A competing risk analysis of cancer survival trends over 46 years in leukemia and solid cancers

Music City Center 

Evaluating the impact of medical advancements on cancer patient survival is complex, as it can be influenced by various factors. Individual research progress in different cancer entities leads to distinct patterns of survival estimates over time. A competing risks analysis was used to disentangle yearly survival trends into their constituent parts, i.e., cancer-related deaths and those attributed to other causes. We examined how hazard ratios changed historically over the last 46 years, utilizing patient data for acute myeloid leukemia and four solid tumors (ovarian, testicular, lung, and breast cancer) extracted from the Surveillance, Epidemiology, and End Results research data (Nov 2023 Sub (1975-2021)). Our proof-of-concept analysis allowed us to characterize the different patterns of progress for the selected cancers. Noticeably, patterns align with past advances in treating these malignancies. Survival estimates for the competing event also show disease specific profiles, but should be interpreted with more care. Overall, our analysis underscores the potential of competing risks analyses to provide valuable insights into the population-level benefits of medical breakthroughs.

Competing risk analysis

Subdistribution hazard ratios

History of cancer survival trends

Indirect analysis of medical advancements in treatment and care

SEER data analysis

"Patterns of progress" 

Biometrics Section