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Are Increasing 5-Year Survival Rates Evidence of Success Against Cancer? A Re-examination Using Data From the U.S. and Australia

Lichtenberg, Frank R (2010) Are Increasing 5-Year Survival Rates Evidence of Success Against Cancer? A Re-examination Using Data From the U.S. and Australia. Forum for Health Economics & Policy, 13 (2). pp. 1-17. ISSN 1558-9544 (online)

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Abstract

Previous investigators argued that increasing 5-year survival for cancer patients should not be taken as evidence of improved prevention, screening, or therapy, because they found little correlation between the change in 5-year survival for a specific tumor and the change in tumor-related mortality. However, they did not control for the change in incidence, which influences mortality and is correlated with 5-year survival. The purpose of this study was to reexamine the question of whether increasing 5-year survival rates constitute evidence of success against cancer. We estimate the relationship across cancer sites between long-run changes in population-based mortality rates and both (1) changes in 5-year relative survival rates, and (2) changes in incidence rates, using data from both the U.S. and Australia. We analyze two outcome measures, and the relationship between them: the unconditional mortality rate (number of deaths per 100,000 population), and the 5-year relative survival rate. When incidence growth is controlled for, there is a highly significant correlation, in both the U.S. and Australia, between the change in 5-year survival for a specific tumor and the change in tumor-related mortality. The increase in the relative survival rate is estimated to have reduced the unconditional mortality rate by about 15% in the U.S. between 1976 and 2002, and by about 15% in Australia between 1984 and 2001. While the change in the 5-year survival rate is not a perfect measure of progress against cancer, in part because it is potentially subject to lead-time bias, it does contain useful information; its critics may have been unduly harsh. Part of the long-run increase in 5-year cancer survival rates is due to improved prevention, screening, or therapy.

Item Type: Article
Uncontrolled Keywords: ResPubID20936, cancer, neoplasms, survival, mortality, incidence
Subjects: FOR Classification > 1402 Applied Economics
SEO Classification > 9402 Government and Politics
Faculty/School/Research Centre/Department > Centre for Strategic Economic Studies (CSES)
Depositing User: VUIR
Date Deposited: 21 May 2012 03:19
Last Modified: 19 Mar 2015 00:52
URI: http://vuir.vu.edu.au/id/eprint/6977
DOI: 10.2202/1558-9544.1202
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