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NHL 07 Global incidence of non-Hodgkin lymphoma Non-Hodgkin lymphoma: both sexes, all ages. Estimated age-standardized incidence rate per 100,000. The incidence of non-Hodgkin lymphoma (NHL) varies by geographic region. The areas with the highest incidence of NHL are North America, Europe, and Australasia, as well as several countries in Africa and South America. Source Globocan (2011) Graphs and maps. http://globocan.iarc.fr/ (URL accessed 20.02.12). <2.9 <4.1 <5.3 <6.8 <16.6 Contents Overview Section 1 Breast Cancer Section 2 Epidemiology Section 3 Treatment Section 4 Avastin® (bevacizumab) and breast cancer References Section 2 Epidemiology i. Incidence and mortality Worldwide: Globally, over one million women are diagnosed with breast cancer every year.1 It is the most frequently diagnosed cancer in women1 and the leading cause of cancer death in women.2 Every year more than 500,000 women die from the disease.2 Europe: In Europe over 400,000 women are diagnosed with breast cancer every year and 120,000 women die from the disease. Breast cancer is the most frequently diagnosed cancer in Europe and the leading cause of cancer death in European women.10 It accounts for 17% of female cancer deaths in this region.10 Figure 4 Incidence and mortality of some of the most common cancers worldwide Breast of all new cancer cases in North America are breast cancer of all new cancer cases in Central America are breast cancer 27% 571,204 288,654 27% of all new cancer cases in South America are breast cancer Colorectum 515,999 427,586 Lung 348,571 273,489 224,747 140,163 Ovary Every year more than 500,000 women die from breast cancer worldwide of all new cancer cases in Europe are breast cancer 19% of all new cancer cases in Asia are breast cancer 25% of all new cancer cases in Africa are breast cancer Across the world over one million women are diagnosed with breast cancer every year 28% of all new cancer cases in Australia & New Zealand are breast cancer Source: WHO GLOBOCAN 2008 Stomach 226,312 217,302 28% 19% 1,384,155 458,503 Figure 5 The global impact of breast cancer Liver Incidence and mortality of some of the most common cancers for women worldwide Source WHO GLOBOCAN 2008 North America: Over 200,000 women are diagnosed with breast cancer every year in North America.11 Breast cancer is the second most deadly form of cancer in North American women after lung; it kills over 45,000 women a year,11 representing almost 15% of female cancer deaths in North America. 7/ 12 Contents Overview Section 1 Breast Cancer Section 2 Epidemiology Section 3 Treatment Section 4 Avastin® (bevacizumab) and breast cancer References Section 2 Epidemiology i. Incidence and mortality Worldwide: Globally, over one million women are diagnosed with breast cancer every year.1 It is the most frequently diagnosed cancer in women1 and the leading cause of cancer death in women.2 Every year more than 500,000 women die from the disease.2 Europe: In Europe over 400,000 women are diagnosed with breast cancer every year and 120,000 women die from the disease. Breast cancer is the most frequently diagnosed cancer in Europe and the leading cause of cancer death in European women.10 It accounts for 17% of female cancer deaths in this region.10 Figure 4 Incidence and mortality of some of the most common cancers worldwide Breast of all new cancer cases in North America are breast cancer of all new cancer cases in Central America are breast cancer 27% 571,204 288,654 27% of all new cancer cases in South America are breast cancer Colorectum 515,999 427,586 Lung 348,571 273,489 224,747 140,163 Ovary Every year more than 500,000 women die from breast cancer worldwide of all new cancer cases in Europe are breast cancer 19% of all new cancer cases in Asia are breast cancer 25% of all new cancer cases in Africa are breast cancer Across the world over one million women are diagnosed with breast cancer every year 28% of all new cancer cases in Australia & New Zealand are breast cancer Source: WHO GLOBOCAN 2008 Stomach 226,312 217,302 28% 19% 1,384,155 458,503 Figure 5 The global impact of breast cancer Liver Incidence and mortality of some of the most common cancers for women worldwide Source WHO GLOBOCAN 2008 North America: Over 200,000 women are diagnosed with breast cancer every year in North America.11 Breast cancer is the second most deadly form of cancer in North American women after lung; it kills over 45,000 women a year,11 representing almost 15% of female cancer deaths in North America. 