Relative survival tables and an application

Year 2023, Volume: 16 Issue: 1, 1 - 25, 29.06.2023

Sema Akyol , Nihal Ata Tutkun

Abstract

In survival analysis studies with long follow-up periods, cause of death information may not be available or there may be some lack of information. It may not be possible to directly predict the probability of survival due to the disease when the cause of death is unclear or the available information is unreliable. Therefore, the probability of survival due to the disease is sometimes evaluated by a measure of the relative probability of survival between a group diagnosed with the disease and the larger population. Creating life tables and obtaining survival probabilities have an important place in relative survival analysis. For the estimation of these probabilities Ederer I, Ederer II, Hakulinen and Pohar Perme methods are used. In this study, these methods were applied on the prostate cancer dataset in the literature which includes competing risks. Life tables containing relative survival probabilities for different age groups were obtained. Ederer I, Ederer II, Hakulinen methods were used for the relative survival and Pohar Perme method was used for the net survival and no significant difference was observed between the results obtained. In all methods, the five year relative survival for male patients with prostate cancer was 44% for patients were aged 44-59, 49% for patients were aged 60-74, and 36% for patients were aged 75 or over. Similarly, life tables were created using age standardization, no significant difference was observed in survival probabilities as a result of age standardization. In addition, crude death probabilities due to both prostate cancer and competing risks were obtained and interpreted.

Keywords

Relative survival, Net survival, Competing risks, Life table, Excess hazard ratio

Göreli yaşam tabloları ve bir uygulama

Abstract

Uzun takip süreleri olan gözlemsel yaşam çözümlemesi çalışmalarında ölüm nedeni bilgisi bulunmayabilir veya bazı bilgi eksiklikleri olabilir. Yaşam çözümlemesinde, ölüm nedeni belli olmadığında veya eldeki bilgi güvenilir olmadığında hastalığa bağlı yaşam olasılığını doğrudan tahmin etmek mümkün olmayabilir. Bu nedenle hastalığa bağlı yaşam olasılığı, bazen hastalık teşhisi koyulmuş bir grup ile daha geniş bir kitle arasındaki göreli yaşam olasılığının bir ölçüsü ile değerlendirilir. Böyle durumlarda göreli yaşam çözümlemesi yöntemlerinin kullanılması gerekmektedir. Yalnızca hasta takip zamanlarının ve takip sonundaki yaşamsal durumun kaydedildiği kanser araştırmaları, göreli yaşam çözümlemesinin sıklıkla kullanıldığı bir alandır.

Göreli yaşam çözümlemesinde yaşam tablolarının oluşturulması ve yaşam olasılıklarının elde edilmesi önemli bir yere sahiptir. Bu olasılıkların tahmini için Ederer I, Ederer II, Hakulinen ve Pohar Perme yöntemleri kullanılmaktadır. Bu yöntemler, literatürde yer alan ve yarışan riskleri içeren prostat kanseri veri kümesi üzerinde uygulanmıştır. Farklı yaş grupları için göreli yaşam olasılıklarını içeren yaşam tabloları elde edilmiştir. Göreli yaşam olasılığı için Ederer I, Ederer II, Hakulinen ve net yaşam olasılığı için Pohar Perme yöntemleri kullanılmış, elde edilen sonuçlar arasında belirgin bir farklılık görülmemiştir. Tüm yöntemlerde prostat kanserine yakalanmış erkek hastalara ait beş yıllık göreli yaşam olasılığı 44-59 yaş aralığındaki hastalar için %44, 60-74 yaş aralığındaki hastalar için %49 ve 75 yaş ve üzeri hastalar için %36 olarak elde edilmiştir. Benzer biçimde yaş standartlaştırma kullanılarak da yaşam tabloları oluşturulmuş, yaş standartlaştırması sonucunda yaşam olasılıklarında belirgin bir değişiklik gözlenmemiştir. Ayrıca hem prostat kanserine bağlı hem yarışan risklere bağlı kaba ölüm olasılıkları elde edilmiş ve yorumlanmıştır.

Keywords

Göreli yaşam, Net yaşam, Yarışan riskler, Yaşam tablosu, Aşırı tehlike oranı

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