Reporting net survival in populations: A sensitivity analysis in lung cancer demonstrates the differential implications of reporting relative survival and cause-specific survival Journal Article

   

Authors:	Tan, K. S.; Eguchi, T.; Adusumilli, P. S.
Article Title:	Reporting net survival in populations: A sensitivity analysis in lung cancer demonstrates the differential implications of reporting relative survival and cause-specific survival
Abstract:	Background: Net survival is commonly quantified as relative survival (observed survival among lung cancer patients versus expected survival among the general population) and cause-specific survival (lung cancer-specific survival among lung cancer patients). These approaches have drastically different assumptions; hence, failure to distinguish between them results in significant implications for study findings. We quantified the differences between relative and cause-specific survival when reporting net survival of patients with non-small cell lung cancer (NSCLC). Methods: Cases of NSCLC diagnosed between 2004 and 2014 were extracted from the Surveillance, Epidemiology, and End Results database. The net survival of each stage-by-age stratum was expressed as cause-specific survival (Kaplan-Meier approach) and relative survival (Ederer II approach); percentage-point (pp) differences between the survival estimates were quantified up to 10 years postdiagnosis. Results: Analyses included 263,894 cases. Cause-specific survival estimates were higher than relative survival estimates across all strata. Although the differences were negligible at 1 year postdiagnosis, they increased with increasing years of follow-up, up to 9.3 pp at 10 years (eg, aged 60-74 with stage I disease: 53.0% vs 43.7%). Differences in survival estimates between the methods also increased by increasing age groups (eg, at 10 years postdiagnosis: 5.1 pp for ages 18-44, 8.8 pp for ages 45-59, and 9.3 pp for ages 60-74) but decreased drastically for those aged ≥75 (3.1 pp). Conclusion: Relative survival and cause-specific survival are not interchangeable. The type of survival estimate used in cancer studies should be specified, particularly for long-term survival. © 2019 Tan et al.
Keywords:	adult; cancer survival; controlled study; middle aged; major clinical study; mortality; cancer staging; follow up; sensitivity analysis; lung cancer; age; population research; disease duration; cancer epidemiology; biostatistics; cause specific survival; non small cell lung cancer; long term survival; relative survival; human; male; female; article; net survival; epidemiological methods
Journal Title:	Clinical Epidemiology
Volume:	11
ISSN:	1179-1349
Publisher:	Dove Medical Press Ltd
Date Published:	2019-01-01
Start Page:	781
End Page:	792
Language:	English
DOI:	10.2147/clep.S210894
PROVIDER:	scopus
PMCID:	PMC6730547
PUBMED:	31564983
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85073393667&doi=10.2147%2fCLEP.S210894&partnerID=40&md5=c11b36a1551c0d4c0e3a0ed42ec77f93
Notes:	Article -- Export Date: 1 November 2019 -- Source: Scopus

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