Different survival analysis methods for measuring long-term outcomes of Indigenous and non-Indigenous Australian cancer patients in the presence and absence of competing risks

Autor: Yuejen Zhao, Vincent Y. F. He, Peter D. Baade, John R. Condon, Xiaohua Zhang
Rok vydání: 2016
Předmět:
Male
Native Hawaiian or Other Pacific Islander
Indigenous Australians
Epidemiology
0302 clinical medicine
Risk Factors
Cause of Death
Neoplasms
Outcome Assessment
Health Care
030212 general & internal medicine
Young adult
Child
Cause of death
Aged
80 and over
education.field_of_study
Cause of death data
Relative survival
Smoking
Middle Aged
Competing risks
3. Good health
030220 oncology & carcinogenesis
Child
Preschool
Female
Fine-Gray model
Adult
Adolescent
Population
03 medical and health sciences
Young Adult
Net survival
Life tables
medicine
Northern Territory
Humans
Lung cancer
education
Survival analysis
Aged
Probability
Proportional Hazards Models
Cancer prognosis
Proportional hazards model
business.industry
Research
Public Health
Environmental and Occupational Health
Infant
Newborn
Cancer
Infant
Health Status Disparities
medicine.disease
Crude probability of death
business
Demography
Zdroj: Population Health Metrics
ISSN: 1478-7954
Popis: Background Net survival is the most common measure of cancer prognosis and has been used to study differentials in cancer survival between ethnic or racial population subgroups. However, net survival ignores competing risks of deaths and so provides incomplete prognostic information for cancer patients, and when comparing survival between populations with different all-cause mortality. Another prognosis measure, “crude probability of death”, which takes competing risk of death into account, overcomes this limitation. Similar to net survival, it can be calculated using either life tables (using Cronin-Feuer method) or cause of death data (using Fine-Gray method). The aim of this study is two-fold: (1) to compare the multivariable results produced by different survival analysis methods; and (2) to compare the Cronin-Feuer with the Fine-Gray methods, in estimating the cancer and non-cancer death probability of both Indigenous and non-Indigenous cancer patients and the Indigenous cancer disparities. Methods Cancer survival was investigated for 9,595 people (18.5% Indigenous) diagnosed with cancer in the Northern Territory of Australia between 1991 and 2009. The Cox proportional hazard model along with Poisson and Fine-Gray regression were used in the multivariable analysis. The crude probabilities of cancer and non-cancer methods were estimated in two ways: first, using cause of death data with the Fine-Gray method, and second, using life tables with the Cronin-Feuer method. Results Multivariable regression using the relative survival, cause-specific survival, and competing risk analysis produced similar results. In the presence of competing risks, the Cronin-Feuer method produced similar results to Fine-Gray in the estimation of cancer death probability (higher Indigenous cancer death probabilities for all cancers) and non-cancer death probabilities (higher Indigenous non-cancer death probabilities for all cancers except lung cancer and head and neck cancers). Cronin-Feuer estimated much lower non-cancer death probabilities than Fine-Gray for non-Indigenous patients with head and neck cancers and lung cancers (both smoking-related cancers). Conclusion Despite the limitations of the Cronin-Feuer method, it is a reasonable alternative to the Fine-Gray method for assessing the Indigenous survival differential in the presence of competing risks when valid and reliable subgroup-specific life tables are available and cause of death data are unavailable or unreliable. Electronic supplementary material The online version of this article (doi:10.1186/s12963-016-0118-9) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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