Journal article
Choice of Survival Metric and Its Impacts on Cancer Survival Estimates for American Indian and Alaska Native People
Cancer epidemiology biomarkers & prevention, Vol.32(3), pp.398-405
03/06/2023
DOI: 10.1158/1055-9965.EPI-22-1059
PMCID: PMC9992150
PMID: 36723409
Abstract
Different survival metrics have different applicability to clinical practice and research. We evaluated how choice of survival metric influences assessment of cancer survival among American Indian and Alaska Native (AIAN) people relative to non-Hispanic Whites (NHW). A secondary objective was to present variations in survival among AIAN people by age, sex, stage, and Indian Health Service (IHS) region.
Five-year survival was calculated using the North American Association of Central Cancer Registries Cancer in North America dataset. We calculated survival among AIAN people, compared with NHW using four approaches: (i) observed (crude) survival, (ii) cause-specific survival, (iii) relative survival using age- and sex-adjusted lifetables, and (iv) relative survival using lifetables additionally adjusted for race, geography, and socioeconomic status. For AIAN people, we evaluated how survival varied by age, stage at diagnosis, and IHS region.
Observed survival methods produced the lowest estimates, and-excepting prostate cancer-cause-specific methods produced the highest survival estimates. Survival was lower among AIAN people than NHW for all methods. Among AIAN people, survival was higher among those 20-64 years, females, and tumors diagnosed at local stage. Survival varied by IHS region and cancer sites.
These results support the assertion that using the same methodology to compare survival estimates between racial and ethnic groups is of paramount importance, but that the choice of metric requires careful consideration of study objectives.
These findings have the potential to impact choice of survival metric to explore disparities among AIAN people.
Details
- Title: Subtitle
- Choice of Survival Metric and Its Impacts on Cancer Survival Estimates for American Indian and Alaska Native People
- Creators
- Sarah H Nash - University of IowaMadison M Wahlen - University of IowaAngela L W Meisner - New Mexico Tumor Registry, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, New MexicoBożena M Morawski - Cancer Data Registry of Idaho, Idaho Hospital Association, Boise, Idaho
- Resource Type
- Journal article
- Publication Details
- Cancer epidemiology biomarkers & prevention, Vol.32(3), pp.398-405
- DOI
- 10.1158/1055-9965.EPI-22-1059
- PMID
- 36723409
- PMCID
- PMC9992150
- ISSN
- 1055-9965
- eISSN
- 1538-7755
- Grant note
- name: National Cancer Institute, award: Contract HHSN26120130010I, Task Order HHSN26100005; name: National Cancer Institute, award: Contract HHSN261201800006I; name: National Cancer Institute, award: (NCI Contract HHSN261201800014I, Task order HHSN26100001; DOI: 10.13039/100000030, name: Centers for Disease Control and Prevention, award: Cooperative Agreement 1NU58DP006270; name: National Cancer Institute, award: R01CA254628
- Language
- English
- Electronic publication date
- 02/01/2023
- Date published
- 03/06/2023
- Academic Unit
- Epidemiology; Center for Social Science Innovation; Community and Behavioral Health
- Record Identifier
- 9984365059302771
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