white (84%; 117

n=3,705,309). The most commonly encountered diagnosis was breast cancer (14.9%; n = 118

657,211); with solid tumors constituting 91.1% (n = 4,019,427) of the included cohort (Table 119

1). 120

121

The median overall survival for all patients included in the study was 66 months (95% 122

confidence interval (CI): 65.8–66.2 months) and showed a significant increase over time (35 123

months, 51 months, 77 months, and 101 months for cases diagnosed between 1975 and 1984, 124

1985 and 1994, 1995 and 2004, and 2005 and 2014, respectively; p<0.001) (Figure 1). The 125

highest 20-year relative survival was observed in thyroid cancer (95.2%), germ cell and 126

trophoblastic neoplasms (90.3%), melanoma (86.8%), Wilms’ tumor (86.2%), and prostate 127

cancer (83.5%) (Table 3). 128

129

Survival was compared across different prognostic factors including age, gender, stage, grade, 130

and cancer type. Results revealed that the 15-24 age group had better median overall survival 131

compared to 25-54, 55-64 and 65+ age groups (363.3 months vs 261 months, 112 months, and 132

37 months ; p<0.001) (Figure 1). Female patients had longer overall survival compared to male 133

patients (83 months vs 54 months, p<0.001) (Figure 1). Patients of black races had lower 134

survival rates compared to (American Indian/AK natives, Asian/pacific islanders) and white 135

races (115.2 months vs 152.2 months, and 134.9 months, p<0.001). In Cox regression analysis, 136

improvement in survival across time remained significant (hazard ratio (HR)= 0.899) and the 137

significance was also maintained across different age groups (HR=1.865), genders (HR: 138

1.008), races (HR: 0.939), and tumor types (HR: 0.781) (Table 2). 139

140

Despite consistent increase in survival rates in both tumor types, the 20-, 10-, and 5-year 141

survival rates were higher in solid tumors compared to hematological malignancies (50.8% vs. 142

38%, 57% vs. 47.4%, and 62.2% vs. 57.4%, respectively). Table 4 shows survival rates for 143

commonly diagnosed cancers.1 144

145

Discussion 146

The progress made in the oncology field has substantially improved cancer outcomes 13 but 147

little is known about how this was translated into a long-term survival benefit in patients with 148

cancer. To the best of our knowledge, this is the widest-scale analysis of long-term survival for 149

cancer patients that explored follow up data for up to 20 years after diagnosis using a tumor 150

agnostic approach. Data presented in this study are crucial to inform treating physicians about 151

the probability of long-term survival in different malignancies. This information is commonly 152

addressed during doctor–patient conversations, particularly in patients with advanced disease. 153

Current evidence suggests that the accuracy of oncologists’ expectations for survival in end-154

stage cancer patients was as low as 25%. This inaccuracy can not only lead to a lack of 155

credibility in physicians’ disclosed information but also mislead treatment-related decisions, 156

such as the need to refer patients for hospice care or the necessity of continuation of active 157

treatment.14–16 158

159

We have demonstrated, based on data from US cancer registries, that several malignancies have 160

a considerable long-term survival. The highest 20-year relative survival was observed in 161

thyroid cancer (95.2%), followed by germ cell and trophoblastic neoplasms, melanoma, and 162

Wilms’ tumor (90.3%, 86.8%, and 86.2%, respectively). A potential explanation for high 163

survival rates in these tumors is the early disease-related manifestations, the availability of 164

easy-access diagnostic approaches, and the advances in treatment options with curative intent 165

in those tumor types. Similar data were reported in the United Kingdom (UK) by Quaresma et 166

al., who have reported the highest 10-year survival in patients with testicular cancer (98.2%).19 167

168

Although some data support the notion that the highest rates of cancer survival are reported in 169

the US and Canada,18 trends in our survival analysis were consistent with findings from other 170

studies in other parts of the world. Most publications addressing shorter survival intervals have 171

reported improved survival over time; which is usually attributed to the introduction of new 172

treatment options for various tumors.18–20 This has been consistent with data reported in our 173

study, which showed a steady increase in 5-, 10-, and 20-year survival across almost all tumor 174

types. Interestingly, the survival probability showed an incremental decrease after 5 years as 175

compared to anticipated linear increase in the probability of death. For example, breast cancer 176

survival probability fell from 86.4% at the 5-year follow-up to only 70.1% at 20 years. In 177

colorectal cancer, the 20-year survival rate of 50.5% actually compares to that of 61.4% at 5 178

years. This highlights the fact that most death events would occur early in the course of disease. 179

