Abstract
BackgroundSurvival rate is used to develop cancer control plans. However, there are limitations and biases when interpreting patient survival rate data. This study aimed to identify and account for potential biases and/or limitations on estimating survival rate to enable more effective control of cancer.MethodsThe authors searched PubMed from December 2010 to December 2015 for articles that investigated or described biases in estimating patient survival using cancer registries. Articles that only described the tendency of survival rate and investigated relationships between patient characteristics, treatment, and survival rate were excluded.ResultsIn total, 50 articles met the inclusion criteria. The identified potential biases were categorized into three areas, as follows: 1) the quality of registry data (eg, the completeness of cancer patients, accuracy of data, and follow-up rates); 2) limitations related to estimated methods of survival rates (eg, misclassification of cause of death for cause-specific survival rate or a lack of comparability of background mortality for relative survival rate); and 3) the comparability of survival rates among different groups (eg, age-adjustment or patients with multiple cancers).ConclusionWe concluded that survival rate can be suitable for answering questions related to health policy and research. Several factors should be considered when interpreting survival rates estimated using cancer registries.
Highlights
Survival rate is used as a measure of cancer burden, and is often employed by policymakers to compare cancer outcomes between different populations and time periods.[1]
Beral and Peto interpreted trends in mortality from breast cancer as incompatible with the lower survival in the United Kingdom than in other countries.[3]. They hypothesize that the lower reported survival rates in the United Kingdom could arise as an artefact from two main errors: 1) the registration of cancer is not statutory in England and Wales, and a large proportion of cases are registered only because death certificates mentioning cancer are routinely provided to the registries; and 2) the United Kingdom survival statistics are falsely low because some long-term survivors are never registered
death certificate only (DCO) proportions after successful trace-back of data of diagnosis were positively associated with lung cancer survival rate and negatively associated with colorectal and breast cancer survival rate.[8]
Summary
Survival rate is used as a measure of cancer burden, and is often employed by policymakers to compare cancer outcomes between different populations and time periods.[1]. Woods et al examined how national estimates of survival would change if each of these errors occurred.[4] Their results showed that even implausibly extreme levels of these hypothesized errors in the cancer registry data could not explain the international differences in survival rate observed between the United Kingdom and other countries. There are limitations and biases when interpreting patient survival rate data. This study aimed to identify and account for potential biases and=or limitations on estimating survival rate to enable more effective control of cancer
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