Proportional hazards models and age-period-cohort analysis of cancer rates.
Age-period-cohort (APC) analysis is widely used in cancer epidemiology to model trends in cancer rates. We develop methods for comparative APC analysis of two independent cause-specific hazard rates assuming that an APC model holds for each one. We construct linear hypothesis tests to determine whether the two hazards are absolutely proportional or proportional after stratification by cohort, period, or age. When a given proportional hazards model appears adequate, we derive simple expressions for the relative hazards using identifiable APC parameters. To demonstrate the utility of these new methods, we analyze cancer incidence rates in the United States in blacks versus whites for selected cancers, using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. The examples illustrate that each type of proportionality may be encountered in practice.
Rosenberg
Philip S
PS
Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20852-7244, USA. rosenbep@mail.nih.gov
Anderson
William F
WF
D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology*; D010190:Pancreatic Neoplasms / Q000453:epidemiology*; D016016:Proportional Hazards Models; D014481:United States; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology*; D044465:White People; D055815:Young Adult