How can we make cancer survival statistics more useful for patients and clinicians: an illustration using localized prostate cancer in Sweden

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MARC

Eloranta, SandraKarolinska Institutet (author)

How can we make cancer survival statistics more useful for patients and clinicians : an illustration using localized prostate cancer in Sweden

Article/chapterEnglish2013

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2013-01-08
Springer Science and Business Media LLC,2013
printrdacarrier

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LIBRIS-ID:oai:DiVA.org:umu-67379
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-67379URI
https://doi.org/10.1007/s10552-012-0141-5DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:126163727URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

Notes

Studies of cancer patient survival typically report relative survival or cause-specific survival using data from patients diagnosed many years in the past. From a risk-communication perspective, such measures are suboptimal for several reasons; their interpretation is not transparent for non-specialists, competing causes of death are ignored and the estimates are unsuitable to predict the outcome of newly diagnosed patients. In this paper, we discuss the relative merits of recently developed alternatives to traditionally reported measures of cancer patient survival. In a relative survival framework, using a period approach, we estimated probabilities of death in the presence of competing risks. To illustrate the methods, we present estimates of survival among 23,353 initially untreated, or hormonally treated men with intermediate- or high-risk localized prostate cancer using Swedish population-based data. Among all groups of newly diagnosed patients, the probability of dying from prostate cancer, accounting for competing risks, was lower compared to the corresponding estimates where competing risks were ignored. Accounting for competing deaths was particularly important for patients aged more than 70 years at diagnosis in order to avoid overestimating the risk of dying from prostate cancer. We argue that period estimates of survival, accounting for competing risks, provide the tools to communicate the actual risk that cancer patients, diagnosed today, face to die from their disease. Such measures should offer a more useful basis for risk communication between patients and clinicians and we advocate their use as means to answer prognostic questions.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
Relative survival
Prostate cancer
Competing risks
Period analysis
Population based

Added entries (persons, corporate bodies, meetings, titles ...)

Adolfsson, JanKarolinska Institutet (author)
Lambert, Paul C.Karolinska Institutet (author)
Stattin, PärUmeå universitet,Urologi och andrologi(Swepub:umu)past0003 (author)
Akre, OlofKarolinska Institutet (author)
Andersson, Therese M-L.Karolinska Institutet (author)
Dickman, Paul W.Karolinska Institutet (author)
Karolinska InstitutetUrologi och andrologi (creator_code:org_t)

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In:Cancer Causes and Control: Springer Science and Business Media LLC24:3, s. 505-5150957-52431573-7225

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By the author/editor: Eloranta, Sandra; Adolfsson, Jan; Lambert, Paul C.; Stattin, Pär; Akre, Olof; Andersson, There ...; show more...; Dickman, Paul W.; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

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