Paramita Dasgupta1, Susanna Cramb2, Kou Kou3, Xue Qin Yu4, Peter D Baade5. 1. Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia. Electronic address: paramitadasgupta@cancerqld.org.au. 2. Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia; School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Brisbane QLD 4059, Australia. Electronic address: susanna_cramb@qut.edu.au. 3. Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia; School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Brisbane QLD 4059, Australia. Electronic address: KouKou@cancerqld.org.au. 4. Cancer Research Division, Cancer Council New South Wales, Kings Cross, NSW 1340, Australia; Sydney School of Public Health, University of Sydney, NSW 2006, Australia. Electronic address: xueqiny@nswcc.org.au. 5. Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parklands Drive, Southport QLD 4222, Australia; School of Mathematical Sciences, Queensland University of Technology, Gardens Point, Brisbane QLD 4000, Australia. Electronic address: peterbaade@cancerqld.org.au.
Abstract
BACKGROUND: While net probabilities of death in the relative survival framework ignore competing causes of death, crude probabilities allow estimation of the real risk of cancer deaths. This study quantifies temporal trends in net and crude probabilities of death. METHODS: Australian population-based cohort of 2,015,903 people aged 15-89 years, diagnosed with a single primary invasive cancer from 1984 to 2013 with mortality follow-up to 31 December 2014. Survival was analyzed with the cohort method. Flexible parametric relative survival models were used to estimate both probability measures by diagnosis year for all cancers and selected leading sites. RESULTS: For each site, excess mortality rates reduced over time, especially for prostate cancer. While both the 10-year net and crude probability of cancer deaths decreased over time, specific patterns varied. For example, the crude probability of lung cancer deaths for males aged 50 years decreased from 0.90 (1984) to 0.79 (2013); whereas the corresponding probabilities for kidney cancer were 0.64 and 0.18 respectively. Patterns for crude probabilities of competing deaths were relatively constant. Although for younger patients, both net and crude measures were similar, crude probability of competing deaths increased with age, hence for older ages net and crude measures were different except for lung and pancreas cancers. CONCLUSIONS: The observed reductions in probabilities of death over three decades for Australian cancer patients are encouraging. However, this study also highlights the ongoing mortality burden following a cancer diagnosis, and the need for continuing efforts to improve cancer prevention, diagnosis and treatment.
BACKGROUND: While net probabilities of death in the relative survival framework ignore competing causes of death, crude probabilities allow estimation of the real risk of cancer deaths. This study quantifies temporal trends in net and crude probabilities of death. METHODS: Australian population-based cohort of 2,015,903 people aged 15-89 years, diagnosed with a single primary invasive cancer from 1984 to 2013 with mortality follow-up to 31 December 2014. Survival was analyzed with the cohort method. Flexible parametric relative survival models were used to estimate both probability measures by diagnosis year for all cancers and selected leading sites. RESULTS: For each site, excess mortality rates reduced over time, especially for prostate cancer. While both the 10-year net and crude probability of cancer deaths decreased over time, specific patterns varied. For example, the crude probability of lung cancer deaths for males aged 50 years decreased from 0.90 (1984) to 0.79 (2013); whereas the corresponding probabilities for kidney cancer were 0.64 and 0.18 respectively. Patterns for crude probabilities of competing deaths were relatively constant. Although for younger patients, both net and crude measures were similar, crude probability of competing deaths increased with age, hence for older ages net and crude measures were different except for lung and pancreas cancers. CONCLUSIONS: The observed reductions in probabilities of death over three decades for Australian cancerpatients are encouraging. However, this study also highlights the ongoing mortality burden following a cancer diagnosis, and the need for continuing efforts to improve cancer prevention, diagnosis and treatment.
Authors: Mark J Rutherford; Therese M-L Andersson; Tor Åge Myklebust; Bjørn Møller; Paul C Lambert Journal: BMC Med Res Methodol Date: 2022-01-06 Impact factor: 4.615