title: Estimating the change in life expectancy after a diagnosis of cancer among the Australian population.
abstract: OBJECTIVE
  Communication of relevant prognostic information is critical in helping patients understand the implications of their cancer diagnosis. We describe measures of prognosis to help communicate relevant prognostic information to improve patients' understanding of the implications of their cancer diagnosis.
  
  
  METHODS
  Australia-wide population-based cancer registry cohort.
  
  
  METHODS
  870,878 patients aged 15-89 years diagnosed with invasive cancer between 1990 and 2007, with mortality follow-up information to December 2010.
  
  
  METHODS
  Flexible parametric models were used to estimate loss of life expectancy (LOLE), remaining life expectancy (RLE) and 10-year cumulative probability of cancer-specific death (1-relative survival).
  
  
  RESULTS
  On average, Australians diagnosed with cancer at age 40 years faced losing an average of 11.2 years of life (95% CI 11.1 to 11.4) due to their cancer, while those diagnosed at 80 years faced losing less, an average of 3.9 years (3.9 to 4.0) because of higher competing mortality risks. In contrast, younger people had lower estimated cumulative probabilities of cancer-specific death within 10 years (40 years: 21.5%, 21.4% to 22.1%) compared with older people (80 years: 55.4%, 55.0% to 55.9%). The patterns for individual cancers varied widely, both by cancer type and by age within cancer type.
  
  
  CONCLUSIONS
  The LOLE and RLE measures provide complementary messages to standard relative survival estimates (expressed here in terms of cumulative probability of cancer-specific death). Importantly, relative survival per se underplays the greater absolute impact that a cancer diagnosis has at a younger age on LOLE. When presented in isolation for all cancers, it may provide a misleading impression of future mortality burden of cancer overall, and furthermore, it will obscure patterns of mortality by type and by age data within type. Alternative measures of LOLE, therefore, provide important communication about mortality risk to patients with cancer worldwide and should be incorporated into standard reporting and dissemination strategies.
authors: Cancer Council Queensland, Brisbane, Queensland, Australia School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
authors: Peter D
authors: PD
authors: Baade
authors: Cancer Council Queensland, Brisbane, Queensland, Australia.
authors: Danny R
authors: DR
authors: Youlden
authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors: Therese M-L
authors: TM
authors: Andersson
authors: Cancer Council Queensland, Brisbane, Queensland, Australia School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
authors: Philippa H
authors: PH
authors: Youl
authors: Cancer Council Queensland, Brisbane, Queensland, Australia School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia AusSun Research Laboratory, Institute of Health and Biotechnical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
authors: Michael G
authors: MG
authors: Kimlin
authors: Cancer Council Queensland, Brisbane, Queensland, Australia School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
authors: Joanne F
authors: JF
authors: Aitken
authors: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia AusSun Research Laboratory, Institute of Health and Biotechnical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
authors: Robert J
authors: RJ
authors: Biggar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009369:Neoplasms / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult
keywords: Cancer; Life expectancy; Risk communication; Survival