Division of Cancer Control and Population Sciences, NCI, Bethesda, Maryland.
Information Management Services Inc., Calverton, Maryland.
Cancer Epidemiol Biomarkers Prev. 2021 Nov;30(11):2001-2009. doi: 10.1158/1055-9965.EPI-21-0423. Epub 2021 Aug 17.
Improvements in cancer survival are usually assessed by comparing survival in grouped years of diagnosis. To enhance analyses of survival trends, we present the joinpoint survival model webtool (JPSurv) that analyzes survival data by single year of diagnosis and estimates changes in survival trends and year-over-year trend measures.
We apply JPSurv to relative survival data for individuals diagnosed with female breast cancer, melanoma cancer, non-Hodgkin lymphoma (NHL), and chronic myeloid leukemia (CML) between 1975 and 2015 in the Surveillance, Epidemiology, and End Results Program. We estimate the number and location of joinpoints and the trend measures and provide interpretation.
In general, relative survival has substantially improved at least since the mid-1990s for all cancer sites. The largest improvements in 5-year relative survival were observed for distant-stage melanoma after 2009, which increased by almost 3 survival percentage points for each subsequent year of diagnosis, followed by CML in 1995-2010, and NHL in 1995-2003. The modeling also showed that for patients diagnosed with CML after 1995 (compared with before), there was a greater decrease in the probability of dying of the disease in the 4th and 5th years after diagnosis compared with the initial years since diagnosis.
The greatest increases in trends for distant melanoma, NHL, and CML coincided with the introduction of novel treatments, demonstrating the value of JPSurv for estimating and interpreting cancer survival trends.
The JPSurv webtool provides a suite of estimates for analyzing trends in cancer survival that complement traditional descriptive survival analyses.
癌症存活率的提高通常通过比较分组年份的诊断存活率来评估。为了增强对生存趋势的分析,我们提出了 joinpoint 生存模型网络工具(JPSurv),该工具通过单一年份的诊断来分析生存数据,并估计生存趋势变化和逐年趋势指标。
我们将 JPSurv 应用于 1975 年至 2015 年间监测、流行病学和结果计划中诊断为女性乳腺癌、黑色素瘤、非霍奇金淋巴瘤(NHL)和慢性髓性白血病(CML)的个体的相对生存数据。我们估计 joinpoint 的数量和位置以及趋势指标,并提供解释。
总体而言,自 20 世纪 90 年代中期以来,所有癌症部位的相对生存率都有了实质性提高。5 年相对生存率提高最大的是晚期黑色素瘤,自 2009 年以来,每年诊断后增加了近 3 个生存百分点,其次是 1995-2010 年的 CML 和 1995-2003 年的 NHL。建模还表明,与 1995 年之前相比,1995 年后诊断为 CML 的患者在诊断后第 4 年和第 5 年死于该病的可能性降低了。
晚期黑色素瘤、NHL 和 CML 的趋势增幅最大,与新疗法的引入相吻合,这表明 JPSurv 可用于估计和解释癌症生存趋势。
JPSurv 网络工具提供了一套用于分析癌症生存趋势的估计值,补充了传统的描述性生存分析。