Event: Global surveillance of cancer survival: the CONCORD programme

Sydnie Stackland, MSc Epidemiology student, LSHTM

 

Date: 1 February 2018

Venue: John Snow Lecture Theatre (A), Keppel Street, LSHTM

Speakers:

Dr. Claudia Allemani, Associate Professor in Cancer Epidemiology – LSHTM

Dr. Chris James, Economist/Health Policy Analyst, Health Division – OECD

Prof. Richard Sullivan, Director of the Institute of Cancer Policy – King’s College London

Chair: Dr. Michel Coleman, Professor of Epidemiology and Vital Statistics – LSHTM

 

Background: CONCORD is a world-wide cancer surveillance program that is led by researchers at LSHTM. The purpose of CONCORD is to collect information on cancer survival in multiple settings so that the effectiveness of health systems can be compared. Long-term surveillance is essential for policy formation on cancer management and prevention.

Dr. Claudia Allemani began by presenting a brief history of CONCORD. The first CONCORD study, completed in 2008, included 101 registries from 31 participating countries, with data on approximately 2 million people. By CONCORD-2 (2015), the study had grown to include 279 registries and 67 countries that covered over 25 million patients. It was at this time that CONCORD began to get large amounts of media attention, after data analysis found undeniable differences in survival between different countries and extreme disparities in care services (primarily radiotherapy). As a result, the Programme of Action for Cancer Therapy (PACT) initiated a campaign to raise awareness about the inequalities in access to cancer services.

CONCORD-3 launched in May 2016. The updated protocol was translated into multiple languages (Arabic, Chinese, English, French, Italian, Japanese, Portuguese, Russian, Spanish) and data returned from 300 registries in over 70 countries, representing about 75% of the global cancer burden. Data from CONCORD-3 included patient age, sex, race, geographic area, stage of cancer, and first course of treatment. Estimated net survival was calculated using the Pohar Perme approach and 6000+ life tables of all-cause mortality rates were generated.

Dr. Allemani went on to explain the important findings, including a persistent inequality in diagnosis, treatment, and survival between high and low-income countries. She pointed out that world-wide surveillance, like the CONCORD study, is necessary for policy development, but that registries face many issues with instabilities in their political, legislative, and financial settings.

Dr. Chris James then explained how the CONCORD data is being used by the Organisation for Economic Co-operation and Development (OECD), an economic think tank, to inform the biennial “Health at a Glance” (H@G) report.

“Health at a Glance” provides data on trends in different health systems worldwide. The report includes information on health statuses, risk factors, access to care, quality of care, health expenditures, and more for each of the OECD partner countries. CONCORD data in “Health at a Glance” includes both cross-country cancer survival and screening rates, and OECD additionally reports on cancer care and quality indicators. The 2017 publication (most recent), included statistics on patient safety, clinical effectiveness, responsiveness, and patient voice.

Dr. James then went on to discuss the broader work at OECD, which includes measuring health systems outcomes, economics of disease prevention, health inequalities, financial sustainability of health system financing, etc. He noted that future collaboration with the CONCORD team will hopefully result in improved reporting coverage within countries and health care policy reform.

Professor Richard Sullivan gave the closing remarks. He urged the audience to consider what they had learned about the economic inequalities highlighted by CONCORD. Many countries are still not covered by any registries or statistics. Properly funding sustainable cancer registries is an important step in understanding the existing burden, and solidarity in creating better outcomes for the global population is needed.

If you are interested in learning more about CONCORD and cancer survival studies, access the programme website here: http://csg.lshtm.ac.uk/research/themes/concord-programme/

 

To read the full Lancet article about the results from the Concord-3 study, use the link below:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33326-3/fulltext

For information on OECD and “Health at a Glance”:

http://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance_19991312

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