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Estimation of age-standardized net survival, even when age-specific data are sparse

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journal contribution
posted on 2020-09-03, 09:20 authored by Mark J Rutherford, Paul W Dickman, Enzo Coviello, Paul C Lambert
Background: Age-standardization is vital in international comparison studies of cancer patient survival, but standard approaches can fail to produce estimates in the case of sparsity. Methods: The purpose of this paper is to demonstrate that using a standardization pre-weighting approach is a viable alternative approach for external age-standardization in population-based cancer data and performs well in cases of sparsity. We further de;1;scribe how the pre-weighting approach to age-standardization can be coupled with the Pohar Perme estimator in both a cohort and period analysis setting. For period analysis, we compare approaches for defining the internal age distribution. We use SEER public use data to illustrate our approach and estimate survival for Connecticut and by race to create a scenario with sufficient sparsity.
Results: The pre-weighting approach gives comparable estimates to traditional age-standardization in cases with sufficient data and produces estimates throughout follow-up in cases of sparsity when a traditional approach would fail.
Conclusion: International comparison studies and other national population-based survival studies that need to age-standardize estimates for comparability purposes should adopt the Pohar Perme estimator with pre-weighting. This approach avoids issues of non-estimation in the case of sparsity and will allow more consistent comparisons across the produced estimates.

Funding

This work was supported by the Swedish Research Council (grants 521-2013-3383, 2017-01581); and the Swedish Cancer Society (grant CAN2015/583).

History

Citation

Cancer Epidemiology, Volume 67, August 2020, 101745

Author affiliation

Department of Health Sciences, University of Leicester

Version

  • AM (Accepted Manuscript)

Published in

Cancer Epidemiology: the international journal of cancer epidemiology, detection and prevention

Volume

67

Pagination

101745

Publisher

Elsevier

issn

0361-090X

eissn

1877-783X

Acceptance date

2020-05-23

Copyright date

2020

Available date

2021-06-15

Spatial coverage

Netherlands

Language

English

Publisher version

https://www.sciencedirect.com/science/article/pii/S1877782120300795#sec0070

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