Holford Theodore R, Chen Huann-Sheng, Kane Michael J, Krapcho Martin, Annett David, Esclamado Len, Melkonyan Asya, Feuer Eric J
Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States.
Division of Cancer Control and Populations Sciences, National Cancer Institute, Bethesda, MD, United States.
Am J Epidemiol. 2025 Aug 5;194(8):2144-2149. doi: 10.1093/aje/kwae398.
CP*Trends is a widely used Surveillance, Epidemiology, and End Results Program (SEER) website used to explore temporal effects of period and cohort on cancer incidence and mortality. It provides a graphical display of smoothed rates, and a C-P score that helps to assess the magnitude of the effect of cohort and period. This update provides results for African Americans and Whites. The C-P score has an intrinsic bias favoring cohort because there are many more cohorts than periods. An adjusted C-P score removes some of this advantage. Bootstrap confidence intervals are given, which allow one to see the effects of different sample sizes on the model results. Finally, users may control window size used in the smoothing algorithm, which helps to avoid oversmoothing or masking of trends. The method is illustrated using data on cervical cancer incidence trends for African Americans and Whites, 1975-2018. Rates are higher for African Americans, and both races have contributions for cohort. However, the period effect is only strongly evident in Whites. Visual inspection of White trends suggests possible differences for those older and younger than age 50. These methods are applied in an interactive website displaying incidence and mortality trends for over 20 cancer sites in the United States.
CP*Trends是一个广泛使用的监测、流行病学和最终结果计划（SEER）网站，用于探讨时期和队列对癌症发病率和死亡率的时间效应。它提供平滑率的图形显示以及一个C-P分数，有助于评估队列和时期效应的大小。本次更新提供了非裔美国人和白人的结果。由于队列数量远多于时期数量，C-P分数存在有利于队列的内在偏差。调整后的C-P分数消除了部分这种优势。给出了自助法置信区间，使人们能够看到不同样本量对模型结果的影响。最后，用户可以控制平滑算法中使用的窗口大小，这有助于避免过度平滑或趋势掩盖。使用1975 - 2018年非裔美国人和白人宫颈癌发病率趋势数据对该方法进行了说明。非裔美国人的发病率更高，两个种族都有队列贡献。然而，时期效应仅在白人中明显。对白人趋势的直观检查表明，50岁以上和50岁以下人群可能存在差异。这些方法应用于一个交互式网站，该网站展示了美国20多个癌症部位的发病率和死亡率趋势。
