August 15, 2014

Cancer statistics done right

I’ve mentioned a number of times that statistics on cancer survival are often unreliable for the conclusion people want to draw, and that you need to look at cancer mortality.  Today’s story in Stuff is about Otago research that does it right:

The report found for 11-year timeframe, cancer-specific death rates decreased in both countries and cancer mortality fell in both countries. But there was no change in the difference between the death rates New Zealand and Australia, which remained remained 10 per cent higher in New Zealand.

That is, they didn’t look at survival after diagnosis, they looked at the rate of deaths. They also looked at the rate of cancer diagnoses

“The higher mortality from all cancers combined cannot be attributed to higher incidence rates, and this suggests that overall patient survival is lower in New Zealand,” Skegg said.

That’s not quite as solid a conclusion — it’s conceivable that New Zealand really has higher incidence, but Australia compensates by over-diagnosing tumours that wouldn’t ever cause a problem — but it would be a stretch to have that happen over all types of cancer combined, as they observed.

 

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Thomas Lumley (@tslumley) is Professor of Biostatistics at the University of Auckland. His research interests include semiparametric models, survey sampling, statistical computing, foundations of statistics, and whatever methodological problems his medical collaborators come up with. He also blogs at Biased and Inefficient See all posts by Thomas Lumley »

Comments

  • avatar
    Megan Pledger

    It looks like what you suggest is happening around colorectal/anal cancer in women which appears to be one of the main drivers for differences in overall mortality rates and driving down NZ’s incidence rate to match OZ’s.

    In OZ, with population screening, there were 1662 incident c/a cancers in women and 382 deaths – In NZ, without population screening, it was 1324 and 586 respectively.

    3 years ago Reply

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