Brenner Hermann, Hakulinen Timo
Department of Epidemiology, German Centre for Research on Ageing, Bergheimer Strasse 20, D-69115 Heidelberg, Germany.
Eur J Cancer. 2005 Aug;41(12):1788-93. doi: 10.1016/j.ejca.2005.03.029.
Selective under-ascertainment of cancer patients by cancer registries may bias population-based estimates of cancer patient survival. As prognosis is strongly age related for many forms of cancer, age adjustment of cancer survival rates, which is primarily used to enhance the validity of comparative analyses between cancer populations, might also effectively reduce this type of bias. We empirically assessed this potential "side-effect" of age adjustment using data from the Finnish Cancer Registry. Analyses of five-year absolute and relative survival for patients diagnosed in 1990-1994, and age adjustment to the age structure of patients diagnosed in 1985-1989, were used as examples. Various patterns of selective under-ascertainment were simulated, and the bias in crude and age adjusted five-year survival rates was compared. Age adjusted estimates were less biased in most scenarios, which may be an additional argument for application of age adjustment in the analysis and reporting of population-based cancer survival rates.
癌症登记处对癌症患者的选择性漏报可能会使基于人群的癌症患者生存率估计产生偏差。由于许多癌症类型的预后与年龄密切相关，癌症生存率的年龄调整主要用于提高癌症人群之间比较分析的有效性，它也可能有效地减少这类偏差。我们使用芬兰癌症登记处的数据，对年龄调整的这种潜在“副作用”进行了实证评估。以1990 - 1994年确诊患者的五年绝对生存率和相对生存率分析以及根据1985 - 1989年确诊患者的年龄结构进行年龄调整为例。模拟了各种选择性漏报模式，并比较了粗生存率和年龄调整后五年生存率的偏差。在大多数情况下，年龄调整后的估计偏差较小，这可能是在基于人群的癌症生存率分析和报告中应用年龄调整的另一个理由。
