On Estimation in Relative Survival

Authors

  • Maja Pohar Perme,

    Corresponding author
    1. Department of Biostatistics and Medical Informatics, University of Ljubljana, Vrazov trg 2, SI-1000 Ljubljana, Slovenia
      email: maja.pohar@mf.uni-lj.si
    Search for more papers by this author
  • Janez Stare,

    1. Department of Biostatistics and Medical Informatics, University of Ljubljana, Vrazov trg 2, SI-1000 Ljubljana, Slovenia
    Search for more papers by this author
  • Jacques Estève

    1. Université Claude Bernard, Hospices Civils de Lyon, Service de Biostatistique, 162, Avenue Lacassagne 69424 Lyon Cedex 03, France
    Search for more papers by this author

email: maja.pohar@mf.uni-lj.si

Abstract

Summary Estimation of relative survival has become the first and the most basic step when reporting cancer survival statistics. Standard estimators are in routine use by all cancer registries. However, it has been recently noted that these estimators do not provide information on cancer mortality that is independent of the national general population mortality. Thus they are not suitable for comparison between countries. Furthermore, the commonly used interpretation of the relative survival curve is vague and misleading. The present article attempts to remedy these basic problems. The population quantities of the traditional estimators are carefully described and their interpretation discussed. We then propose a new estimator of net survival probability that enables the desired comparability between countries. The new estimator requires no modeling and is accompanied with a straightforward variance estimate. The methods are described on real as well as simulated data.

Ancillary