title: Estimating the crude probability of death due to cancer and other causes using relative survival models.
abstract: Relative survival is used extensively in population-based cancer studies to measure patient survival correcting for causes of death not related to the disease of interest. An advantage of relative survival is that it provides a measure of mortality associated with a particular disease, without the need for information on cause of death. Relative survival provides a measure of net mortality, i.e. the probability of death due to cancer in the absence of other causes. This is a useful measure, but it is also of interest to measure crude mortality, i.e. the probability of death due to cancer in the presence of other causes. A previous approach to estimate the crude probability of death in population-based cancer studies used life table methods, but we show how the estimates can be obtained after fitting a relative survival model. We adopt flexible parametric models for relative survival, which use restricted cubic splines for the baseline cumulative excess hazard and for any time-dependent effects. We illustrate the approach using an example of men diagnosed with prostate cancer in England and Wales showing the differences in net and crude survival for different ages.
authors.affiliation: Department of Health Sciences, Centre for Biostatistics and Genetic Epidemiology, University of Leicester, 2nd Floor, Adrian Building, University Road, Leicester LE1 7RH, U.K. paul.lambert@le.ac.uk
authors.forename: P C
authors.initials: PC
authors.lastname: Lambert
authors.forename: P W
authors.initials: PW
authors.lastname: Dickman
authors.forename: C P
authors.initials: CP
authors.lastname: Nelson
authors.forename: P
authors.initials: P
authors.lastname: Royston
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D056808:Biostatistics; D002423:Cause of Death; D004739:England / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000401:mortality*; D016019:Survival Analysis; D014852:Wales / Q000453:epidemiology