Temporal changes in loss of life expectancy due to cancer in Australia

a flexible parametric approach

Peter D. Baade, Danny R. Youlden, Therese M. Andersson, Philippa H. Youl, Euan T. Walpole, Michael G. Kimlin, Joanne F. Aitken, Robert J. Biggar

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To evaluate changes in cancer mortality burden over time by assessing temporal trends in life expectation for Australian residents diagnosed with cancer. 

Methods: The study cohort consisted of all people diagnosed with cancer in the period 1990–2000 and aged 15–89 years (n = 1,275,978), with mortality follow-up to 31 December 2010. Flexible parametric survival models incorporating background age–sex–year-specific population mortality rates were applied to generate the observed survival curves for all cancers combined and selected major cancer types. Predicted values of loss of life expectancy (LOLE) in years were generated and then averaged across calendar year and age group (15–49, 50–69 and 70–89 years) or spread of disease (localized, regional, distant, unknown). Results: The greatest LOLE burden was for lung cancer (14.3 years per diagnosis) and lowest for melanoma (2.5 years). There was a significant decrease in LOLE over time (−0.13 LOLE per year) for all cancers combined. Decreases were also observed for female breast cancer (−0.21), prostate cancer (−0.17), colorectal cancer (−0.08), melanoma (−0.07) and stomach cancer (−0.02), with slight increases for lung cancer (+0.04). When restricted to the sub-cohort from New South Wales with spread of disease information, these decreases in LOLE were primarily among cancers categorized as localized or regional spread at diagnosis. Conclusions: In Australia, persons diagnosed with cancer have a steadily improving outlook that exceeds that expected by general improvement in population life expectancy. The overall improvement is observed in persons with localized or regional cancers but not in those with advanced cancers, findings which encourage earlier diagnosis.

Original languageEnglish
Pages (from-to)955-964
Number of pages10
JournalCancer Causes and Control
Volume27
Issue number8
DOIs
Publication statusPublished - 1 Aug 2016
Externally publishedYes

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Life Expectancy
Neoplasms
Mortality
Melanoma
Lung Neoplasms
Prostatic Neoplasms
Value of Life
New South Wales
Survival
Population
Stomach Neoplasms
Early Diagnosis
Colorectal Neoplasms
Cohort Studies
Age Groups
Breast Neoplasms

Cite this

Baade, P. D., Youlden, D. R., Andersson, T. M., Youl, P. H., Walpole, E. T., Kimlin, M. G., ... Biggar, R. J. (2016). Temporal changes in loss of life expectancy due to cancer in Australia: a flexible parametric approach. Cancer Causes and Control, 27(8), 955-964. https://doi.org/10.1007/s10552-016-0762-1
Baade, Peter D. ; Youlden, Danny R. ; Andersson, Therese M. ; Youl, Philippa H. ; Walpole, Euan T. ; Kimlin, Michael G. ; Aitken, Joanne F. ; Biggar, Robert J. / Temporal changes in loss of life expectancy due to cancer in Australia : a flexible parametric approach. In: Cancer Causes and Control. 2016 ; Vol. 27, No. 8. pp. 955-964.
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abstract = "Purpose: To evaluate changes in cancer mortality burden over time by assessing temporal trends in life expectation for Australian residents diagnosed with cancer. Methods: The study cohort consisted of all people diagnosed with cancer in the period 1990–2000 and aged 15–89 years (n = 1,275,978), with mortality follow-up to 31 December 2010. Flexible parametric survival models incorporating background age–sex–year-specific population mortality rates were applied to generate the observed survival curves for all cancers combined and selected major cancer types. Predicted values of loss of life expectancy (LOLE) in years were generated and then averaged across calendar year and age group (15–49, 50–69 and 70–89 years) or spread of disease (localized, regional, distant, unknown). Results: The greatest LOLE burden was for lung cancer (14.3 years per diagnosis) and lowest for melanoma (2.5 years). There was a significant decrease in LOLE over time (−0.13 LOLE per year) for all cancers combined. Decreases were also observed for female breast cancer (−0.21), prostate cancer (−0.17), colorectal cancer (−0.08), melanoma (−0.07) and stomach cancer (−0.02), with slight increases for lung cancer (+0.04). When restricted to the sub-cohort from New South Wales with spread of disease information, these decreases in LOLE were primarily among cancers categorized as localized or regional spread at diagnosis. Conclusions: In Australia, persons diagnosed with cancer have a steadily improving outlook that exceeds that expected by general improvement in population life expectancy. The overall improvement is observed in persons with localized or regional cancers but not in those with advanced cancers, findings which encourage earlier diagnosis.",
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Baade, PD, Youlden, DR, Andersson, TM, Youl, PH, Walpole, ET, Kimlin, MG, Aitken, JF & Biggar, RJ 2016, 'Temporal changes in loss of life expectancy due to cancer in Australia: a flexible parametric approach', Cancer Causes and Control, vol. 27, no. 8, pp. 955-964. https://doi.org/10.1007/s10552-016-0762-1

