A New Personalized Oral Cancer Survival Calculator to Estimate Risk of Death From Both Oral Cancer and Other Causes.

Importance: Standard cancer prognosis models typically do not include much specificity in characterizing competing illnesses or general health status when providing prognosis estimates, limiting their utility for individuals, who must consider their cancer in the context of their overall health. This is especially true for patients with oral cancer, who frequently have competing illnesses.

Objective: To describe a statistical framework and accompanying new publicly available calculator that provides personalized estimates of the probability of a patient surviving or dying from cancer or other causes, using oral cancer as the first data set.

Key Points for Clinicians About the SEER Oral Cancer Survival Calculator.

Importance: In the setting of a new cancer diagnosis, the focus is usually on the cancer as the main threat to survival, but people may have other conditions that pose an equal or greater threat to their life than their cancer: a competing risk of death. This is especially true for patients who have cancer of the oral cavity, because prolonged exposure to alcohol and tobacco are risk factors for cancer in this location but also can result in medical conditions with the potential to shorten life expectancy, competing as a cause of death that may intervene in conjunction with or before the cancer.

Observations: A calculator designed for public use has been released that allows patients age 20 to 86 years who have a newly diagnosed oral cancer to obtain estimates of their health status-adjusted age, life expectancy in the absence of the cancer, and probability of surviving, dying of the cancer, or dying of other causes within 1 to 10 years after diagnosis.

Analyzing discrete competing risks data with partially overlapping or independent data sources and nonstandard sampling schemes, with application to cancer registries.

This paper demonstrates the flexibility of a general approach for the analysis of discrete time competing risks data that can accommodate complex data structures, different time scales for different causes, and nonstandard sampling schemes. The data may involve a single data source where all individuals contribute to analyses of both cause-specific hazard functions, overlapping datasets where some individuals contribute to the analysis of the cause-specific hazard function of only one cause while other individuals contribute to analyses of both cause-specific hazard functions, or separate data sources where each individual contributes to the analysis of the cause-specific hazard function of only a single cause. The approach is modularized into estimation and prediction.

Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.

Background: Accurate estimation of the probability of dying of cancer versus other causes is needed to inform goals of care for cancer patients. Further, prognosis may also influence health-care utilization. This paper describes health service utilization patterns of subgroups of prostate cancer and colorectal cancer (CRC) patients with different relative probabilities of dying of their cancer or other conditions.

The Surveillance, Epidemiology, and End Results Cancer Survival Calculator SEER*CSC: validation in a managed care setting.

Background: Nomograms for prostate and colorectal cancer are included in the Surveillance, Epidemiology, and End Results (SEER) Cancer Survival Calculator, under development by the National Cancer Institute. They are based on the National Cancer Institute's SEER data, coupled with Medicare data, to estimate the probabilities of surviving or dying from cancer or from other causes based on a set of patient and tumor characteristics. The nomograms provide estimates of survival that are specific to the characteristics of the tumor, age, race, gender, and the overall health of a patient.

The Cancer Survival Query System: making survival estimates from the Surveillance, Epidemiology, and End Results program more timely and relevant for recently diagnosed patients.

Background: Population-based cancer registries that include patient follow-up generally provide information regarding net survival (ie, survival associated with the risk of dying of cancer in the absence of competing risks). However, registry data also can be used to calculate survival from cancer in the presence of competing risks, which is more clinically relevant.

Methods: Statistical methods were developed to predict the risk of death from cancer and other causes, as well as natural life expectancy if the patient did not have cancer based on a profile of prognostic factors including characteristics of the cancer, demographic factors, and comorbid conditions.

Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths.

Background: In the National Polyp Study (NPS), colorectal cancer was prevented by colonoscopic removal of adenomatous polyps. We evaluated the long-term effect of colonoscopic polypectomy in a study on mortality from colorectal cancer.

Methods: We included in this analysis all patients prospectively referred for initial colonoscopy (between 1980 and 1990) at NPS clinical centers who had polyps (adenomas and nonadenomas).

Estimating average annual per cent change in trend analysis.

Trends in incidence or mortality rates over a specified time interval are usually described by the conventional annual per cent change (cAPC), under the assumption of a constant rate of change. When this assumption does not hold over the entire time interval, the trend may be characterized using the annual per cent changes from segmented analysis (sAPCs). This approach assumes that the change in rates is constant over each time partition defined by the transition points, but varies among different time partitions.

Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study.

Background: Population-based cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute (NCI) are mainly based on medical records and administrative information. Individual-level socioeconomic data are not routinely reported by cancer registries in the United States because they are not available in patient hospital records. The U.

Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S.