Therefore, informing patients about the long-term prognosis of their illness should not rely 180

only on short-term survival data, which can sometimes be misleading. Our findings are 181

concordant with data from a similar study that was done twenty years ago and reported on long-182

term survival of patients diagnosed between 1974-1991. In the study by Wingo et al, an 183

incremental decrease in survival rates happened after 5 years in patients with colorectal cancer 184

with 15-years survival rate reported as 50% compared to 57% survival rate at 5 years.17 185

186

Our findings suggest that solid malignancies have a higher 20-year relative survival than 187

hematological malignancies. This difference in survival was consistent among all age groups 188

and was more prominent in older patients versus patients less than 14 years old who had better 189

survival with hematological malignancies. Improvements in the survival rate in hematological 190

malignancies seem more prominent (73.6% increment increase) than solid malignancies 191

(51.2% increment increase). These data conform to the data reported in previous studies from 192

different geographic areas.7,21,22 The survival difference between different age groups was also 193

reported in a population-based study in the UK where the net survival in the elderly population 194

was lower than that in younger patients over a 40-year period (1971–2011).19 Thus, observing 195

such a discrepancy is not surprising as both solid and hematological malignancies are a 196

heterogeneous group of different diseases with different natural histories and treatment options. 197

Elderly patients commonly show late manifestations and have multiple comorbidities that can 198

affect both treatment decisions and liability to treatment-induced toxicity. 199

200

Improvements in survival, however, do not come without a cost. Long-term cancer survivors 201

are more likely to experience treatment-induced long-term side effects, including organ failure 202

and secondary malignancies. Long-term nonmedical effects, including financial toxicity and 203

lifestyle changes, can also add a burden to long-term survivors. Thus, addressing cancer 204

survivorship issues, particularly in patients with potentially high survival rates, and 205

establishing follow-up guidelines that not only go beyond the normal follow-up periods but 206

also address medical and non-medical needs of cancer survivors are imperative. An effort to 207

address the cancer survivorship issue was made by the European Society for Medical Oncology 208

(ESMO) which provided expert consensus guidelines for management of cancer survivorship. 209

The guidelines identified core components that need to be addressed in cancer survivors 210

including physical and psychological effects, social and financial impact, active surveillance 211

for recurring cancers and second primaries, and promotion of well-being including 212

improvement of cancer prevention approaches and overall health. 23 213

214

This study addressed a huge number of patients with a long follow-up duration. 215

Notwithstanding the resulting comprehensiveness of analysis, our study has several limitations. 216

First, the SEER database does not provide detailed data on treatment options that patients 217

received. The included cohort was diagnosed over a long period of time which might have 218

resulted in heterogenous availability of treatment options and subsequent differences in clinical 219

outcomes. Second, the 20-year survival data could only be calculated for the SEER 9 database, 220

which includes cancer registries present since the inception of the SEER Program. Major 221

updates in SEER were performed, which currently include 22 cancer registries covering 47.9% 222

of the total cancer population in the US. However, the use of long-term data from newly 223

incorporated cancer registries will not be feasible until a couple of years later when the follow-224

up duration can allow for long-term survival analysis. Third, methods to evaluate survival rates 225

can vary and lead to differences in outcome interpretation 24. For example, there has been a 226

reported slightly higher relative survival rates with Ederer II method compared to Hakulinen 227

or Ederer I method when follow up duration exceeds ten years. In some cases, as in 228

malignancies that are diagnosed over a wide range of ages (e.g. thyroid), long term relative 229

survival for all ages combined may vary depending on the method used to estimate expected 230

survival; since Ederer I and Hakulinen methods will provide similar and higher relative survival 231

compared to that calculated by Ederer II 25. Finally, in general and as with data originating 232

from cancer registries, SEER extracted data must be interpreted with caution given the 233

challenges of unrecorded variables, underreported and incomplete adjuvant treatment data, 234

disparity in coding and reporting, and migration of patients between SEER registry regions .26 235

236

Conclusions 237

Long-term follow-up data suggests that 20-year relative survival rates are high for many 238

tumor types. The relative survival rates have significantly improved over time. Long-term 239

follow up programs for cancer survivors should be incorporated into clinical management of 240

patients with cancer. 241

242

Acknowledgments 243

We would like to thank Enago for their consult and help in the language editing of our 244

manuscript. 245

246

Authors’ Contribution 247

MAG conceptualised the study. RAS, EIZ and MAG designed the methodology. RAS, AAN, 248

