Should relative survival be used with lung cancer data?

British Journal of Cancer
Sally R HinchliffePaul C Lambert

Abstract

Under certain assumptions, relative survival is a measure of net survival based on estimating the excess mortality in a study population when compared with the general population. Background mortality estimates are usually taken from national life tables that are broken down by age, sex and calendar year. A fundamental assumption of relative survival methods is that if a patient did not have the disease of interest then their probability of survival would be comparable to that of the general population. It is argued, as most lung cancer patients are smokers and therefore carry a higher risk of smoking-related mortalities, that they are not comparable to a population where the majority are likely to be non-smokers. We use data from the Finnish Cancer Registry to assess the impact that the non-comparability assumption has on the estimates of relative survival through the use of a sensitivity analysis. Under realistic estimates of increased all-cause mortality for smokers compared with non-smokers, the bias in the estimates of relative survival caused by the non-comparability assumption is negligible. Although the assumption of comparability underlying the relative survival method may not be reasonable, it does not have a concerni...Continue Reading

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Nov 25, 2014·Journal of the National Cancer Institute. Monographs·Angela B MariottoLisa M Schwartz
Nov 25, 2014·Journal of the National Cancer Institute. Monographs·Antoinette M StroupAngela B Mariotto
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