Othus Megan, Li Yi, Tiwari Ram
1100 Fairview Ave N, M3-C102, PO Box 19024, Seattle WA 98117-1024, USA.
J Appl Stat. 2012;39(4):901-911. doi: 10.1080/02664763.2011.626849. Epub 2012 Mar 12.
Previous research on prostate cancer survival trends in the United States National Cancer Institute's Surveillance Epidemiology and End Results database has indicated a potential change-point in the age of diagnosis of prostate cancer around age 50. Identifying a change-point value in prostate cancer survival and cure could have important policy and health care management implications. Statistical analysis of this data has to address two complicating features: (1) change-point models are not smooth functions and so present computational and theoretical difficulties; and (2) models for prostate cancer survival need to account for the fact that many men diagnosed with prostate cancer can be effectively cured of their disease with early treatment. We develop a cure survival model that allows for change-point effects in covariates to investigate a potential change-point in the age of diagnosis of prostate cancer. Our results do not indicate that age under 50 is associated with increased hazard of death from prostate cancer.
此前对美国国立癌症研究所监测、流行病学和最终结果数据库中前列腺癌生存趋势的研究表明，前列腺癌诊断年龄在50岁左右可能存在一个变化点。确定前列腺癌生存和治愈方面的变化点值可能对政策和医疗管理具有重要意义。对这些数据进行统计分析必须解决两个复杂特征：（1）变化点模型不是平滑函数，因此存在计算和理论难题；（2）前列腺癌生存模型需要考虑到许多被诊断出前列腺癌的男性通过早期治疗可以有效治愈这一事实。我们开发了一种治愈生存模型，该模型允许协变量存在变化点效应，以研究前列腺癌诊断年龄的潜在变化点。我们的结果并未表明50岁以下的年龄与前列腺癌死亡风险增加有关。
