It is common in population-based cancer registries to use the relative survival ratio to estimate patients' probabilities of surviving if their cancer were the only cause of death. Results from the recently proposed new methods of age-standardisation can be interpreted as ratios between the observed and expected survival proportions. Like the non-standardised ratios, these age-standardised relative survival ratios have, however, the desired probability interpretation only under a specific condition. The condition involved is the survival with respect to other causes up to the given point of follow-up. With different lengths of follow-up, this condition is also different. As a consequence, the non-standardised relative survival ratios and those standardised with the two newest methods produce, for different lengths of follow-up, mutually incomparable estimates with respect to age. Not accounting for this may, for example, lead to erroneous conclusions about the cure of the patients. The traditional method of age-standardisation does not have this problem of incomparability. Results of relative survival analyses of data from the Finnish Cancer Registry are used to illustrate this issue. To avoid overinterpretation and confusion, the different interpretations of the relative survival ratios, both non-standardised and age-standardised, must be known. For example, the very popular cumulative relative survival curves, consisting of consecutive cumulative relative survival ratios, should not be produced for the non-standardised ratios or for ratios age-standardised with the two newest methods. In practical applications, it is crucial to know which method of standardisation, and not only which standard population, has been in use.

译文

在基于人群的癌症登记处中,如果癌症是唯一的死亡原因,则通常使用相对生存率来估计患者的生存概率。最近提出的新年龄标准化方法的结果可以解释为观察到的生存比例和预期生存比例之间的比率。与非标准化比率一样,这些年龄标准化的相对存活率仅在特定条件下才具有所需的概率解释。所涉及的情况是直到给定的随访点为止与其他原因有关的生存。随着随访长度的不同,这种情况也不同。结果,对于不同的随访时间,非标准化的相对存活率和使用两种最新方法标准化的相对存活率产生了关于年龄的互不可比的估计。例如,不考虑这一点可能会导致关于患者治愈的错误结论。传统的年龄标准化方法没有这种不可比性的问题。芬兰癌症登记处数据的相对生存分析结果用于说明这一问题。为了避免过度解释和混淆,必须知道对相对存活率的不同解释,包括非标准化和年龄标准化。例如,对于非标准化比率或使用两种最新方法进行年龄标准化的比率,不应产生由连续累积相对生存率组成的非常流行的累积相对生存率曲线。在实际应用中,至关重要的是要知道使用了哪种标准化方法,而不仅仅是使用了哪种标准人群。

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