Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Nat Rev Clin Oncol. 2010 Jan;7(1):60-3. doi: 10.1038/nrclinonc.2009.184.
If cancer survival is reported to be worsening over time or inferior compared to other countries, politicians and health-care workers may get blamed because suboptimal care is presumed to be the cause. Yet, a variety of reasons exist for cancer survival statistics to change for the worse, of which deterioration of care is only one. Another explanation is that the improved diagnosis of premalignant lesions causes survival statistics to reflect only the most aggressive cancers-those with the poorest prognosis. In addition, deleterious changes in the distribution of prognostic factors and in the distribution of sociodemographic characteristics may negatively affect survival proportions. In this article, we identify the pitfalls that might be encountered in comparisons of published, population-based survival data from different time periods or populations.
如果癌症的存活率报告显示随着时间的推移而恶化，或者比其他国家差，政治家和医疗保健工作者可能会受到指责，因为人们认为治疗效果不佳是造成这种情况的原因。然而，癌症存活率数据恶化的原因有很多，治疗效果不佳只是其中之一。另一个解释是，癌前病变的诊断水平提高，导致生存统计数据仅反映出最具侵袭性的癌症，即预后最差的癌症。此外，预后因素分布和社会人口特征分布的有害变化可能会对生存率产生负面影响。在本文中，我们确定了在比较不同时期或人群的已发表的基于人群的生存数据时可能遇到的陷阱。
