Abstract
Improvements in cancer survival are usually assessed by comparing survival in grouped years of diagnosis. To enhance analyses of survival trends, we present the joinpoint survival model webtool (JPSurv) that analyzes survival data by single year of diagnosis and estimates changes in survival trends and year-over-year trend measures. We apply JPSurv to relative survival data for individuals diagnosed with female breast cancer, melanoma cancer, non-Hodgkin lymphoma (NHL), and chronic myeloid leukemia (CML) between 1975 and 2015 in the Surveillance, Epidemiology, and End Results Program. We estimate the number and location of joinpoints and the trend measures and provide interpretation. In general, relative survival has substantially improved at least since the mid-1990s for all cancer sites. The largest improvements in 5-year relative survival were observed for distant-stage melanoma after 2009, which increased by almost 3 survival percentage points for each subsequent year of diagnosis, followed by CML in 1995-2010, and NHL in 1995-2003. The modeling also showed that for patients diagnosed with CML after 1995 (compared with before), there was a greater decrease in the probability of dying of the disease in the 4th and 5th years after diagnosis compared with the initial years since diagnosis. The greatest increases in trends for distant melanoma, NHL, and CML coincided with the introduction of novel treatments, demonstrating the value of JPSurv for estimating and interpreting cancer survival trends. The JPSurv webtool provides a suite of estimates for analyzing trends in cancer survival that complement traditional descriptive survival analyses.
Highlights
During the past two decades, substantial progress has been made in the treatment, early detection and prevention of many cancers
The largest improvements in 5-year relative survival were observed for distant-stage melanoma after 2009, which increased by almost 3 survival percentage points for each subsequent year of diagnosis, followed by chronic myeloid leukemia (CML) in 1995–2010, and non–Hodgkin lymphoma (NHL) in 1995–2003
The modeling showed that for patients diagnosed with CML after 1995, there was a greater decrease in the probability of dying of the disease in the 4th and 5th years after diagnosis compared with the initial years since diagnosis
Summary
During the past two decades, substantial progress has been made in the treatment, early detection and prevention of many cancers. Population-based cancer statistics, especially trends in cancer rates (incidence and mortality), are the measures used most frequently to report and monitor progress in cancer control [1, 2]. The Joinpoint regression model analyzes rates and proportions over time to identify timepoints (joinpoints) at which trends have changed, and to estimate the regression function with joinpoints identified [3]. A Joinpoint survival model [4] was developed that allows for analysis of survival trends by single calendar year of diagnosis. Improvements in cancer survival are usually assessed by comparing survival in grouped years of diagnosis. To enhance analyses of survival trends, we present the joinpoint survival model webtool (JPSurv) that analyzes survival data by single year of diagnosis and estimates changes in survival trends and year-over-year trend measures
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