EIZ and MAG drafted the original manuscript. AAN reviewed and edited the manuscript and 249

supervised the work. All authors approved the final version of the manuscript. 250

251

References 252

1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 253

2022;72(1):7-33. doi:10.3322/caac.21708 254

2. Heron M. National Vital Statistics Reports Volume 67, Number 5 July 26, 2018.; 2018. 255

3. Miller KD, Nogueira L, Mariotto AB, et al. Cancer Treatment and Survivorship 256

Statistics , 2019. 2019;69(5):363-385. doi:10.3322/caac.21565 257

4. Zeng C, Wen W, Morgans AK, Pao W, Shu X-O, Zheng W. Disparities by Race, Age, 258

and Sex in the Improvement of Survival for Major Cancers. JAMA Oncol. 259

2015;1(1):88. doi:10.1001/jamaoncol.2014.161 260

5. Dal Maso L, Panato C, Guzzinati S, et al. Prognosis and cure of long-term cancer 261

survivors: A population-based estimation. Cancer Med. 2019;8(9):4497-4507. 262

doi:10.1002/cam4.2276 263

6. Abbema D Van, Vissers P, Vos-geelen J De, Lemmens V, Janssen-heijnen M, Tjan-264

heijnen V. Trends in Overall Survival and Treatment Patterns in Two Large 265

Population-Based Cohorts of Patients with Breast and Colorectal Cancer. 266

7. Monnereau A, Troussard X, Belot A, et al. Unbiased estimates of long‐term net 267

survival of hematological malignancy patients detailed by major subtypes in France. 268

Int J Cancer. 2013;132(10):2378-2387. doi:10.1002/ijc.27889 269

8. Gatta G, Botta L, Rossi S, et al. Childhood cancer survival in Europe 1999–2007: 270

results of EUROCARE-5—a population-based study. Lancet Oncol. 2014;15(1):35-47. 271

doi:10.1016/S1470-2045(13)70548-5 272

9. De Angelis R, Sant M, Coleman MP, et al. Cancer survival in Europe 1999–2007 by 273

country and age: results of EUROCARE-5—a population-based study. Lancet Oncol. 274

2014;15(1):23-34. doi:10.1016/S1470-2045(13)70546-1 275

10. Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) 276

SEER*Stat Database: Incidence - SEER Research Data, 9 Registries, Nov 2019 Sub 277

(1975-2017) - Linked To County Attributes - Time Dependent (1990-2017) 278

Income/Rurality, 1969-2018 Counties, National Cancer Institute, DCCPS, Surveillance 279

Research Program, released April 2020, based on the November 2019 submission. 280

11. GUIDANCE: Data Sets Not Requiring IRB Review. From:shorturl.at/owEK. 281

Accessed:22nd nov 2022. 282

12. Arias E, Xu J. United States Life Tables, 2017.; 2019. 283

13. Hajdu SI, Vadmal M, Tang P. A note from history: Landmarks in history of cancer, 284

part 7. Cancer. 2015;121(15):2480-2513. doi:10.1002/cncr.29365 285

14. Chow E, Harth T, Hruby G, Finkelstein J, Wu J, Danjoux C. How Accurate are 286

Physicians’ Clinical Predictions of Survival and the Available Prognostic Tools in 287

Estimating Survival Times in Terminally III Cancer Patients? A Systematic Review. 288

Clin Oncol. 2001;13(3):209-218. doi:10.1053/clon.2001.9256 289

15. Vasista A, Stockler M, Martin A, et al. Accuracy and Prognostic Significance of 290

Oncologists’ Estimates and Scenarios for Survival Time in Advanced Gastric Cancer. 291

Oncologist. 2019;24(11). doi:10.1634/theoncologist.2018-0613 292

16. Glare P. A systematic review of physicians’ survival predictions in terminally ill 293

cancer patients. BMJ. 2003;327(7408):195-0. doi:10.1136/bmj.327.7408.195 294

17. Wingo A, Parker L, Gloeckler LA, Heath W. Long-Term Cancer Patient Survival in 295

the United States. 1998;7(April). 296

18. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer 297

survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 298

patients diagnosed with one of 18 cancers from 322 population-based registries in 71 299

countries. Lancet. 2018;391(10125):1023-1075. doi:10.1016/S0140-6736(17)33326-3 300

19. Quaresma M, Coleman MP, Rachet B. 40-year trends in an index of survival for all 301

cancers combined and survival adjusted for age and sex for each cancer in England and 302

