0000000000215278

AUTHOR

Nadine Bossard

Modeling excess hazard with time--to--cure as a parameter

Cure models have been widely developed to estimate the cure fraction when some subjects never experience the event of interest. However these models were rarely focused on the estimation of the time-to-cure i.e. the delay elapsed between the diagnosis and "the time from which cure is reached", an important indicator, for instance to address the question of access to insurance or loans for subjects with personal history of cancer. We propose a new excess hazard regression model that includes the time-to-cure as a covariate dependent parameter to be estimated. The model is written similarly to a Beta probability distribution function and is shown to be a particular case of the non-mixture cur…

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Estimation de l’incidence des hémopathies malignes en France entre 1980 et 2012

International audience; BACKGROUND:The classification of hematological malignancies (HMs) has changed in recent decades. For the first time, the French network of cancer registries (Francim) provides estimates for incidence and trends of HM in France between 1980 and 2012 for major HM subtypes.METHODS:Incidence was directly estimated by modeling the incidence rates measured in the cancer registry area. For each HM subtype, a "usable incidence period" was defined a priori, corresponding to the years for which all the registries collected them in a homogeneous way. For both sexes and each HM subtype, age-period-cohort models were used to estimate national incidence trends.RESULTS:Overall in F…

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Trends in excess mortality in follicular lymphoma at a population level

Background Since the 1990s and since the development of humanised monoclonal antibodies in 1998, the treatment of non-Hodgkin lymphoma has undergone profound changes. Follicular lymphoma (FL) was the first to benefit from this treatment, and several clinical trials have shown a significant improvement in overall survival, but little information is available at a population level. Objective Our objective was to estimate changes in FL-specific mortality at a population level, with an appropriate methodology. Methods Two French retrospective population-based studies on FL were conducted, one from 1995 to 2004, in 1477 patients, and one from 1995 to 2010, in 451 patients. Trends in excess morta…

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Impact de l’âge et de l’année sur les indicateurs de survie nette et de guérison par sous-type de leucémie aiguë myéloïde en France entre 1989 et 2010

Etat de la question Estimer la survie nette et les indicateurs guerison par sous-type de leucemie aigue myeloide (LAM) en France. Materiel et methodes Au total, 6460 cas de LAM dont l’âge ≥ 15 ans, diagnostiques entre 1989 et 2010 ont ete inclus. Cinq sous-types de LAM ont ete definis a l’aide de la classification ICD-O-3 et HAEMACARE. La survie nette a ete obtenue en utilisant le modele flexible ajuste sur l’âge, le sexe et l’annee de diagnostic pour chaque sous-type de LAM. Lorsque l’hypothese de guerison etait acceptable, un modele de guerison flexible a ete utilise pour estimer la proportion de gueri (P), le temps de guerison (TTC) et le temps de survie median pour les patients non guer…

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Time-to-cure and cure proportion in solid cancers in France. A population based study.

In cancer care, the cure proportion (P) and time-to-cure (TTC) are important indicators for practitioners, patients, and healthcare policy makers. The recent definition of TTC as the time at which the probability of belonging to the cured group reaches 95% was used for the first time.The data stem from the common database of French cancer registries including 335,358 solid tumours diagnosed between 1995 and 2009 at 27 sites. P and TTC were estimated through a flexible parametric net survival cure model for each cancer site, sex, and age at diagnosis with acceptable assumption of cure (excess mortality rate ≤0.05).TTC was ≤5 years and P was80% for skin melanoma and thyroid and testis cancers…

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Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). METHODS We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes a…

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Cancer net survival on registry data: use of the new unbiased Pohar-Perme estimator and magnitude of the bias with the classical methods

Net survival, the survival which might occur if cancer was the only cause of death, is a major epidemiological indicator required for international or temporal comparisons. Recent findings have shown that all classical methods used for routine estimation of net survival from cancer-registry data, sometimes called "relative-survival methods," provide biased estimates. Meanwhile, an unbiased estimator, the Pohar-Perme estimator (PPE), was recently proposed. Using real data, we investigated the magnitude of the errors made by four "relative-survival" methods (Ederer I, Hakulinen, Ederer II and a univariable regression model) vs. PPE as reference and examined the influence of time of follow-up,…

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