Brenner H
Department of Epidemiology, German Centre for Research on Ageing, Bergheimer Str. 20, D-69115 Heidelberg, Germany.
Br J Cancer. 2003 Jun 2;88(11):1693-7. doi: 10.1038/sj.bjc.6600947.
Survival rates of children with cancer have strongly improved during the past decades, but much of this improvement has been disclosed with substantial delay by traditional methods of survival analysis, which reflect survival experience of patients diagnosed many years ago. In this paper, the use of a new method of survival analysis, denoted period analysis, for providing more up-to-date estimates of 10-year survival curves of children with cancer is empirically evaluated using data of the Surveillance, Epidemiology, and End Results Program of the United States National Cancer Institute. It is shown that period analysis provides much more up-to-date estimates of survival curves than traditional cohort-based survival analysis indeed, at least as long as there is ongoing improvement in survival rates over time, as it seems to be the case for many forms of childhood cancer. The most recent 10-year period survival estimates indicate that survival rates of children with cancer achieved by the end of the 20th century are substantially higher than previously available survival statistics have suggested. Application of period analysis may be particularly useful in the field of childhood cancer as it may help to prevent patients, their families and clinicians from being burdened by outdated, often too pessimistic survival expectations.
在过去几十年中,癌症患儿的生存率有了显著提高,但传统生存分析方法在很大程度上延迟披露了这种改善情况,这些传统方法反映的是多年前确诊患者的生存经历。在本文中,我们利用美国国立癌症研究所监测、流行病学和最终结果计划的数据,对一种新的生存分析方法(称为时期分析)进行了实证评估,以提供更及时的癌症患儿10年生存曲线估计。结果表明,时期分析确实比传统的基于队列的生存分析能提供更及时的生存曲线估计,至少只要随着时间推移生存率持续提高,就像许多儿童癌症的情况一样。最新的10年时期生存估计表明,20世纪末癌症患儿的生存率远高于此前可用的生存统计数据所显示的水平。时期分析的应用在儿童癌症领域可能特别有用,因为它有助于防止患者及其家人和临床医生被过时且往往过于悲观的生存预期所困扰。