Impact of the Management and Proportion of Lost to Follow-Up Cases on Cancer Survival Estimates for Small Population-Based Cancer Registries.
Journal
Journal of cancer epidemiology
ISSN: 1687-8558
Titre abrégé: J Cancer Epidemiol
Pays: Egypt
ID NLM: 101519967
Informations de publication
Date de publication:
2022
2022
Historique:
received:
01
10
2021
revised:
22
12
2021
accepted:
13
01
2022
entrez:
10
2
2022
pubmed:
11
2
2022
medline:
11
2
2022
Statut:
epublish
Résumé
Estimation of survival requires follow-up of patients from diagnosis until death ensuring complete and good quality data. Many population-based cancer registries in low- and middle-income countries have difficulties linking registry data with regional or national vital statistics, increasing the chances of cases lost to follow-up. The impact of lost to follow-up cases on survival estimates from small population-based cancer registries (<500 cases) has been understudied, and bias could be larger than in larger registries. We simulated scenarios based on idealized real data from three population-based cancer registries to assess the impact of loss to follow-up on 1-5-year overall and net survival for stomach, colon, and thyroid cancers-cancer types with very different prognosis. Multiple scenarios with varying of lost to follow-up proportions (1-20%) and sample sizes of (100-500 cases) were carried out. We investigated the impact of excluding versus censoring lost to follow-up cases; punctual and bootstrap confidence intervals for the average bias are presented. Censoring of lost to follow-up cases lead to overestimation of the overall survival, this effect was strongest for cancers with a poor prognosis and increased with follow-up time and higher proportion of lost to follow-up cases; these effects were slightly larger for net survival than overall survival. Excluding cases lost to follow-up did not generate a bias on survival estimates on average, but in individual cases, there were under- and overestimating survival. For gastric, colon, and thyroid cancer, relative bias on 5-year cancer survival with 1% of lost to follow-up varied between 6% and 125%, 2% and 40%, and 0.1% and 1.0%, respectively. Estimation of cancer survival from small population-based registries must be interpreted with caution: even small proportions of censoring, or excluding lost to follow-up cases can inflate survival, making it hard to interpret comparison across regions or countries.
Sections du résumé
BACKGROUND
BACKGROUND
Estimation of survival requires follow-up of patients from diagnosis until death ensuring complete and good quality data. Many population-based cancer registries in low- and middle-income countries have difficulties linking registry data with regional or national vital statistics, increasing the chances of cases lost to follow-up. The impact of lost to follow-up cases on survival estimates from small population-based cancer registries (<500 cases) has been understudied, and bias could be larger than in larger registries.
METHODS
METHODS
We simulated scenarios based on idealized real data from three population-based cancer registries to assess the impact of loss to follow-up on 1-5-year overall and net survival for stomach, colon, and thyroid cancers-cancer types with very different prognosis. Multiple scenarios with varying of lost to follow-up proportions (1-20%) and sample sizes of (100-500 cases) were carried out. We investigated the impact of excluding versus censoring lost to follow-up cases; punctual and bootstrap confidence intervals for the average bias are presented.
RESULTS
RESULTS
Censoring of lost to follow-up cases lead to overestimation of the overall survival, this effect was strongest for cancers with a poor prognosis and increased with follow-up time and higher proportion of lost to follow-up cases; these effects were slightly larger for net survival than overall survival. Excluding cases lost to follow-up did not generate a bias on survival estimates on average, but in individual cases, there were under- and overestimating survival. For gastric, colon, and thyroid cancer, relative bias on 5-year cancer survival with 1% of lost to follow-up varied between 6% and 125%, 2% and 40%, and 0.1% and 1.0%, respectively.
CONCLUSION
CONCLUSIONS
Estimation of cancer survival from small population-based registries must be interpreted with caution: even small proportions of censoring, or excluding lost to follow-up cases can inflate survival, making it hard to interpret comparison across regions or countries.
Identifiants
pubmed: 35140789
doi: 10.1155/2022/9068214
pmc: PMC8818438
doi:
Types de publication
Journal Article
Langues
eng
Pagination
9068214Informations de copyright
Copyright © 2022 Fabian Gil et al.
Déclaration de conflit d'intérêts
The authors declare that they have no competing interests.
Références
J Natl Cancer Inst Monogr. 2014 Nov;2014(49):210-7
pubmed: 25417234
Epidemiol Rev. 2017 Jan 1;39(1):161-169
pubmed: 28472440
BMJ. 2011 Jun 09;342:d3399
pubmed: 21659366
CA Cancer J Clin. 2021 May;71(3):209-249
pubmed: 33538338
Br J Cancer. 2011 Jun 28;105(1):170-6
pubmed: 21559016
Biometrics. 2012 Mar;68(1):113-20
pubmed: 21689081
Br J Cancer. 2013 Feb 19;108(3):691-8
pubmed: 23361055
Salud Publica Mex. 2016 Apr;58(2):309-16
pubmed: 27557391
Br J Cancer. 2021 Mar;124(5):1026-1032
pubmed: 33293692
BMJ Open. 2020 Jan 13;10(1):e033510
pubmed: 31937655
Colomb Med (Cali). 2018 Mar 30;49(1):121-127
pubmed: 29983472
Lancet. 2018 Mar 17;391(10125):1023-1075
pubmed: 29395269
Epidemiology. 2016 Jan;27(1):91-7
pubmed: 26484424
Int J Cancer. 2009 Jul 15;125(2):432-7
pubmed: 19422045
Salud Publica Mex. 2013 Aug;55(4):368-78
pubmed: 24165712
Int J Cancer. 2021 Jul 1;149(1):12-20
pubmed: 33231289
Cancer Epidemiol. 2021 Apr;71(Pt A):101881
pubmed: 33440295
Lancet Diabetes Endocrinol. 2021 Apr;9(4):225-234
pubmed: 33662333
Cancer. 2021 Aug 15;127(16):3029-3030
pubmed: 34086348
Cancer Epidemiol. 2016 Dec;45 Suppl 1:S13-S19
pubmed: 27760725
Lancet Diabetes Endocrinol. 2021 Jun;9(6):330-332
pubmed: 33891886