Reference adjusted loss in life expectancy for population-based cancer patient survival comparisons - with an application to colon cancer in Sweden
The loss in life expectancy, LLE, is defined as the difference in life expectancy between cancer patients and that of the general population. It is a useful measure for summarising the impact of a cancer diagnosis on an individual's life expectancy. However, it is less useful for making compari...
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| Published in: | Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2022-09, Vol.31 (9), p.1720-1726 |
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| Main Authors: | , , , , |
| Format: | Article |
| Language: | eng |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | The loss in life expectancy, LLE, is defined as the difference in life expectancy between cancer patients and that of the general population. It is a useful measure for summarising the impact of a cancer diagnosis on an individual's life expectancy. However, it is less useful for making comparisons of cancer survival across groups or over time, since the LLE is influenced by both mortality due to cancer and other causes and the life expectancy in the general population.
We present an approach for making LLE estimates comparable across groups and over time by using reference expected mortality rates with flexible parametric relative survival models. The approach is illustrated by estimating temporal trends in LLE of colon cancer patients in Sweden.
The life expectancy of Swedish colon cancer patients has improved, but the LLE has not decreased to the same extent since the life expectancy in the general population has also increased. When using a fixed population and other-cause mortality, i.e. a reference-adjusted approach, the LLE decreases over time. For example, using 2010 mortality rates as the reference, the LLE for females diagnosed at age 65 decreased from 11.3 if diagnosed in 1976 to 7.2 if diagnosed in 2010, and from 3.9 to 1.9 years for women 85 years old at diagnosis.
The reference-adjusted LLE is useful for making comparisons across calendar time, or groups, since differences in other cause mortality are removed.
The reference-adjusted approach enhances the use of LLE as a comparative measure. |
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| ISSN: | 1055-9965 1538-7755 1538-7755 |