title: The loss in expectation of life after colon cancer: a population-based study.
abstract: BACKGROUND
  To demonstrate how assessment of life expectancy and loss in expectation of life can be used to address a wide range of research questions of public health interest pertaining to the prognosis of cancer patients.
  
  
  METHODS
  We identified 135,092 cases of colon adenocarcinoma diagnosed during 1961-2011 from the population-based Swedish Cancer Register. Flexible parametric survival models for relative survival were used to estimate the life expectancy and the loss in expectation of life.
  
  
  RESULTS
  The loss in expectation of life for males aged 55 at diagnosis was 13.5 years (95 % CI 13.2-13.8) in 1965 and 12.8 (12.4-13.3) in 2005. For males aged 85 the corresponding figures were 3.21 (3.15-3.28) and 2.10 (2.04-2.17). The pattern was similar for females, but slightly greater loss in expectation of life. The loss in expectation of life is reduced given survival up to a certain time point post diagnosis. Among patients diagnosed in 2011, 945 life years could potentially be saved if the colon cancer survival among males could be brought to the same level as for females.
  
  
  CONCLUSIONS
  Assessment of loss in expectation of life facilitates the understanding of the impact of cancer, both on individual and population level. Clear improvements in survival among colon cancer patients have led to a gain in life expectancy, partly due to a general increase in survival from all causes.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE-171 77, Stockholm, Sweden. therese.m-l.andersson@ki.se.
authors.forename: Therese M-L
authors.initials: TM
authors.lastname: Andersson
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE-171 77, Stockholm, Sweden. paul.dickman@ki.se.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Dickman
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE-171 77, Stockholm, Sweden. sandra.eloranta@ki.se.
authors.forename: Sandra
authors.initials: S
authors.lastname: Eloranta
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, Center of Surgical Gastroenterology, Karolinska University Hospital, Stockholm, Sweden. annika.sjovall@karolinska.se.
authors.forename: Annika
authors.initials: A
authors.lastname: Sjövall
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE-171 77, Stockholm, Sweden. mats.lambe@ki.se.|Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden. mats.lambe@ki.se.
authors.forename: Mats
authors.initials: M
authors.lastname: Lambe
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE-171 77, Stockholm, Sweden. pl4@leicester.ac.uk.|Department of Health Sciences, University of Leicester, Leicester, UK. pl4@leicester.ac.uk.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Lambert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000266:history; D005260:Female; D005500:Follow-Up Studies; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012042:Registries; D012307:Risk Factors; D062211:Spatio-Temporal Analysis; D013548:Sweden / Q000453:epidemiology