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Maximizing the Benefits of Model-Based Period Analysis of Cancer Patient Survival

¹ Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany and ² Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland

Requests for reprints: Hermann Brenner, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Bergheimer Strasse 20, D-69115 Heidelberg, Germany. Phone: 49-6221-548140; Fax: 49-6221-548142. E-mail: h.brenner{at}dkfz-heidelberg.de

Period analysis has been shown to provide more up-to-date estimates of cancer survival than traditional methods of survival analysis. There is, however, a tradeoff between up-to-dateness and precision of period survival estimates: increasing up-to-dateness by restricting the analysis to a relatively short period, such as the most recent calendar year, goes along with loss of precision. Recently, a model-based approach was proposed, in which more precise period survival estimates for the most recent year can be obtained through modeling of survival trends within a recent 5-year period. We assess possibilities to extend the time window used for modeling to come up with even more precise, but equally accurate and up-to-date estimates of prognosis. Empirical evaluation using data from the Finnish Cancer Registry shows that extension of the time window to about 10 years provides, in most cases, as accurate results as using a 5-year time window (whereas further extension may lead to considerably less accurate results in some cases). Using 10-year time windows for modeling, SEs of survival estimates can be approximately halved compared with conventional period survival estimates for the most recent calendar year. Furthermore, we present a modification of the modeling approach, which allows extension to 10-year time windows to be achieved without the need to include additional cohorts of patients diagnosed longer time ago and which provides similarly accurate survival estimates at comparable levels of precision in most cases. Our analyses indicate opportunities to further maximize benefits of model-based period analysis of cancer survival. (Cancer Epidemiol Biomarkers Prev 2007;16(8):1675–81)