Lenner P
Centre of Oncology, University of Umeå, Sweden.
Acta Oncol. 1990;29(5):573-6. doi: 10.3109/02841869009090053.
Death cause registers and cancer incidence registers are often used to elucidate progress (or lack of progress) in the battle against cancer. Trends in the age-adjusted mortality rate of cancer or of specific cancer types may thus mirror the overall effect of anticancer interventions (prevention, early diagnostics, treatment), but are often influenced by changes in the death cause diagnostics or in the coding routines at the registers. Relative survival rate (or its inversion, relative mortality rate) is sometimes used in order to elucidate improvement due to treatment. It is independent of the death cause diagnoses but often seriously influenced by changes in diagnostics of incident cancer; earlier diagnosis and increased detection of non-fatal cases may thus give an improved relative survival rate, quite unrelated to any improvement in the treatment. In the present paper the excess mortality rate is introduced as a measure which can give additional information concerning effects of anticancer interventions. In contrast to age-adjusted mortality rate it is not dependent on death cause diagnoses or coding routines, and in contrast to relative survival it is independent of the rate of non-fatal incident cancer cases.
死因登记册和癌症发病率登记册常被用于阐明抗癌斗争中的进展（或缺乏进展）情况。因此，癌症或特定癌症类型的年龄调整死亡率趋势可能反映了抗癌干预措施（预防、早期诊断、治疗）的总体效果，但往往受到死因诊断变化或登记册编码程序变化的影响。有时会使用相对生存率（或其倒数，相对死亡率）来阐明治疗带来的改善。它与死因诊断无关，但常常受到新发癌症诊断变化的严重影响；因此，更早的诊断和非致命病例检测的增加可能会提高相对生存率，这与治疗方面的任何改善完全无关。在本文中，引入了超额死亡率作为一种能够提供有关抗癌干预措施效果的额外信息的衡量指标。与年龄调整死亡率不同，它不依赖于死因诊断或编码程序，与相对生存率不同，它独立于非致命新发癌症病例的发生率。