Temporal changes in loss of life expectancy due to cancer in Australia : a flexible parametric approach. / Baade, Peter D.; Youlden, Danny R.; Andersson, Therese M.; Youl, Philippa H.; Walpole, Euan T.; Kimlin, Michael G.; Aitken, Joanne F.; Biggar, Robert J.

In: Cancer Causes and Control, Vol. 27, No. 8, 01.08.2016, p. 955-964.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Temporal changes in loss of life expectancy due to cancer in Australia

T2 - a flexible parametric approach

AU - Baade, Peter D.

AU - Youlden, Danny R.

AU - Andersson, Therese M.

AU - Youl, Philippa H.

AU - Walpole, Euan T.

AU - Kimlin, Michael G.

AU - Aitken, Joanne F.

AU - Biggar, Robert J.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Purpose: To evaluate changes in cancer mortality burden over time by assessing temporal trends in life expectation for Australian residents diagnosed with cancer. Methods: The study cohort consisted of all people diagnosed with cancer in the period 1990–2000 and aged 15–89 years (n = 1,275,978), with mortality follow-up to 31 December 2010. Flexible parametric survival models incorporating background age–sex–year-specific population mortality rates were applied to generate the observed survival curves for all cancers combined and selected major cancer types. Predicted values of loss of life expectancy (LOLE) in years were generated and then averaged across calendar year and age group (15–49, 50–69 and 70–89 years) or spread of disease (localized, regional, distant, unknown). Results: The greatest LOLE burden was for lung cancer (14.3 years per diagnosis) and lowest for melanoma (2.5 years). There was a significant decrease in LOLE over time (−0.13 LOLE per year) for all cancers combined. Decreases were also observed for female breast cancer (−0.21), prostate cancer (−0.17), colorectal cancer (−0.08), melanoma (−0.07) and stomach cancer (−0.02), with slight increases for lung cancer (+0.04). When restricted to the sub-cohort from New South Wales with spread of disease information, these decreases in LOLE were primarily among cancers categorized as localized or regional spread at diagnosis. Conclusions: In Australia, persons diagnosed with cancer have a steadily improving outlook that exceeds that expected by general improvement in population life expectancy. The overall improvement is observed in persons with localized or regional cancers but not in those with advanced cancers, findings which encourage earlier diagnosis.

AB - Purpose: To evaluate changes in cancer mortality burden over time by assessing temporal trends in life expectation for Australian residents diagnosed with cancer. Methods: The study cohort consisted of all people diagnosed with cancer in the period 1990–2000 and aged 15–89 years (n = 1,275,978), with mortality follow-up to 31 December 2010. Flexible parametric survival models incorporating background age–sex–year-specific population mortality rates were applied to generate the observed survival curves for all cancers combined and selected major cancer types. Predicted values of loss of life expectancy (LOLE) in years were generated and then averaged across calendar year and age group (15–49, 50–69 and 70–89 years) or spread of disease (localized, regional, distant, unknown). Results: The greatest LOLE burden was for lung cancer (14.3 years per diagnosis) and lowest for melanoma (2.5 years). There was a significant decrease in LOLE over time (−0.13 LOLE per year) for all cancers combined. Decreases were also observed for female breast cancer (−0.21), prostate cancer (−0.17), colorectal cancer (−0.08), melanoma (−0.07) and stomach cancer (−0.02), with slight increases for lung cancer (+0.04). When restricted to the sub-cohort from New South Wales with spread of disease information, these decreases in LOLE were primarily among cancers categorized as localized or regional spread at diagnosis. Conclusions: In Australia, persons diagnosed with cancer have a steadily improving outlook that exceeds that expected by general improvement in population life expectancy. The overall improvement is observed in persons with localized or regional cancers but not in those with advanced cancers, findings which encourage earlier diagnosis.

KW - Australia

KW - Cancer

KW - Life expectancy

KW - Prognosis

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