Are Increasing 5-Year Survival Rates Evidence of Success Against Cancer? A Reexamination Using Data from the U.S. and Australia

Forum for Health Economics & Policy, Vol. 13, No. 2, p. 11, 2010

18 Pages Posted: 26 Oct 2011

See all articles by Frank R. Lichtenberg

Frank R. Lichtenberg

Columbia Business School - Finance and Economics; National Bureau of Economic Research (NBER); CESifo (Center for Economic Studies and Ifo Institute for Economic Research)

Multiple version iconThere are 2 versions of this paper

Date Written: May 2010

Abstract

Previous investigators argued that increasing 5-year survival for cancer patients should not be taken as evidence of improved prevention, screening, or therapy, because they found little correlation between the change in 5-year survival for a specific tumor and the change in tumor-related mortality. However, they did not control for the change in incidence, which influences mortality and is correlated with 5-year survival. The purpose of this study was to reexamine the question of whether increasing 5-year survival rates constitute evidence of success against cancer. We estimate the relationship across cancer sites between long-run changes in population-based mortality rates and both (1) changes in 5-year relative survival rates, and (2) changes in incidence rates, using data from both the U.S. and Australia. We analyze two outcome measures, and the relationship between them: the unconditional mortality rate (number of deaths per 100,000 population), and the 5-year relative survival rate. When incidence growth is controlled for, there is a highly significant correlation, in both the U.S. and Australia, between the change in 5-year survival for a specific tumor and the change in tumor-related mortality. The increase in the relative survival rate is estimated to have reduced the unconditional mortality rate by about 15% in the U.S. between 1976 and 2002, and by about 15% in Australia between 1984 and 2001. While the change in the 5-year survival rate is not a perfect measure of progress against cancer, in part because it is potentially subject to lead-time bias, it does contain useful information; its critics may have been unduly harsh. Part of the long-run increase in 5-year cancer survival rates is due to improved prevention, screening, or therapy.

Suggested Citation

Lichtenberg, Frank R., Are Increasing 5-Year Survival Rates Evidence of Success Against Cancer? A Reexamination Using Data from the U.S. and Australia (May 2010). Forum for Health Economics & Policy, Vol. 13, No. 2, p. 11, 2010, Available at SSRN: https://ssrn.com/abstract=1949304

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