LAUSR

Abstract Background Recent data on world-wide trends in population-based survival from glioblastoma are not available. We aimed to investigate disparities in survival using data contributed to the third cycle of the CONCORD programme (CONCORD-3). Methods Age-specific and age-standardised net survival was estimated using the non-parametric Pohar Perme estimator, correcting for background mortality by single year of age, sex and calendar year in each country. Results During 2000-2004, age-standardised two-year net survival was mostly in the range 10-20%, but survival was less than 10% in Finland, Lithuania, the Netherlands, and New Zealand. Survival between 2005 and 2009 was slightly higher, in the range 20-30% in several countries, while it remained around 10-20% in Finland, Poland, the Russian Federation, Spain, Thailand, and the United Kingdom. During 2010-2014, age-standardised two-year survival was still below 20% in Poland, the Russian Federation, Spain, Thailand, and the United Kingdom. It reached 30% in Japan, Korea and Singapore, and survival otherwise stabilised in the range 20-30%. In patients younger than 45 years, age-standardised two-year net survival during 2000-2004 was 30% or less in 15 countries, including Canada, France, Ireland, Israel, New Zealand, Norway, Portugal, Slovakia and Switzerland, while it was in the range 35-40% in Belgium, Italy, Japan, Korea and the United States. During 2005-2009, 14 countries still lagged behind, with two-year net survival below 35% (e.g. Canada, France, Ireland, Portugal, the Russian Federation, Slovakia, Sweden), while survival rose to 45% or more in Australia, Belgium, Japan, Korea, Slovenia and Switzerland. More recently (2010-2014), two-year net survival was still 35% or less in France, Ireland, Portugal, the Russian Federation and Slovakia. Conclusions The increase in population-based survival from glioblastoma during 2000-2014 is likely to have been determined by the use of chemo-radiation in eligible patients from 2005 onwards. However, there were wide international disparities, suggesting little or no uptake of chemo-radiation protocols, especially in younger patients. Legal entity responsible for the study London School of Hygiene and Tropical Medicine. Funding Davidson and O’Gorman Fellowship from Children with Cancer UK. Disclosure All authors have declared no conflicts of interest.