Combining cohort and period methods for retrospective time trend analyses of long-term cancer patient survival rates
Open accessAbstract
Assessing trends in long-term cancer patient survival is an essential component of monitoring progress against cancer by cancer registries. Traditional assessment of long-term survival ('cohort analysis') is very useful to disclose trends in long-term survival rates of patients diagnosed many years ago, but it does not allow the disclosure of recent trends in long-term survival rates. The latter can be achieved by an alternative method of survival analysis ('period analysis'), which has been proposed a few years ago. On the other hand, unlike cohort analysis, period analysis does not provide estimates of long-term survival rates for patients diagnosed in the early years after initiation of cancer registration. In this paper, a method of retrospective analysis of time trends in long-term survival rates is introduced, which combines the advantages of both cohort and period analysis ('mixed analysis'). This method thereby allows for a comprehensive monitoring of trends in long-term survival over an extended time span from the earliest to the most recent years of cancer registration. The use of the method is illustrated for retrospective time trend analyses of long-term survival of cancer patients in the United States with the 1973-1999 database of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The Pohar Perme estimator was used because it takes unbiased account of the higher competing risks of death in the elderly.
“We used the Pohar Perme estimator,33 which takes unbiased account of the higher competing risks of death in the elderly, implemented with the algorithm stns34 in Stata (version 14).35”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The relative survival rate: a statistical methodology.
Ederer, F., Axtell, L. M., & CUTLER, S. J. (1961) · PubMed · Cited by 1,152 · see citing works
Bosl, G. J., & Motzer, R. J. (1997) · New England Journal of Medicine · doi:10.1056/nejm199707243370406 · Cited by 896 · see citing works
Brenner, H. (2002) · The Lancet · doi:10.1016/s0140-6736(02)11199-8 · Cited by 543 · see citing works
Self-citationCancer Survival Corrected for Heterogeneity in Patient Withdrawal
Hakulinen, T. R. (1982) · Biometrics · doi:10.2307/2529873 · Cited by 458 · see citing works
Sugihara, K., Moriya, Y., Akasu, T., & Fujita, S. (1996) · Cancer · doi:10.1002/(sici)1097-0142(19961101)78:9 · Cited by 245 · see citing works
Self-citationCancer survival in developing countries
Sankaranarayanan, R. (1998) · Cited by 193 · see citing works
Survival of Cancer Patients in Finland 1955-1994
Dickman, P. W., Hakulinen, T. R., Luostarinen, T., Pukkala, ., Sankila, R. J., Söderman, B., & Teppo, L. (1999) · Acta Oncologica · doi:10.1080/028418699432996 · Cited by 176 · see citing works
Up-to-Date Long-Term Survival Curves of Patients With Cancer by Period Analysis
Brenner, H. (2002) · Journal of Clinical Oncology · doi:10.1200/jco.20.3.826 · Cited by 174 · cited 2× · see citing works
“…demonstrated use of period estimates for a given calendar year as a surrogate for the survival rates later observed for patients diagnosed in that year (Brenner and Hakulinen, 2002b; Brenner et al, 2002b) may only be meaningful for those calendar years for which cohort estimates are not available.”
BackgroundSelf-citationSurvival of Cancer Patients in Europe: The EUROCARE-2 study.
etc. (1999) · PubMed · Cited by 164 · see citing works
Long-term cancer patient survival in the United States.
Wingo, P. A., Ries, L. A. G., Parker, S. L., & Heath, C. (1998) · PubMed · Cited by 158 · see citing works
An overview of cancer survival in developing countries.
Sankaranarayanan, R., Rj, B., Swaminathan, R., & Dm, P. (1998) · PubMed · Cited by 153 · see citing works
Brenner, H., Söderman, B., & Hakulinen, T. R. (2002) · International Journal of Epidemiology · doi:10.1093/intjepid/31.2.456 · Cited by 146 · see citing works
Self-citationDeriving more up-todate estimates of long-term patient survival
Brenner, H., & Gefeller, O. (1997) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(97)00280-1 · Cited by 131 · cited 1× · see citing works
“To provide more recent estimates of long-term survival, an alternative method, denoted ‘period analysis’, has been proposed a couple of years ago (Brenner and Gefeller, 1996, 1997).”
