Survival rates represent one measure of population-wide progress in cancer control. Data from the Surveillance, Epidemiology and End Results (SEER program of the National Cancer Institute (NCI) document that, during the 1970s, survival rates for several cancers improved. For the major gynecologic cancers and breast cancer, improvements are evident for some sites but, areas of decline also are observed. Black women in the US have a poorer survival rate than white women and the trend in recent years suggests that this gap may be widening. Comparisons of survival rates from comprehensive cancer centers and population-based rates indicate differences in outcomes associated with the treatment setting. Data from the American College of Surgeons (ACS) patterns of care surveys suggest substantial interhospital variability in cancer survival which is largely explained by characteristics of the patient populations served. Recent studies of patterns of care document major shifts in treatment practices in the US and provide insight concerning the rate at which treatment changes are adopted at the community level.
Cancer 60: 1965-1969. 1987.
YNECOLOGIC CANCERS and breast cancer consti-G tute the majority of cancers affecting women in the US. Progress in controlling these diseases by clinical interventions may be measured along multiple dimensions. The ultimate objective of disease control efforts is the reduction of mortality. Death rates are, however, the product of many factors, including incidence rates, which may not be related to the effectiveness of early detection, diagnosis, or treatment. More specific and immediate indicators of progress in cancer treatment are indices of the longevity of persons following the diagnosis of cancer. Survival statistics play an important role in clinical research where they are used to assess the effectiveness of novel therapeutic approaches compared to standard treatments. Identifying means of treating cancer patients through clinical research is, however, only the first step in achieving public health impact. Translating research advances into applications that affect the general population of cancer patients is the subsequent, and perhaps more difficult, phase of the overall process of cancer control. Population based survival rates may