Standardisation of stage information collected by European population-based cancer registries: an application to breast cancer survival.

Authors

S Rossi, F Cerza, D Bennett, K Innos, K Henau, E Demuru, L Botta, K Hammas, C Vener, R Lillini, A Bernasconi, A Trama, R De Angelis, EUROCARE-6 Working Group

Published in

ESMO real world data and digital oncology. Volume 14. Pages 100794. Epub Oct 20, 2026.

Abstract

Stage at diagnosis strongly influences breast cancer (BC) prognosis. However, differences in staging systems and incomplete data in European population-based cancer registries (PBCRs) limit international comparisons. We propose a standardized TNM-based stage reconstruction to analyse long-term stage-specific BC survival across Europe.
We analysed 714 864 female BC cases diagnosed during 2001-2013 from 23 PBCRs in 14 European countries from the EUROCARE-6 dataset. Stage data were standardized to the seventh TNM edition. Stage was reconstructed into four categories (I-IV). Ten-year relative survival (RS) and 10-year RS conditional on surviving 5 years (CRS_10/5) were estimated in the period 2010-2014 using period analysis.
Availability of stage information for BC ranged from 75% to 99% across countries. Early-stage disease (I-II) represented 80% of known stages, with higher prevalence of stage I in Northern and Central Europe than in Eastern Europe. Overall, 10-year age-adjusted RS decreased from 97% in stage I to 10% in stage IV. Geographic variation was limited for stage I and marked for other stages, with poorer outcomes in Eastern Europe. CRS_10/5 showed minimal excess mortality after 5 years for stage I but persistent excess mortality for more advanced stages. Younger women had poorer outcomes than those aged 45-54 years.
Population-based data on stage for BC confirm the importance of early diagnosis and highlight large disparities in treatment and prognosis across Europe for patients with advanced-stage BC. Improved availability of harmonized stage information at population level is essential for designing and assessing evidence-based cancer control policies.

PMID:
42960025
Bibliographic data and abstract were imported from PubMed on 30 Oct 2026.

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