Abstract
BackgroundTo demonstrate how assessment of life expectancy and loss in expectation of life can be used to address a wide range of research questions of public health interest pertaining to the prognosis of cancer patients.MethodsWe identified 135,092 cases of colon adenocarcinoma diagnosed during 1961–2011 from the population-based Swedish Cancer Register. Flexible parametric survival models for relative survival were used to estimate the life expectancy and the loss in expectation of life.ResultsThe loss in expectation of life for males aged 55 at diagnosis was 13.5 years (95 % CI 13.2–13.8) in 1965 and 12.8 (12.4–13.3) in 2005. For males aged 85 the corresponding figures were 3.21 (3.15–3.28) and 2.10 (2.04–2.17). The pattern was similar for females, but slightly greater loss in expectation of life. The loss in expectation of life is reduced given survival up to a certain time point post diagnosis. Among patients diagnosed in 2011, 945 life years could potentially be saved if the colon cancer survival among males could be brought to the same level as for females.ConclusionAssessment of loss in expectation of life facilitates the understanding of the impact of cancer, both on individual and population level. Clear improvements in survival among colon cancer patients have led to a gain in life expectancy, partly due to a general increase in survival from all causes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1427-2) contains supplementary material, which is available to authorized users.
Highlights
To demonstrate how assessment of life expectancy and loss in expectation of life can be used to address a wide range of research questions of public health interest pertaining to the prognosis of cancer patients
How many life years does a person of a particular age on average lose due to their cancer diagnosis, and what is the total number of life-years lost in a particular population? these measures are used very little in practice since estimation generally requires extrapolation of survival as the studies typically don’t follow all patients to the end of life
For the purpose of the present study, we demonstrate how estimation of loss in expectation of life can be used to address a wide range of research questions of public health interest pertaining to the survival and prognosis of colon cancer patients
Summary
Results: The loss in expectation of life for males aged 55 at diagnosis was 13.5 years (95 % CI 13.2–13.8) in 1965 and 12.8 (12.4–13.3) in 2005. Among patients diagnosed in 2011, 945 life years could potentially be saved if the colon cancer survival among males could be brought to the same level as for females. The most commonly reported measure of cancer patient survival in population-based cancer studies is the 5-year relative survival ratio (RSR) [1]. In a Andersson et al BMC Cancer (2015) 15:412 recent study, we showed that the loss in expectation of life can be reliably estimated using flexible parametric relative survival models [3], and we developed software to enable the estimation [4]
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