Abstract
We compared measurements of temporal trends in cancer survival either based on observed survival or relative survival. Survival rates for cutaneous malignant melanoma diagnosed in Sweden 1960–1982 were used as an example. In a proportional hazards model based on observed survival, the hazard ratio for patients diagnosed during the period 1975–1979 was 0.56 (95 % confidence limits 0.49–0.64) in men and 0.45 (0.38–0.53) in women when the period 1960–1964 was the reference. When relative survival was the outcome measure, during the same period, the hazard ratio decreased to 0.47 (0.39–0.56) in men and 0.36 (0.29-0.44) in women. Thus, the effect of period of diagnosis was larger when the analysis was based on relative survival rates. The reasons for the differences between these two alternative measurements are explained in the article and advantages/disadvantages of the two approaches are discussed.
Similar content being viewed by others
References
Enstrom J E and Austin D F. Interpreting cancer survival rates.Science,195, 847 (1977).
Bailar J C III and Smith EM. Progress against cancer?N Engl J Med,314, 1226 (1986).
Adami H O, Sparén P, Bergström R, Holmberg L, Krusemo U B and Pontön J. Increasing survival trend after cancer diagnosis in Sweden: 1960-1984.J Natl Cancer Inst,81, 1640 (1989).
Doll R. Progress against cancer: are we winning thewar?Acta Oncol,28, 611 (1989).
Davis D L, Hoel D, Fox J and Lopez A. International trends in cancer mortality in France, West Germany, Italy, Japan, England and Wales, and the USA.Lancet,ii, 474 (1990)o
Adami HO. What is progress against cancer?Cancer Causes and Control,4, 483 (1993).
Cutler S and Ederer F. Maximun utilization of the life table method in analyzing survival.J Chronic Dis,8, 699 (1958).
Ederer F, Axtell L M and Cutler S J. The relative survival rate: a statistical methodology.Natl Cancer Inst Monogr 6, 101 (1961).
Thörn M, Adami H O, Bergström R, Ringborg U, andKrusemo U B. Trends in survival from malignant melanoma: remarkable improvement in 23 years.J Natl Cancer Inst,81, 611 (1989).
Mattsson B and Wallgren A. Completeness of the Swedish Cancer Register. Non-notified cancer cases recorded on death certificates in 1978.Acta Radiol Oncol Radiat Phys Biol,23, 305 (1984).
Cancer incidence in Sweden 1982. National Board of Health and Welfare, Stockholm (1985).
Hakulinen T, Abeywickrama K H. A computer program package for relative survival analyses.Comput Methods Programs Biomed,19, 197 (1985).
Cox D R. Regression models and life-tables.JR Stat Soc,B 34, 187 (1972).
Baker R J and Nelder J A.Generalised linear interactive modelling (Release 3). Numerical Algorithms Group, Oxford (1978).
Hakulinen T and Tenkanen L. Regression analysis of relative survival rates.Appl Stat,36, 309 (1987).
Pontén J, Adami H O and Sparén P. Trends in cancer survival and mortality rates.Med Oncol & Tumor Pharmacother,8, 147 (1991).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bergström, R., Thörn, M. & Adami, HO. Methodological aspects on measurements of temporal trends in melanoma survival. Med Oncol 11, 13–18 (1994). https://doi.org/10.1007/BF02990086
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02990086