Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data

Background: During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the cont...

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Autores: Vilaprinyo, Ester, Rué, Montserrat, Marcos Gragera, Rafael, Martínez Alonso, Montserrat
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2009
País:España
Recursos:Universidad de Barcelona
Repositório:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/126637
Acesso em linha:https://hdl.handle.net/2445/126637
Access Level:Acceso aberto
Palavra-chave:Càncer de mama
Mortalitat
Breast cancer
Mortality
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spelling Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival dataVilaprinyo, EsterRué, MontserratMarcos Gragera, RafaelMartínez Alonso, MontserratCàncer de mamaMortalitatBreast cancerMortalityBackground: During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia ( Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions. Methods: Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations. Results: We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975-79, Catalonia 1980-89) and after (USA and Catalonia 1990-2001). Survival in Catalonia in the 1980-89 period was worse than in the USA during 1975-79, but the differences disappeared in 1990-2001. Conclusion: Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On the other hand, we obtained detailed breast cancer survival functions that will be used for modeling the effect of screening and adjuvant treatments in Catalonia.BioMed Central2009info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/126637Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1186/1471-2407-9-98BMC Cancer, 2009, vol. 9, num. 98https://doi.org/10.1186/1471-2407-9-98cc by (c) Vilaprinyo et al., 2009http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1266372026-05-27T06:46:51Z
dc.title.none.fl_str_mv Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data
title Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data
spellingShingle Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data
Vilaprinyo, Ester
Càncer de mama
Mortalitat
Breast cancer
Mortality
title_short Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data
title_full Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data
title_fullStr Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data
title_full_unstemmed Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data
title_sort Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data
dc.creator.none.fl_str_mv Vilaprinyo, Ester
Rué, Montserrat
Marcos Gragera, Rafael
Martínez Alonso, Montserrat
author Vilaprinyo, Ester
author_facet Vilaprinyo, Ester
Rué, Montserrat
Marcos Gragera, Rafael
Martínez Alonso, Montserrat
author_role author
author2 Rué, Montserrat
Marcos Gragera, Rafael
Martínez Alonso, Montserrat
author2_role author
author
author
dc.subject.none.fl_str_mv Càncer de mama
Mortalitat
Breast cancer
Mortality
topic Càncer de mama
Mortalitat
Breast cancer
Mortality
description Background: During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia ( Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions. Methods: Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations. Results: We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975-79, Catalonia 1980-89) and after (USA and Catalonia 1990-2001). Survival in Catalonia in the 1980-89 period was worse than in the USA during 1975-79, but the differences disappeared in 1990-2001. Conclusion: Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On the other hand, we obtained detailed breast cancer survival functions that will be used for modeling the effect of screening and adjuvant treatments in Catalonia.
publishDate 2009
dc.date.none.fl_str_mv 2009
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/126637
url https://hdl.handle.net/2445/126637
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/1471-2407-9-98
BMC Cancer, 2009, vol. 9, num. 98
https://doi.org/10.1186/1471-2407-9-98
dc.rights.none.fl_str_mv cc by (c) Vilaprinyo et al., 2009
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Vilaprinyo et al., 2009
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.300719

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