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Botta L, Goungounga J, Capocaccia R, Romain G, Colonna M, Gatta G, Boussari O, Jooste V. A new cure model that corrects for increased risk of non-cancer death: analysis of reliability and robustness, and application to real-life data. BMC Med Res Methodol 2023; 23:70. [PMID: 36966273 PMCID: PMC10040108 DOI: 10.1186/s12874-023-01876-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 02/22/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND Non-cancer mortality in cancer patients may be higher than overall mortality in the general population due to a combination of factors, such as long-term adverse effects of treatments, and genetic, environmental or lifestyle-related factors. If so, conventional indicators may underestimate net survival and cure fraction. Our aim was to propose and evaluate a mixture cure survival model that takes into account the increased risk of non-cancer death for cancer patients. METHODS We assessed the performance of a corrected mixture cure survival model derived from a conventional mixture cure model to estimate the cure fraction, the survival of uncured patients, and the increased risk of non-cancer death in two settings of net survival estimation, grouped life-table data and individual patients' data. We measured the model's performance in terms of bias, standard deviation of the estimates and coverage rate, using an extensive simulation study. This study included reliability assessments through violation of some of the model's assumptions. We also applied the models to colon cancer data from the FRANCIM network. RESULTS When the assumptions were satisfied, the corrected cure model provided unbiased estimates of parameters expressing the increased risk of non-cancer death, the cure fraction, and net survival in uncured patients. No major difference was found when the model was applied to individual or grouped data. The absolute bias was < 1% for all parameters, while coverage ranged from 89 to 97%. When some of the assumptions were violated, parameter estimates appeared more robust when obtained from grouped than from individual data. As expected, the uncorrected cure model performed poorly and underestimated net survival and cure fractions in the simulation study. When applied to colon cancer real-life data, cure fractions estimated using the proposed model were higher than those in the conventional model, e.g. 5% higher in males at age 60 (57% vs. 52%). CONCLUSIONS The present analysis supports the use of the corrected mixture cure model, with the inclusion of increased risk of non-cancer death for cancer patients to provide better estimates of indicators based on cancer survival. These are important to public health decision-making; they improve patients' awareness and facilitate their return to normal life.
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Affiliation(s)
- Laura Botta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS "Istituto nazionale dei Tumori", Via Venezian 1, 20133, Milan, Italy.
- Registre Bourguignon des Cancers Digestifs, Dijon-Bourgogne University Hospital, F-21000, Dijon, France.
- UMR 1231, EPICAD team, INSERM, Université Bourgogne-Franche-Comté, Dijon, France.
| | - Juste Goungounga
- Registre Bourguignon des Cancers Digestifs, Dijon-Bourgogne University Hospital, F-21000, Dijon, France
- UMR 1231, EPICAD team, INSERM, Université Bourgogne-Franche-Comté, Dijon, France
- Univ Rennes, EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS-U 1309, F-3500, Rennes, France
| | | | - Gaelle Romain
- Registre Bourguignon des Cancers Digestifs, Dijon-Bourgogne University Hospital, F-21000, Dijon, France
- UMR 1231, EPICAD team, INSERM, Université Bourgogne-Franche-Comté, Dijon, France
| | - Marc Colonna
- Isere Cancer Registry, Centre Hospitalier Universitaire Grenoble-Alpes, 38043, Grenoble Cedex 9, France
- FRANCIM, 1, Avenue Irène Joliot Curie, F-31059, Toulouse, France
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS "Istituto nazionale dei Tumori", Via Venezian 1, 20133, Milan, Italy
| | - Olayidé Boussari
- UMR 1231, EPICAD team, INSERM, Université Bourgogne-Franche-Comté, Dijon, France
- Fédération Francophone de Cancérologie Digestive (FFCD), Département de Méthodologie, F-21000, Dijon, France
| | - Valérie Jooste
- Registre Bourguignon des Cancers Digestifs, Dijon-Bourgogne University Hospital, F-21000, Dijon, France
- UMR 1231, EPICAD team, INSERM, Université Bourgogne-Franche-Comté, Dijon, France
- FRANCIM, 1, Avenue Irène Joliot Curie, F-31059, Toulouse, France
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Tanaka R, Sugiyama H, Saika K, Matsuzaka M, Sasaki Y. Difference in net survival using regional and national life tables in Japan. Cancer Epidemiol 2022; 81:102269. [PMID: 36182832 DOI: 10.1016/j.canep.2022.102269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND National life table is commonly used for estimating cancer net survival. However, the national life table does not reflect condition of people in local area accurately, because there are disparities in cancer mortality rates among the local area in many cases. We investigated magnitude of difference in cancer net survival using the local area in Japan and Japanese life tables. METHODS We analyzed data from 32,942 cancer patients diagnosed between 2010 and 2012 in Aomori prefecture, Japan. Expected survival rates in Aomori (ESA) and Japan (ESJ) were estimated based on the life table of each area. Five-year net survival rates using ESA and the ESJ were estimated using the Pohar-Perme method. RESULTS The difference between net survival rates using the ESA (NSA) and the ESJ (NSJ) were larger than in men (0.3-3.0%) than in women (0.1-0.8%). The largest difference in the net survival rate was observed in prostate cancer patients, because the difference in the expected survival in oldest old men was remarkable. CONCLUSION Two factors affected the difference in the net survival rates resulting from the sensitivity analysis. The difference was larger (1) among older patients or (2) with a longer observation period (person-years).
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Affiliation(s)
- Rina Tanaka
- Department of Medical Informatics, Hirosaki University Graduate School of Medicine, Japan.
| | - Hiromi Sugiyama
- Department of Epidemiology, Radiation Effects Research Foundation, Japan
| | - Kumiko Saika
- Department of Medical Informatics, Hirosaki University Graduate School of Medicine, Japan; Saku Central Hospital Advanced Care Cente, Japan
| | - Masashi Matsuzaka
- Clinical Research Support Center, Hirosaki University Hospital, Japan; Department of Medical Informatics, Hirosaki University Hospital, Japan
| | - Yoshihiro Sasaki
- Department of Medical Informatics, Hirosaki University Graduate School of Medicine, Japan; Department of Medical Informatics, Hirosaki University Hospital, Japan
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Aldama G, Rebollal F, Piñón P. Prognosis after an acute myocardial infarction: survivor life expectancy. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:820-822. [PMID: 33972188 DOI: 10.1016/j.rec.2021.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 02/26/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Guillermo Aldama
- Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - Fernando Rebollal
- Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Pablo Piñón
- Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
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