Wales, 1971–2011: a population-based study. Lancet. 2015;385(9974):1206-1218. 303

doi:10.1016/S0140-6736(14)61396-9 304

20. Allemani C, Weir HK, Carreira H, et al. Global surveillance of cancer survival 1995–305

2009: analysis of individual data for 25 676 887 patients from 279 population-based 306

registries in 67 countries (CONCORD-2). Lancet. 2015;385(9972):977-1010. 307

doi:10.1016/S0140-6736(14)62038-9 308

21. Cowppli-Bony A, Uhry Z, Remontet L, et al. Survival of solid cancer patients in 309

France, 1989–2013. Eur J Cancer Prev. 2017;26(6):461-468. 310

doi:10.1097/CEJ.0000000000000372 311

22. Sant M, Minicozzi P, Mounier M, et al. Survival for haematological malignancies in 312

Europe between 1997 and 2008 by region and age: results of EUROCARE-5, a 313

population-based study. Lancet Oncol. 2014;15(9):931-942. doi:10.1016/S1470-314

2045(14)70282-7 315

23. Vaz-Luis I, Masiero M, Cavaletti G, et al. ESMO Expert Consensus Statements on 316

Cancer Survivorship: promoting high-quality survivorship care and research in Europe. 317

Ann Oncol. 2022;33(11):1119-1133. doi:10.1016/j.annonc.2022.07.1941 318

24. Makkar N, Ostrom QT, Kruchko C, Barnholtz-Sloan JS. A comparison of relative 319

survival and cause-specific survival methods to measure net survival in cancer 320

populations. Cancer Med. 2018;7(9):4773-4780. 321

doi:https://doi.org/10.1002/cam4.1706 322

25. Cho H, Howlader N, Mariotto AB, Cronin KA. Estimating relative survival for cancer 323

patients from the SEER Program using expected rates based on Ederer I versus Ederer 324

II method. 2011. 325

26. Park HS, Lloyd S, Decker RH, Wilson LD, Yu JB. Limitations and Biases of the 326

Surveillance, Epidemiology, and End Results Database. Curr Probl Cancer. 327

2012;36(4):216-224. doi:https://doi.org/10.1016/j.currproblcancer.2012.03.011 328

329

Figure 1: Kaplan–Meier curve for cases diagnosed with cancer between 1975 and 2014 330

stratified by age group, race, gender, stage, grade, and year of initial diagnosis. 331

332

333

Figure 2: Twenty-year survival for different age groups stratified according to tumor type. The 334

highest survival rates are observed in the 15-24 age group. Age groups are plotted on the x axis 335

and survival probability is plotted on the y axis. 336

337

Table 1: patients’ characteristics in the included cohort. 338
N %

Age group 0–14 years 31,594 0.7%

15–24 years 41,614 0.9%

25–54 years 917,720 20.8%

55–64 years 968,584 22%

65+ years 2,452,512 55.6%

Gender Male 2,262,378 51.3%

Female 2,149,646 48.7%

Race White 3,705,309 84%

Black 407,066 9.2%

Other (American

Indian/AK native,

Asian/pacific islander)

281,266 6.4%

Unknown 18,383 0.4%

Year of diagnosis 1975–1984 758,808 17.2%

1985–1994 1,025,529 23.2%

1995–2004 1,220,374 27.7%

2005–2014 1,407,313 31.9%

Tumor type Solid 4,019,427 91.1%

Hematology 392,597 8.9%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

0-14 years 15-24 years 20-54 years 55-64 years *65 years

20 year relative suvival

Solid Hematological All

Diagnosis Breast 657,211 14.9%

Prostate 610,247 13.8%

Lung and Bronchus 592,921 13.4%

Urinary Bladder 196,378 4.5%

Melanoma of the Skin 168,236 3.8%

Corpus Uteri 136,199 3.1%

NHL - Nodal 120,148 2.7%

Kidney and Renal

Pelvis

114,658 2.6%

Pancreas 112,114 2.5%

Other tumors 1,703,912 39%

339

Table 2: Cox regression analysis for different prognostic factors affecting survival time. P-340

value < 0.001 341
Regression

Coefficient
HR 95.0% CI for HR

Lower Upper

Age 0.623 1.865 1.862 1.867

Year of diagnosis -0.106 0.899 0.898 0.900

Stage 0.163 1.177 1.176 1.178

Grade 0.071 1.073 1.073 1.074

Cancer Type (solid and Hematological) -0.242 0.785 0.781 0.788

Sex 0.008 1.008 1.006 1.011

Race -0.063 0.939 0.938 0.940

342

Table 3: Survival data of cancers having highest 20-year relative survival.
5 year survival 10 year survival 20 year survival