MethodSelf-citationA computer program for period analysis of cancer patient survival
Brenner, H., Gefeller, O., & Hakulinen, T. R. (2002) · European Journal of Cancer · doi:10.1016/s0959-8049(02)00003-5 · Cited by 110 · cited 2× · see citing works
“…demonstrated use of period estimates for a given calendar year as a surrogate for the survival rates later observed for patients diagnosed in that year (Brenner and Hakulinen, 2002b; Brenner et al, 2002b) may only be meaningful for those calendar years for which cohort estimates are not available.”
BackgroundSelf-citationUp-to-Date Long-Term Survival Curves of Patients With Cancer by Period Analysis
Brenner, H., & Hakulinen, T. R. (2002) · Journal of Clinical Oncology · doi:10.1200/jco.2002.20.3.826 · Cited by 110 · see citing works
Self-citationHermon, C., & Beral, V. (1996) · British Journal of Cancer · doi:10.1038/bjc.1996.171 · Cited by 107 · cited 1× · see citing works
“For example, the increase in survival observed for patients with testicular cancer is likely to be mainly due to a breakthrough in therapy (in particular, the inclusion of cis-platin in chemotherapy schemes) (Bosl and Motzer, 1997), whereas the increase in survival rates of patients with breast cancer might reflect bo…”
BackgroundAngiogenesis in pancreatic carcinoma
Fujioka, S., Yoshida, K., Yanagisawa, S., Kawakami, M., Aoki, T., & Yamazaki, Y. (2001) · Cancer · doi:10.1002/1097-0142(20011001)92:7 · Cited by 90 · see citing works
Self-citationBrenner, H. (2002) · American Journal of Epidemiology · doi:10.1093/aje/kwf071 · Cited by 62 · cited 2× · see citing works
“…demonstrated use of period estimates for a given calendar year as a surrogate for the survival rates later observed for patients diagnosed in that year (Brenner and Hakulinen, 2002b; Brenner et al, 2002b) may only be meaningful for those calendar years for which cohort estimates are not available.”
BackgroundSelf-citationBrenner, H., & Hakulinen, T. R. (2001) · British Journal of Cancer · doi:10.1054/bjoc.2001.1905 · Cited by 61 · see citing works
Self-citationAareleid, T., & Brenner, H. (2002) · International Journal of Cancer · doi:10.1002/ijc.10663 · Cited by 37 · cited 1× · see citing works
“Period analysis has meanwhile been applied for the latter purpose in different cancer registries (e.g., Brenner et al, 1998, 1999, 2001; Brenner and Hakulinen, 2001; Aareleid and Brenner, 2002; Brenner, 2002; Smith et al, 2003), whereas mixed analysis has, with very few exceptions (Kaatsch et al, 2000; Burkhardt-Hamme…”
MethodSelf-citationIncreasing Survival Trend After Cancer Diagnosis in Sweden: 1960-1984
Adami, H., Sparén, P., Bergström, R., Holmberg, L., Krusemo, U. B., & Pontén, J. (1989) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/81.21.1640 · Cited by 33 · see citing works
Up-to-date survival curves of children with cancer by period analysis
Brenner, H. (2003) · British Journal of Cancer · doi:10.1038/sj.bjc.6600947 · Cited by 32 · see citing works
Self-citationChanges in long term prognosis for breast cancer in a Dutch cancer registry
Nab, H. W., Hop, W. C. J., Crommelin, M. A., Kluck, H. M., van der Heijden, L. H., & Coebergh, J. W. W. (1994) · BMJ · doi:10.1136/bmj.309.6947.83 · Cited by 30 · see citing works
Recent improvement in survival of breast cancer patients in Saarland, Germany
Brenner, H., Stegmaier, C., & Ziegler, H. (1998) · British Journal of Cancer · doi:10.1038/bjc.1998.562 · Cited by 25 · see citing works
Self-citationTrends in survival of patients with ovarian cancer in Saarland, Germany, 1976-1995
