Abstract:
BACKGROUND:Age-standardization is vital in international comparison studies of cancer patient survival, but standard approaches can fail to produce estimates in the case of sparsity. METHODS:The purpose of this paper is to demonstrate that using a standardization pre-weighting approach is a viable alternative approach for external age-standardization in population-based cancer data and performs well in cases of sparsity. We further de;1;scribe how the pre-weighting approach to age-standardization can be coupled with the Pohar Perme estimator in both a cohort and period analysis setting. For period analysis, we compare approaches for defining the internal age distribution. We use SEER public use data to illustrate our approach and estimate survival for Connecticut and by race to create a scenario with sufficient sparsity. RESULTS:The pre-weighting approach gives comparable estimates to traditional age-standardization in cases with sufficient data and produces estimates throughout follow-up in cases of sparsity when a traditional approach would fail. CONCLUSION:International comparison studies and other national population-based survival studies that need to age-standardize estimates for comparability purposes should adopt the Pohar Perme estimator with pre-weighting. This approach avoids issues of non-estimation in the case of sparsity and will allow more consistent comparisons across the produced estimates.
journal_name
Cancer Epidemioljournal_title
Cancer epidemiologyauthors
Rutherford MJ,Dickman PW,Coviello E,Lambert PCdoi
10.1016/j.canep.2020.101745subject
Has Abstractpub_date
2020-08-01 00:00:00pages
101745eissn
1877-7821issn
1877-783Xpii
S1877-7821(20)30079-5journal_volume
67pub_type
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