7/ 12 CLL06 Global incidence of chronic lymphocytic leukemia Leukemia: both sexes, all ages. Estimated age-standardized incidence rate. The incidence of chronic lymphocytic leukemia (CLL) varies by geographic region. The areas with the highest incidence of CLL are North America, Europe and Australasia. <2.2 Source Globocan (2011) Graphs and maps. http://globocan.iarc.fr/ (URL accessed on 20.02.12). <3.8 <5.0 <6.5 <11.9 Contents Overview Section 1 Lung Cancer Section 2 Epidemiology Section 3 Treatment Section 4 Avastin® (bevacizumab) and NSCLC References Section 2 Epidemiology i. Incidence & mortality Lung cancer is the most common type of cancer worldwide (accounting for 16.5% of all cancers), and is responsible for the greatest number of cancer deaths worldwide.1 Worldwide • 1.6 million new cases of lung cancer are diagnosed every year.1 • It is the most common cancer in men, and the third most common cancer in women in both developed and developing countries.8 • Lung cancer is the leading cause of cancer mortality and is responsible for 1.38 million deaths each year.1 • Each day, more than 3,000 people die from lung cancer worldwide, equal to two deaths every minute.2 • Almost half of the diagnosed cases of lung cancer occur in developing countries (49.9%), with the incidence generally being lower in women (globally, 12.1 per 100,000 women compared to 35.5 per 100,000 in men). 2000 where it accounts for an average of 20.3% of all cancer deaths.8 Figure 3 Lung cancer incidence by region North America Central & South America 1.38 Europe million deaths from lung cancer every year 1.6 Asia Africa million new cases of lung cancer every year Australia & New Zealand 85% Accounts for 28.4% of all cancer deaths in North America of cases are non-small cell lung cancer Accounts for an average of 20.3% of all cancer deaths in Europe 28.4% 20.3% 16.3% Accounts for an average of 11.6% of all cancer deaths in South and Central America 11.6% Accounts for an average of 9% of cancer deaths in Southern and Northern Africa Accounts for an average of 16.3% of all cancer deaths in Eastern, South Eastern, South Central and Western Asia 9% Accounts for an average of 22.4% of all cancer deaths in Australia, New Zealand and Micronesia 22.4% Parkin MD et al. Global Cancer Statistics, 2002. CA Cancer J Clin 2005; 55:74-108 Allen J et al. Neoadjuvant Chemotherapy in Stage III NSCLC J Natl Compr Canc Netw. 2008 6 (3):285-93 Garcia M, et al. Global Cancer Facts & Figures 2007. Atlanta, GA: American Cancer Society, 2007 *Developed countries defined as Europe, Japan, Australia, New Zealand and North America. Developing countries defined as Africa, Latin America and the Caribbean, Asia, Micronesia, Polynesia and Melanesia Europe Lung cancer is the leading cause of cancer related death in Europe, accounting for 18.9% of all cancer deaths in Western Europe and 21.1% of all cancer deaths in Northern Europe.8 Approximately 375,000 cases were attributed to lung cancer in The average estimated age-standardised incidence per 100,000 population was 71.8 for men and 21.7 for women, across the European Union (25-member states), in 2006.8 North America and Canada Lung cancer is the most common cause of cancer death in North America, accounting for 28.4% of all cancer deaths, and is the third most common type of new cancer cases (14.5%) in this region. North America has one of the highest lung cancer incidence rates for men and women with approximately 1.75 million new cancer cases and deaths in 2007.8 South and Central America Lung cancer is the most common cause of cancer death in South and Central America (accounting for 12% and 11.6% of all cancer deaths, respectively).8 9/ 14 NHL 09a Comparing the 5 year survival rate of patients with follicular lymphoma – a common type of non-Hodgkin lymphoma The average 5 year survival rate for follicular lymphoma patients with 0-1 risk factors The average 5 year survival rate for follicular lymphoma patients with 2 risk factors The average 5 year survival rate for follicular lymphoma patients with 3 or more risk factors Follicular Lymphoma International Prognostic Index (FLIPI) risk factors: • age 60+ • Ann Arbor stage III/IV • LDH (lactate dehydrogenase) > upper limit of normal • hemoglobin < 12g/dL • ≥ 5 nodal sites of disease Source NHL Cyberfamily (2012) Treatment Options http://www.nhlcyberfamily.org/outcomes.htm#ipi (URL accessed on 20.02.12). Survival Mortality NHL 09b Comparing the 5 year survival rate of patients with diffuse large B-cell lymphoma (DLBCL) – a common type of non-Hodgkin lymphoma The average 5 year survival rate for DLBCL patients with 0-1 risk factors The average 5 year survival rate for DLBCL patients with 2 risk factors The average 5 year survival rate for DLBCL patients with 3 risk factors The average 5 year survival rate for DLBCL patients with 4-5 risk factors International Prognostic Index (IPI) risk factors: • age 60+ • Ann Arbor stage III/IV • serum LDH (lactate dehydrogenase) > 1 x reference range • performance status ≥ 2 • >1 extranodal site Source The International Non-Hodgkin's Lymphoma Prognostic Factors Project (1993). NEJM 329 (14): 987-994. Survival Mortality Contents Overview Section 1 Breast Cancer Section 2 Epidemiology Section 3 Treatment ii. Lifetime risk of breast