Measuring social class differences in cancer patient survival: is it necessary to control for social class differences in general population mortality? A Finnish population-based study.
Estimation of cancer patient survival by social class has been performed using observed, corrected (cause specific), and relative (with expected survival based on the national population) survival rates. Each of these measures are potentially biased and the optimal method is to calculate relative su...
| Published in: | Journal of Epidemiology & Community Health Vol. 52; no. 11; pp. 727 - 735 |
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| Main Authors: | , , , |
| Format: | research Journal Article |
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BMJ Publishing Group
Nov1998
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104717290&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104717290 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0143005X C0H jtl: Journal of Epidemiology & Community Health issn: 0143005X maglogo: N pubinfo: dt: Nov1998 vid: 52 iid: 11 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 104717290 104717290 2011074918 10.1136/jech.52.11.727 NLM10396505 PMC1756645 104717290 ppf: 727 ppct: 8 formats: tig: atl: Measuring social class differences in cancer patient survival: is it necessary to control for social class differences in general population mortality? A Finnish population-based study. aug: au: Dickman, P W Auvinen, A Voutilainen, E T Hakulinen, T affil: Department of Cancer Epidemiology, Karolinska Institute, Stockholm, Sweden. sug: subj: Neoplasms Mortality Social Class Adolescence Adult Aged Cause of Death Child Child, Preschool Female Finland Human Infant Infant, Newborn Male Middle Age Regression Survival Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Child: 6-12 years Child, Preschool: 2-5 years Infant: 1-23 months Infant, Newborn: birth-1 month Middle Aged: 45-64 years Female Male ab: Estimation of cancer patient survival by social class has been performed using observed, corrected (cause specific), and relative (with expected survival based on the national population) survival rates. Each of these measures are potentially biased and the optimal method is to calculate relative survival rates using social class specific death rates to estimate expected survival. This study determined the degree to which the choice of survival measure affects the estimation of social class differences in cancer patient survival. All Finnish residents diagnosed with at least one of 10 common malignant neoplasms during the period 1977-1985 were identified from the Finnish Cancer Registry and followed up for deaths to the end of 1992. Survival rates were calculated by site, sex, and age at 5, 10, and 15 years subsequent to diagnosis for each of three measures of survival; relative survival, corrected (cause specific) survival, and relative survival adjusted for social class differences in general mortality. Regression models were fitted to each set of rates for the first five years of follow up. The degree of variation in relative survival resulting from social class decreased, although did not disappear, after controlling for social class differences in general mortality. The results obtained using corrected survival were close to those obtained using relative survival with a social class correction. The differences between the three measures were largest when the proportion of deaths from other causes was large, for example, in cancers with high survival, among older patients, and for longer follow up times. Although each of the three measures gave comparable results, it is recommended that relative survival rates are used with expected survival adjusted for social class when studying social class variation in cancer patient survival. If this is not an available option, it is recommended that corrected survival rates are used. Relative survival rates without the social class correction overestimate social class differences and should be used with caution. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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