TNM stage in the Nordic Cancer Registries 2004–2016: Registration and availability

Authors

  • Gerda Engholm Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark https://orcid.org/0000-0002-5337-6234
  • Frida E. Lundberg Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden https://orcid.org/0000-0001-7061-7178
  • Simon M. Kønig Danish Cancer Institute, Cancer Epidemiology and Surveillance, Danish Cancer Society, Copenhagen, Denmark
  • Elínborg Ólafsdóttir Icelandic Cancer Registry, Reykjavik, Iceland
  • Tom B. Johannesen Cancer Registry of Norway, Oslo, Norway
  • David Pettersson Swedish Cancer Registry, National Board of Health and Welfare, Stockholm, Sweden
  • Nea Malila Finnish Cancer Registry, Helsinki, Finland
  • Lina S. Mørch Danish Cancer Institute, Cancer and Medicine, Danish Cancer Society, Copenhagen, Denmark
  • Anna L.V. Johansson Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Cancer Registry of Norway, Oslo, Norway https://orcid.org/0000-0002-1191-7231
  • Søren Friis Danish Cancer Institute, Cancer Epidemiology and Surveillance, Danish Cancer Society, Copenhagen, Denmark

DOI:

https://doi.org/10.2340/1651-226X.2024.35232

Keywords:

TNM, Cancer Stage, Cancer Registries, NORDCAN, relative survival

Abstract

Background and purpose: Stage at cancer diagnosis is an important predictor of cancer survival. TNM stage is constructed for anatomic solid cancer diagnoses from tumor size (T), nodal spread (N) and distant metastasis (M) and categorized in groups 0–I, II, II and IV. TNM stage is imperative in cancer diagnosis, management and control, and of high value in cancer surveillance, for example, monitoring of stage distributions. This study yields an overview of TNM availability and trends in stage distribution in the Nordic countries for future use in monitoring and epidemiologic studies.

Material and methods: TNM information was acquired from the cancer registries in Denmark, Norway, Sweden, and Iceland during 2004–2016 for 26 cancer sites in the three former countries and four in Iceland. We studied availability, comparability, and distribution of TNM stage in three periods: 2004–2008, 2009–2013, and 2014–2016, applying a previously validated algorithm of ‘N0M0 for NXMX’. For cancers of colon, rectum, lung, breast, and kidney, we examined TNM stage-specific 1-year relative survival to evaluate the quality in registration of TNM between countries.

Results: Denmark, Sweden, and Iceland exhibited available TNM stage proportions of 75–95% while proportions were lower in Norway. Proportions increased in Sweden over time but decreased in Denmark. One-year relative survival differed substantially more between TNM stages than between countries emphasizing that TNM stage is an important predictor for survival and that stage recording is performed similarly in the Nordic countries.

Interpretation: Assessment and registration of TNM stage is an imperative tool in evaluations of trends in cancer survival between the Nordic countries.

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Author Biographies

Frida E. Lundberg, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden

Department og Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden

Anna L.V. Johansson, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Cancer Registry of Norway, Oslo, Norway

Cancer Registry of Norway, Oslo, Norway

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Additional Files

Published

2024-05-07

How to Cite

Engholm, G., Lundberg, F. E., Kønig, S. M., Ólafsdóttir, E., Johannesen, T. B., Pettersson, D., … Friis, S. (2024). TNM stage in the Nordic Cancer Registries 2004–2016: Registration and availability. Acta Oncologica, 63(1), 303–312. https://doi.org/10.2340/1651-226X.2024.35232

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