Brenner, H., Stegmaier, C., & Ziegler, H. (1999) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s004320050250 · Cited by 25 · see citing works
Self-citationUp-to-date estimates of long-term cancer survival in England and Wales
Smith, L. K., Lambert, P. C., & Jones, D. R. (2003) · British Journal of Cancer · doi:10.1038/sj.bjc.6600976 · Cited by 19 · see citing works
Burkhardt‐Hammer, T., Spix, C., Brenner, H., Kaatsch, P., Berthold, F., Hero, B., & Michaelis, J. (2002) · Medical and Pediatric Oncology · doi:10.1002/mpo.10132 · Cited by 15 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Allemani, C., Matsuda, T., Di Carlo, V., Harewood, R., Matz, M., Nikšić, M., Bonaventure, A., Valkov, M., Johnson, C. J., Estève, J., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(17)33326-3 · Cited by 6,145 · see citing works
Pediatric Germ Cell Tumors From 1987 to 2011: Incidence Rates, Time Trends, and Survival
Kaatsch, P., Häfner, C., Calaminus, G., Blettner, M., & Tulla, M. (2014) · PEDIATRICS · doi:10.1542/peds.2014-1989 · Cited by 89 · see citing works
Girardi, F., Matz, M., Stiller, C. A., You, H., Gragera, R. M., Valkov, М. Y., Bulliard, J., De, P., Morrison, D. S., Wanner, M., et al. (2022) · Neuro-Oncology · doi:10.1093/neuonc/noac217 · Cited by 74 · see citing works
“24,25 We produced age-standardized 5-year survival estimates for each histology group, country, and calendar period.”
Incidence, Trends, and Survival of Children With Embryonal Tumors
Tulla, M., Berthold, F., Graf, N. M., Rutkowski, S., von Schweinitz, D., Spix, C., & Kaatsch, P. (2015) · PEDIATRICS · doi:10.1542/peds.2015-0224 · Cited by 71 · see citing works
Self-citationGuevara, M., Molinuevo, A., Salmerón, D., Marcos‐Gragera, R., Carulla, M., Chirlaque, M., Camblor, M. R., Alemán, A., Rojas, D., Vizcaíno-Batllés, A., et al. (2022) · Cancers · doi:10.3390/cancers14102441 · Cited by 57 · see citing works
Trama, A., Bernasconi, A., McCabe, M. G., Guevara, M., Gatta, G., Botta, L., the RARECAREnet Working Group, Ries, L., & Bleyer, A. (2018) · Pediatric Blood & Cancer · doi:10.1002/pbc.27407 · Cited by 56 · see citing works
Strategies to improve the quality of survival for childhood brain tumour survivors
Tallen, G. R. N., Resch, A., Calaminus, G., Wiener, A., Leiss, U., Pletschko, T., Friedrich, C., ten Langer, T. S., Grabow, D., Driever, P. H., et al. (2015) · European Journal of Paediatric Neurology · doi:10.1016/j.ejpn.2015.07.011 · Cited by 49 · see citing works
Pediatric bone tumors in Germany from 1987 to 2011: incidence rates, time trends and survival
Kaatsch, P., Strothotte, J., Becker, C., Bielack, S., Dirksen, U., & Blettner, M. (2016) · Acta Oncologica · doi:10.1080/0284186x.2016.1195509 · Cited by 42 · see citing works
“Survival predictions were done by applying the life table method [11], trends of survival were analyzed with a two-sided log-rank test.”
MethodAn Empirical Evaluation of Period Survival Analysis Using Data from the Canadian Cancer Registry
Ellison, L. F. (2005) · Annals of Epidemiology · doi:10.1016/j.annepidem.2005.02.017 · Cited by 39 · see citing works
Cancer survivors in Switzerland: a rapidly growing population to care for
Herrmann, C., Cerny, T., Savidan, A., Vounatsou, P., Konzelmann, I., Bouchardy, C., Frick, H., & Ess, S. M. (2013) · BMC Cancer · doi:10.1186/1471-2407-13-287 · Cited by 36 · see citing works
“up was calculated on the pooled dataset comparing observed survival with expected survival in Switzerland using the Ederer II method [18] with the so called mixedapproach [19] by consecutive 3-year periods from 1981 to 2010 and 5 distinct agegroups (0-14, 15-49, 50-69, 70-79, 80+).”