1975-

1984

1985-

1994

1995-

2004

2005-

2014

All Years 1975-

1984

1985-

1994

1995-

2004

2005-

2014

All Years 1975-

1984

1985-

1994

1995-

2004

2005-

2014

All

Years

Thyroid

carcinoma

92.90% 94.60% 96.60% 98.50% 96.80% 91.40% 93.50% 95.90% 98.50% 96.10% 90.10% 92.40% 95.10% N/A 95.10%

Germ Cell and

Trophoblastic

Neoplasms

85.10% 92.50% 94.40% 95.50% 92.60% 83.80% 91.50% 94.20% 95.20% 92.00% 80.40% 90.30% 93.30% N/A 90.30%

Melanoma 82.00% 87.50% 91.00% 93.10% 89.90% 77.10% 84.40% 89.10% 92.10% 87.40% 75.00% 83.40% 88.90% N/A 86.70%

Wilms tumor 79.30% 91.10% 90.70% 94.10% 89.00% 77.70% 90.50% 89.10% 93.00% 87.80% 76.60% 89.00% 86.10% N/A 86.20%

N/A: 20 years survival rates cannot be calculated for this patient population due to short follow up to date.

Table 4: Survival data for commonly diagnosed tumors. Cancers listed are those shown to have highest incidence rates according to Siegel et al

2022.

5 year survival 10 year survival 20 year survival

1975-
1984

1985-
1994

1995-
2004

2005-
2014

All Years 1975-
1984

1985-
1994

1995-
2004

2005-
2014

All Years 1975-
1984

1985-
1994

1995-2004 2005-
2014

All Years

Breast 75.50% 84.00% 89.00% 91.10% 86.10% 63.60% 76.10% 83.50% 86.30% 78.80% 53.20% 67.50% 75.70% N/A 69.80%

Prostate 70.50% 89.10% 98.60% 99.10% 93.40% 55.70% 81.90% 97.90% 99.10% 89.70% 39.60% 72.40% 94.40% N/A 81.70%

Lung and Bronchus 12.70% 13.40% 15.30% 19.60% 15.40% 8.70% 9.00% 10.20% 13.10% 10.40% 4.80% 4.80% 5.50% N/A 5.60%

Colon and Rectum 52.10% 60.00% 64.00% 66.40% 60.80% 46.50% 53.90% 58.40% 60.10% 54.90% 42.60% 49.50% 52.60% N/A 50.00%

Corpus and Uterus, NOS 83.50% 82.80% 83.60% 83.20% 83.30% 81.60% 80.40% 80.70% 80.30% 80.80% 79.50% 76.80% 76.40% N/A 77.70%

Urinary Bladder 74.60% 78.80% 79.80% 78.70% 78.20% 66.50% 71.50% 73.10% 72.30% 71.00% 55.20% 60.10% 61.50% N/A 59.70%

Melanoma of the Skin 82.90% 88.60% 92.00% 94.00% 90.90% 78.40% 86.00% 90.50% 93.40% 88.90% 76.60% 85.20% 90.40% N/A 88.40%

Kidney and Renal Pelvis 51.50% 58.40% 65.50% 75.10% 65.80% 44.50% 50.80% 57.70% 68.80% 58.40% 36.80% 40.90% 47.00% N/A 47.60%

Non-Hodgkin Lymphoma 49.00% 51.30% 63.20% 73.40% 61.70% 37.20% 41.10% 55.70% 66.50% 52.60% 26.80% 31.70% 46.60% N/A 41.80%

Oral Cavity and Pharynx 52.50% 55.00% 60.50% 67.40% 59.30% 42.30% 44.40% 51.30% 59.30% 49.40% 29.80% 32.40% 38.40% N/A 36.10%

Leukemia 36.20% 44.20% 52.30% 64.50% 50.90% 25.40% 33.90% 44.70% 57.60% 41.60% 17.90% 26.70% 37.00% N/A 32.90%

Pancreas 2.70% 3.80% 4.90% 9.10% 5.60% 1.80% 2.60% 3.60% 6.50% 3.90% 1.30% 1.80% 2.10% N/A 2.60%

Thyroid 92.70% 94.40% 96.50% 98.40% 96.60% 91.30% 93.30% 95.80% 98.40% 96.00% 89.90% 92.10% 94.90% N/A 95.00%

N/A: 20 years survival rates cannot be calculated for this patient population due to short follow up to date.