Objectives: We report cancer incidence, mortality, and stage distributions among Asians and Pacific Islanders (API) residing in the U.S. and note health disparities, using the cancer experience of the non-Hispanic white population as the referent group.

Quality of race, Hispanic ethnicity, and immigrant status in population-based cancer registry data: implications for health disparity studies.

Population-based cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute are based on medical records and administrative information. Although SEER data have been used extensively in health disparities research, the quality of information concerning race, Hispanic ethnicity, and immigrant status has not been systematically evaluated. The quality of this information was determined by comparing SEER data with self-reported data among 13,538 cancer patients diagnosed between 1973-2001 in the SEER--National Longitudinal Mortality Study linked database.

Tissues from population-based cancer registries: a novel approach to increasing research potential.

Population-based cancer registries, such as those included in the Surveillance, Epidemiology, and End-Results (SEER) Program, offer tremendous research potential beyond traditional surveillance activities. We describe the expansion of SEER registries to gather formalin-fixed, paraffin-embedded tissue from cancer patients on a population basis. Population-based tissue banks have the advantage of providing an unbiased sampling frame for evaluating the public health impact of genes or protein targets that may be used for therapeutic or diagnostic purposes in defined communities.

CK20 and CK7 protein expression in colorectal cancer: demonstration of the utility of a population-based tissue microarray.

The ability to use archival tissue to test externally valid hypotheses of carcinogenesis is dependent on the availability of population-based samples of cancer tissue. Tissue microarrays (TMAs) provide an efficient format for developing population-based samples of tissue. A TMA was constructed consisting of archival tissue from patients diagnosed with invasive colorectal cancer in the state of Hawaii in 1995.

Persistent area socioeconomic disparities in U.S. incidence of cervical cancer, mortality, stage, and survival, 1975-2000.

Background: Temporal cervical cancer incidence and mortality patterns and ethnic disparities in patient survival and stage at diagnosis in relation to socioeconomic deprivation measures have not been well studied in the United States. The current article analyzed temporal area socioeconomic inequalities in U.S.

Cancer survival and incidence from the Surveillance, Epidemiology, and End Results (SEER) program.

An overview of data on cancer at all sites combined and on selected, frequently occurring cancers is presented. Descriptive cancer statistics include average annual Surveillance, Epidemiology, and End Results (SEER) Program incidence, U.S.

Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control.

Background: The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to update cancer rates and trends in the United States. This report updates statistics on lung, female breast, prostate, and colorectal cancers and highlights the uses of selected surveillance data to assist development of state-based cancer control plans.

Methods: Age-adjusted incidence rates from 1996 through 2000 are from state and metropolitan area cancer registries that met NAACCR criteria for highest quality.

Impact of reporting delay and reporting error on cancer incidence rates and trends.

Background: Cancer incidence rates and trends are a measure of the cancer burden in the general population. We studied the impact of reporting delay and reporting error on incidence rates and trends for cancers of the female breast, colorectal, lung/bronchus, prostate, and melanoma.

Methods: Based on statistical models, we obtained reporting-adjusted (i.

Cancer survival among US whites and minorities: a SEER (Surveillance, Epidemiology, and End Results) Program population-based study.

Background: Available cancer statistics pertain primarily to white and African American populations. This study describes racial or ethnic patterns of cancer-specific survival and relative risks (RRs) of cancer death for all cancers combined and for cancers of the colon and rectum, lung and bronchus, prostate, and female breast for the 6 major US racial or ethnic groups.

Methods: Cancer-specific survival rates were analyzed for more than 1.

Changing area socioeconomic patterns in U.S. cancer mortality, 1950-1998: Part II--Lung and colorectal cancers.

Background: Lung cancer and colorectal cancer are leading causes of U.S. cancer mortality.

Changing area socioeconomic patterns in U.S. cancer mortality, 1950-1998: Part I--All cancers among men.

Background: Area socioeconomic deprivation indices are widely used to monitor health disparities in Europe. However, such indices have not been used in cancer surveillance in the United States. We developed an area socioeconomic index to examine area socioeconomic patterns in all-cancer mortality among U.

Impact of sociodemographic factors, hormone receptor status, and tumor grade on ethnic differences in tumor stage and size for breast cancer in US women.

The importance of sociodemographic factors and tumor biomarkers in explaining ethnic differences in tumor stage and size at diagnosis was investigated in over 106,000 female breast cancer patients reported during 1992-1996 from 11 US population-based cancer registries. Japanese and non-Hispanic White women tended to be diagnosed at an earlier stage, with smaller diameter tumors and with a lower tumor grade than women from seven other ethnic groups. Statistical adjustment for individual- and group-level sociodemographic factors produced 50-80% reductions in the odds ratios for distant (vs.