iii. Prognosis cancer Cancer statistics often use an ‘overall 5 On average one in eight women will develop breast cancer in their lifetime. This is double the risk of developing lung cancer, the second most common cancer in women.12, 13 Figure 6 Lifetime risk of common female cancers On average one in eight women will develop breast cancer at some time in their lives year survival rate’ to give a better idea of the longer term outlook for people with a particular cancer. It is almost impossible to predict how long an individual patient might live, but 5 year survival rates can give an approximate range. The 5 year survival rate describes on average the ‘amount’ of people that will be alive 5 years after diagnosis. The average 5 year survival rate for women with early stage breast cancer is 81%.3 However, on average only 35% of women with late or advanced stage breast cancer currently survive for 5 years.3 Section 4 Avastin® (bevacizumab) and breast cancer References Figure 7 Five year survival rates for breast cancer by stage The average five year survival rate for early stage breast cancer is 81% The average five year survival rate for later or advanced stage breast cancer is 35% Source American Cancer Society. These numbers come from the National Cancer Data Base, and are based on people who were diagnosed with breast cancer in 2001 and 2002. Early stage disease was assumed to include stages 0-IIIA; later or advanced stage disease was assumed to include stages IIIB-IV. Breast Cancer Lung Cancer Ovarian Cancer This is compared to a risk of 1 in 16 of developing lung cancer and 1 in 71 of developing ovarian cancer Source American Cancer Society 8/ 12 Contents Overview Section 1 Ovarian Cancer Section 2 Epidemiology Section 3 Treatment Section 4 Avastin® (bevacizumab) and ovarian cancer References Section 2 Epidemiology i. Incidence & mortality Worldwide Ovarian cancer is diagnosed in nearly a quarter of a million women each year. It is the eighth most common cancer in women and the seventh leading cause of cancer death among women, responsible for approximately 140,000 deaths each year. These figures confirm that globally, ovarian cancer is the most deadly of the gynaecological cancers.1 Europe In 2008, there were approximately 41,448 deaths from ovarian cancer across Europe, accounting for 5.5% of all female cancer deaths. Europeans have the highest incidence of ovarian cancer and it is the fifth most commonly diagnosed female cancer in Europe.1 Figure 3 Age standardised mortality rate for ovarian cancer Over 220,000 new cases of ovarian cancer every year 140,000 women die each year from the disease North America Ovarian cancer is the eighth most commonly diagnosed cancer in women in North America with 23,895 new cases diagnosed in 2008. It accounts for 3% of female cancer diagnoses but 5.6% of female cancer deaths in North America.1 3< 4< 5< Age Standardised Rate ASR Source: WHO GLOBOCAN 2008 Figure 4 Annual incidence and mortality rates of female cancers worldwide Cancer Incidence vs Cancer Mortality Uterus 288,387 73,854 Breast 1,384,155 458,503 Cervix 530,232 275,008 Ovary 224,747 140,163 Source: WHO GLOBOCAN 2008 7/ 13 Contents Overview Section 1 Ovarian Cancer ii. Prognosis Cancer statistics often use an ‘overall 5-year survival rate’ to give a better idea of the longer term outlook for people with a particular cancer. Over half of women diagnosed with ovarian cancer will not live beyond five years.6 The overall 5-year survival rate for women with ovarian cancer is 45%. This compares to a 5-year survival rate of up to 89% in women diagnosed with breast cancer.6, 7 The reasons for this poor prognosis are that there is no effective screening for ovarian cancer and symptoms can be ambiguous, leading to a high percentage of cases being diagnosed at an advanced stage when the disease is more difficult to treat. Section 2 Epidemiology Section 3 Treatment Section 4 Avastin® (bevacizumab) and ovarian cancer References Figure 5 5-year survival rate of ovarian cancer vs. breast cancer The overall 5-year survival rate for patients with ovarian cancer is 45% The 5-year survival rate for patients with breast cancer is up to 89% Source: American Cancer Society. Cancer Facts and Figures 2007. Atlanta, American Cancer Society 2007. Source: American Cancer Society. Breast Cancer Facts and Figures 2009-2010. Atlanta, American Cancer Society, Inc. 8/ 13 Contents Overview Section 1 Colorectal cancer Section 2 Epidemiology Section 3 Treatment Section 4 Avastin® (bevacizumab) and colorectal cancer References Section 2 Epidemiology i. Incidence & mortality Worldwide Colorectal cancer is diagnosed in over 1.2 million people globally each year; it is the second most common cancer in women and the third most common cancer in men. The disease is responsible for approximately 609,000 deaths each year (8% of all cancer deaths),1 making it the fourth leading cause of cancer