JSM 2005 - Toronto

Abstract #302472

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Legend: = Applied Session, = Theme Session, = Presenter
Activity Number: 10
Type: Invited
Date/Time: Sunday, August 7, 2005 : 2:00 PM to 3:50 PM
Sponsor: ENAR
Abstract - #302472
Title: Modeling and Estimation of Trends in Cancer Incidence and Mortality with Application to Prostate Cancer
Author(s): Alex Tsodikov*+
Companies: University of California, Davis
Address: Division of Biostatistics, Davis, CA, 95616, United States
Keywords: screening ; prostate cancer ; frailty
Abstract:

Modeling and estimation of population impact of screening presents a number of challenges. Typically, individual schedules of screening are unavailable and screening dissemination data is represented by a model for the "risk" of a screening test given explanatory variables measured on the population level. Survival post diagnosis is confounded by screening dissemination through lead time and length bias in addition to a shift in distribution and the meaning of clinical variables measured at diagnosis. In this paper, a statistical population model for cancer incidence is presented that incorporates random screening schedules regressed on characteristics of dissemination of screening in a population. A semiparametric frailty model is used for cancer survival post diagnosis. The distribution for the frailty variable is an outcome of the incidence model representing uncertainty in individual history of the disease and screening conditional on the disease presentation at diagnosis. The joint model for incidence and mortality lends itself naturally to predictions of population effects of screening.

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Revised March 2005