ORCID Profile
0000-0002-6130-3537
Current Organisation
University of Nottingham
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Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.CANEP.2011.09.007
Abstract: Relative survival is an extensively used method in population based cancer studies as it provides a measure of survival without the need for accurate cause of death information. It gives an estimate for the probability of dying from cancer in the absence of other causes by estimating the excess mortality in the study population when compared to an external group. The external group is usually the general population within a country or state and mortality estimates are taken from national life tables that are broken down by age, sex, calendar year and, where applicable, race/ethnicity. One potential bias when using relative survival that is most often overlooked occurs when there are a high proportion of deaths due to a specific cancer in the external group. This paper uses data from the Finnish Cancer Registry to illustrate, through the use of a simple sensitivity analysis, the impact that specific cancer deaths in the population mortality figures can have on the estimate of relative survival. We found that when examining specific diseases such as breast cancer and colon cancer, the proportion of deaths due to these specific cancers in the general population is so small in comparison to the total mortality that they make little difference to the relative survival estimates. However, prostate cancer proved to be an exception to this. For all cancer sites combined the sensitivity analysis illustrates a major limitation for this type of analysis, particularly with the older age groups. We recommend that, with a classification of diseases as wide as all cancer sites, relative survival should not be used without appropriate adjustment.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 10-07-2015
Abstract: Myeloproliferative neoplasms (MPNs) are associated with a shortened life expectancy. We assessed causes of death in patients with MPN and matched controls using both relative risks and absolute probabilities in the presence of competing risks. From Swedish registries, we identified 9,285 patients with MPN and 35,769 matched controls. A flexible parametric model was used to estimate cause-specific hazard ratios (HRs) of death and cumulative incidence functions, each with 95% CIs. In patients with MPN, the HRs of death from hematologic malignancies and infections were 92.8 (95% CI, 70.0 to 123.1) and 2.7 (95% CI, 2.4 to 3.1), respectively. In patients age 70 to 79 years at diagnosis (the largest patient group), the HRs of death from cardiovascular and cerebrovascular disease were 1.5 (95% CI, 1.4 to 1.7) and 1.5 (95% CI, 1.3 to 1.8), respectively all were statistically significantly elevated compared with those of controls. In the same age group, no difference was observed in the 10-year probability of death resulting from cardiovascular disease in patients with MPN versus controls (16.8% v 15.2%) or cerebrovascular disease (5.6% v 5.2%). In patients age 50 to 59 years at diagnosis, the 10-year probability of death resulting from cardiovascular and cerebrovascular disease was elevated, 4.2% versus 2.1% and 1.9% versus 0.4%, respectively. Survival in patients with MPN increased over time, mainly because of decreased probabilities of dying as a result of hematologic malignancies, infections, and, in young patients, cardiovascular disease. Patients with MPN had an overall higher mortality rate than that of matched controls, primarily because of hematologic malignancy, infections, and vascular events in younger patients. Evidently, there is still a need for effective disease-modifying agents to improve patient outcomes.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Sally Wilkes.