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首页> 美国卫生研究院文献>International Journal of Environmental Research and Public Health >Understanding Differences in Cancer Survival between Populations: A New Approach and Application to Breast Cancer Survival Differentials between Danish Regions
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Understanding Differences in Cancer Survival between Populations: A New Approach and Application to Breast Cancer Survival Differentials between Danish Regions

机译：了解人群之间的癌症生存差异：丹麦地区之间的乳腺癌生存差异的新方法和应用。

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Large variations in cancer survival have been recorded between populations, e.g., between countries or between regions in a country. To understand the determinants of cancer survival differentials between populations, researchers have often applied regression analysis. We here propose the use of a non-parametric decomposition method to quantify the exact contribution of specific components to the absolute difference in cancer survival between two populations. Survival differences are here decomposed into the contributions of differences in stage at diagnosis, population age structure, and stage-and-age-specific survival. We demonstrate the method with the example of differences in one-year and five-year breast cancer survival between Denmark’s five regions. Differences in stage at diagnosis explained 45% and 27%, respectively, of the one- and five-year survival differences between Zealand and Central Denmark for patients diagnosed between 2008 and 2010. We find that the introduced decomposition method provides a powerful complementary analysis and has several advantages compared with regression models: No structural or distributional assumptions are required; aggregated data can be used; and the use of absolute differences allows quantification of the survival that could be gained by improving, for example, stage at diagnosis relative to a reference population, thus feeding directly into health policy evaluation.
机译：在人群之间，例如在国家之间或一个国家的区域之间，记录了癌症存活率的巨大差异。为了理解人口之间癌症生存差异的决定因素，研究人员经常应用回归分析。我们在这里提出使用非参数分解方法来量化特定成分对两个人群之间癌症生存的绝对差异的确切贡献。在这里，生存差异被分解为诊断阶段，人群年龄结构以及特定阶段和年龄段的生存差异。我们以丹麦五个地区在一年和五年乳腺癌生存率方面的差异为例来说明该方法。在诊断阶段的差异分别解释了2008年至2010年间在西兰和丹麦中部诊断出的患者的一年和五年生存率差异的45％和27％。与回归模型相比，具有以下优点：无需结构或分布假设；可以使用汇总数据；绝对差异的使用可以量化生存，例如可以通过提高相对于参考人群的诊断阶段来提高生存率，从而直接进入卫生政策评估。

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