title: Has equity in relative survival improved over time in Finland - a methodological exercise.
abstract: BACKGROUND
  Population-based relative survival is widely used as a method of monitoring the success of cancer control. This success may not be relevant only for an entire country but also regional developments over time are of interest. It would not only be important that the relative survival improved but also that the differences between regions decreased over time.
  
  
  METHODS
  In this paper the authors show how relative survival methods can be used to study such differences. In addition to standard methods, some more recently introduced approaches are used, most notably a method for checking the goodness of fit of the relative survival model. This gives confidence in the obtained results and provides additional insight when assumptions are not met.
  
  
  RESULTS
  An analysis of cancers of the colon and ovary by cancer control region in Finland in 1953-2003 shows an overall improvement in relative survival, accompanied in colon cancer also by a decrease of differences in relative survival between the regions. Thus, the desired course was observed in colon cancer but not in cancer of the ovary.
  
  
  CONCLUSIONS
  These results, applied to further sites, should lead to investigation of differences in cancer control policies between regions.
authors.affiliation: Institute of Biostatistics and Medical Informatics, University of Ljubljana, Slovenia.
authors.forename: Maja Pohar
authors.initials: MP
authors.lastname: Perme
authors.forename: Timo
authors.initials: T
authors.lastname: Hakulinen
authors.forename: Manca
authors.initials: M
authors.lastname: Jesenko
authors.forename: Risto
authors.initials: R
authors.lastname: Sankila
authors.forename: Janez
authors.initials: J
authors.lastname: Stare
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D004812:Epidemiologic Methods; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D016016:Proportional Hazards Models; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends