Abstract

BackgroundAccurate cancer survival statistics are necessary for describing population‐level survival patterns and measuring advancements in cancer care. Net cancer survival is measured using two methods: cause‐specific survival (CSS) and relative survival (RS). Both are valid methodologies for estimating net survival and are used widely in medical research. In these analyses, we compare CSS to RS at selected cancer sites.MethodsUsing data from 18 SEER registries between 2000 and 2014, five‐year RS and CSS estimates were generated overall as well as by age groups and by sex. To assess how closely the two survival methods corresponded, net survival percent difference was calculated with the following formula: ((RS‐CSS)/RS)*100.ResultsDiscrepancies between estimates obtained from CSS and RS methods varied with cancer site and age, but not by sex. In most cases, CSS was greater than RS, but cancers with available early screening and high survival rate had higher RS than CSS. Net survival percent differences were small in children and adolescents and young adults, and large in adults over the age of 40.ConclusionsWhile both CSS and RS aim to quantify net survival, the estimates tend to differ due to the biases present in both methodologies. Error when estimating CSS most frequently stems from misclassification of cause of death, whereas RS is subject to error when no suitable life tables are available. Appropriate use of CSS and RS requires a detailed understanding of the characteristics of the disease that may lead to differences in the estimates generated by these methods.

Highlights

  • Cancer survival statistics are valuable tools for researchers, physicians, and patients

  • Misclassification can be divided into two groups: genuine or TABLE 2 5-­Year net survival estimates, 95% confidence intervals, and percent difference between cause-s­ pecific survival (CSS) and relative survival (RS) by selected sites and sex (SEER 2000-­2014)

  • While our results demonstrated that cause-­specific survival (CSS) is a reliable method to estimate net survival in many situations, it is important to acknowledge the limitations of the study

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Summary

Introduction

Cancer survival statistics are valuable tools for researchers, physicians, and patients. As net cancer survival isolates the effects of a cancer diagnosis on survival, it is a valuable statistic to describe cancer prognosis. Accurate cancer survival statistics are necessary for describing population-­level survival patterns and measuring advancements in cancer care. Net cancer survival is measured using two methods: cause-­specific survival (CSS) and relative survival (RS). Both are valid methodologies for estimating net survival and are used widely in medical research. In these analyses, we compare CSS to RS at selected cancer sites. To assess how closely the two survival methods corresponded, net survival percent difference was calculated with the following formula: ((RS-­CSS)/RS)*100. Appropriate use of CSS and RS requires a detailed understanding of the characteristics of the disease that may lead to differences in the estimates generated by these methods

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