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Partitioning of time trends in prevalence and mortality of lung cancer.

Publication ,  Journal Article
Akushevich, I; Kravchenko, J; Yashkin, AP; Fang, F; Yashin, AI
Published in: Stat Med
July 30, 2019

BACKGROUND: Time trends of lung cancer prevalence and mortality are the result of three competing processes: changes in the incidence rate, stage-specific survival, and ascertainment at early stages. Improvements in these measures act concordantly to improve disease-related mortality, but push the prevalence rate in opposite directions making a qualitative interpretation difficult. The goal of this paper is to evaluate the relative contributions of these components to changes in lung cancer prevalence and mortality. METHODS: Partitioning of prevalence and mortality trends into their components using SEER data for 1973-2013. RESULTS: The prevalence of lung cancer increases for females and decreases for males. In 1998, the former was due to increased incidence (45%-50% of total trend), improved survival (40%-45%), and increased ascertainment at early stages (10%-15%). In males, a rapidly declining incidence rate overpowered the effects of survival and ascertainment resulting in an overall decrease in prevalence over time. Trends in lung cancer mortality are determined by incidence during 1993-2002 with noticeable contribution of survival after 2002. CONCLUSION: Lung cancer incidence was the main driving force behind trends in prevalence and mortality. Improved survival played essential role from 2000 onwards. Trends in stage ascertainment played a small but adverse role. Our results suggest that further improvement in lung cancer mortality can be achieved through advances in early stage ascertainment, especially for males, and that in spite of success in treatment, adenocarcinoma continues to exhibit adverse trends (especially in female incidence) and its role among other histology-specific lung cancers will increase in the near future.

Duke Scholars

Published In

Stat Med

DOI

EISSN

1097-0258

Publication Date

July 30, 2019

Volume

38

Issue

17

Start / End Page

3184 / 3203

Location

England

Related Subject Headings

  • Survival Rate
  • Statistics & Probability
  • Sex Factors
  • SEER Program
  • Prevalence
  • Neoplasm Staging
  • Models, Statistical
  • Male
  • Lung Neoplasms
  • Incidence
 

Citation

APA
Chicago
ICMJE
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Akushevich, I., Kravchenko, J., Yashkin, A. P., Fang, F., & Yashin, A. I. (2019). Partitioning of time trends in prevalence and mortality of lung cancer. Stat Med, 38(17), 3184–3203. https://doi.org/10.1002/sim.8170
Akushevich, Igor, Julia Kravchenko, Arseniy P. Yashkin, Fang Fang, and Anatoliy I. Yashin. “Partitioning of time trends in prevalence and mortality of lung cancer.Stat Med 38, no. 17 (July 30, 2019): 3184–3203. https://doi.org/10.1002/sim.8170.
Akushevich I, Kravchenko J, Yashkin AP, Fang F, Yashin AI. Partitioning of time trends in prevalence and mortality of lung cancer. Stat Med. 2019 Jul 30;38(17):3184–203.
Akushevich, Igor, et al. “Partitioning of time trends in prevalence and mortality of lung cancer.Stat Med, vol. 38, no. 17, July 2019, pp. 3184–203. Pubmed, doi:10.1002/sim.8170.
Akushevich I, Kravchenko J, Yashkin AP, Fang F, Yashin AI. Partitioning of time trends in prevalence and mortality of lung cancer. Stat Med. 2019 Jul 30;38(17):3184–3203.
Journal cover image

Published In

Stat Med

DOI

EISSN

1097-0258

Publication Date

July 30, 2019

Volume

38

Issue

17

Start / End Page

3184 / 3203

Location

England

Related Subject Headings

  • Survival Rate
  • Statistics & Probability
  • Sex Factors
  • SEER Program
  • Prevalence
  • Neoplasm Staging
  • Models, Statistical
  • Male
  • Lung Neoplasms
  • Incidence