death after lung, stomach and liver cancers. Europe Colorectal cancer is the most common cancer in Europe, with approximately 430,000 new cases each Figure 3 Colorectal deaths by region, as a percentage of the incidence of all cancers year;1 the highest incidence rate of colorectal cancer in the world. It is also the second greatest cause of cancer death in Europe following lung cancer, accounting for 12% of all cancer deaths. North America There were approximately 177,000 new cases of colorectal cancer in North America in 2008, making it the second most commonly diagnosed cancer in the region. Colorectal cancer accounted for 11% of all cancer incidence and 9% of all cancer deaths in North America in the same year.1 Figure 4 Incidence and mortality of some of the most common cancers worldwide 1.2 million new cases each year Breast 1,384,155 458,503 Prostate 899,102 258,133 Lung 1,092,056 948,993 515,999 427,586 12.8% of all cancer deaths in Australia & New Zealand Colorectal 663,904 571,204 320,397 5.3% of all cancer deaths in Africa Incidence and mortality of some of the most common cancers worldwide 288,654 Stomach 640,031 4th leading cause 348,571 273,489 463,930 of cancer death globally Male incidence Male mortality Female incidence mortality Liver 8% Responsible for of all cancer deaths 12.8% of all cancer deaths in Australia & New Zealand 523,432 478,134 226,312 217,592 Source WHO IARC GLOBOCAN, Cancer incidence and Mortality Worldwide in 2008 at http://globocan.iarc.fr/ Source WHO IARC GLOBOCAN, Cancer incidence and Mortality Worldwide in 2008 at http://globocan.iarc.fr/ 7/ 13 Contents Overview Section 1 Lung Cancer Prognosis Section 2 Epidemiology Section 3 Treatment Section 4 Avastin® (bevacizumab) and NSCLC References Figure 2 Lung cancer average 5 year survival rates depending on stage at diagnosis Cancer statistics often use an ‘overall 5-year survival rate’ to give a better idea of the longer term outlook for people with a particular cancer. Five year survival rates for lung cancer are poor when compared to other high incidence cancers. For example, the five year survival rate for patients with breast cancer is up to 89%.3 For lung cancer patients that figure is only around 15%.4 Average 5 year survival rates at Stage I NSCLC: 58% Average 5 year survival rates at Stage IV NSCLC: 7.5% Cancer Research UK: http://www.cancerhelp.org.uk/type/lung-cancer/treatment/statistics-and-outlook-for-lung-cancer#nonsmall 8/ 14 Contents Overview Section 1 Colorectal cancer ii. Prognosis Cancer statistics often use an ‘overall 5-year survival rate’ to give a better idea of the longer term outlook for people with a particular cancer. The overall 5-year survival rate for colorectal cancer patients is 65%,17 although this differs greatly depending on how advanced the cancer is. The 5-year survival rate for a patient diagnosed with stage I or II colorectal cancer, where the tumour is localised to the colon, is up to 90%. Approximately two fifths of patients are diagnosed at this stage. However the 5-year survival rate for patients diagnosed with stage IV disease, once the cancer has metastasised to other organs, is only 12%.17 Section 2 Epidemiology Section 3 Treatment Section 4 Avastin® (bevacizumab) and colorectal cancer References Figure 5 Incidence and mortality of some of the most common cancers worldwide Colorectal cancer average 5-year survival rate depending on stage of diagnosis 5-year survival rates for early-stage CRC: up to 90% 5-year survival rates for later-stage CRC: 12% Source Altekruse SF et al. SEER Cancer Statistics Review, 1975-2007, National Cancer Institute. http://seer.cancer.gov/csr/1975_2007/ Survivors Fatalities 8/ 13 Contents Overview Section 1 Ovarian Cancer ii. Prognosis Cancer statistics often use an ‘overall 5-year survival rate’ to give a better idea of the longer term outlook for people with a particular cancer. Over half of women diagnosed with ovarian cancer will not live beyond five years.6 The overall 5-year survival rate for women with ovarian cancer is 45%. This compares to a 5-year survival rate of up to 89% in women diagnosed with breast cancer.6, 7 The reasons for this poor prognosis are that there is no effective screening for ovarian cancer and symptoms can be ambiguous, leading to a high percentage of cases being diagnosed at an advanced stage when the disease is more difficult to treat. Section 2 Epidemiology Section 3 Treatment Section 4 Avastin® (bevacizumab) and ovarian cancer References Figure 5 5-year survival rate of ovarian cancer vs. breast cancer The overall 5-year survival rate for patients with ovarian cancer is 45% The 5-year survival rate for patients with breast cancer is up to 89% Source: American Cancer Society. Cancer Facts and Figures 2007. Atlanta, American Cancer Society 2007. Source: American Cancer Society. Breast Cancer Facts and Figures 2009-2010. Atlanta, American Cancer Society, Inc. 8/ 13