MethodGirardi, F., Carlo, V. D., Stiller, C. A., Gatta, G., Woods, R. R., Visser, O. J., Lacour, B., Tucker, T. C., Coleman, M. P., Allemani, C., et al. (2022) · Neuro-Oncology · doi:10.1093/neuonc/noac232 · Cited by 36 · see citing works
“27,28 We produced 5-year survival estimates for tumors in each histology group, by country and calendar period.”
Colon cancer: survival after curative surgery
Link, K. H., Sagban, T. A., M�rschel, M., Tischbirek, K., Holtappels, M., Apell, V., Zayed, K., Kornmann, M., & Staib, L. (2004) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-004-0508-5 · Cited by 28 · see citing works
“Estimates of expected survival rates could be derived from pertinent life tables according to Hakulinen’s method [4].”
MethodFan, X., He, W., Zhang, Q., Zhang, B., Dong, L., Li, L., & Liu, X. (2024) · Cancer Control · doi:10.1177/10732748241232324 · Cited by 13 · see citing works
“19 Our fi ndings based on the SEER database indicated that the relative survival rate of cervical cancer increased over time within the three observation periods from 2002 to 2016, which may bene fi t from the rapid progress of medical prevention and treatment technologies, the enhancement of health…”
MethodZuccolo, L., Dama, E., Maule, M. M., Pastore, G., Merletti, F., & Magnani, C. (2006) · European Journal of Cancer · doi:10.1016/j.ejca.2005.08.046 · Cited by 11 · see citing works
ACCESS TO HIGH-QUALITY ONCOLOGY CARE ACROSS EUROPEPreprint
Hofmarcher, T., Jönsson, B., & Wilking, N. E. (2014) · RePEc: Research Papers in Economics · Cited by 6 · see citing works
Modeling Survival After Diagnosis of a Specific Disease Based on Case Surveillance Data
Song, R., Qin, G., Harrison, K. M., Zhang, X., & Hall, H. I. (2014) · International Journal of Statistics in Medical Research · doi:10.6000/1929-6029.2014.03.01.2 · Cited by 2 · see citing works
“If the focus is the later, then one may follow the method proposed by Brenner and Spix [19] to obtain a good current estimate for the true survival of that cohort using the survival data not only in the diagnosis year, but also in years thereafter.”
MethodChirurgie und multimodale Therapie des Kolonkarzinoms: Evidenzbasis?
Link, K. H., Mörschel, M., Sagban, T. A., Apell, V., Holtappels, M., & Tischbirek, K. (2004) · Visceral Medicine · doi:10.1159/000078067 · Cited by 2 · see citing works
Heinz Becker, A., Sprenger, T., & Liersch, T. (2015) · Elsevier eBooks · doi:10.1016/b978-3-437-24811-5.00015-8 · Cited by 1 · see citing works
Brenner, H., Wahl, H.-W., & Rott, C. (2003) · Experimental Gerontology · doi:10.1016/j.exger.2003.10.005
Self-citationHeinz Becker, A., & Liersch, T. (2006) · Elsevier eBooks · doi:10.1016/b978-343723710-2.50035-4
Link, K. H., Hauser, H., Mann, M., & Schlag, P. M. (2009) · Springer eBooks · doi:10.1007/978-3-211-48613-9_27
PDF-Datei der Kurzfassung der Patienteninformation zur akuten myeloischen Leukämie (AML)
Yiallouros, M., & Creutzig, U. (2006) · doi:10.1591/poh.patinfo.aml.kurz
Trends in incidence and survival for uveal melanoma in Norway, 1993–2021
Leitzinger, N., Falk, R. S., Jespersen, H., Eide, N. A., Green, A. C., Robsahm, T. E., & Veierød, M. B. (2026) · British Journal of Ophthalmology · doi:10.1136/bjo-2025-327605
- Authors
- Brenner, H., & Spix, C.
- Affiliations
- Heidelberg University (DE)
- Corresponding author
- Brenner, H
- ORCID
- Venue
- British Journal of Cancer
- Published
- 2003-09-30
- Volume
- 89
- Issue
- 7
- Pages
- 1260-1265
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC2394294
- OpenAlex
- W2004495081
- Cited by
- 23
- References
- 27
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 3 · 2018: 2 · 2016: 1 · 2015: 3 · 2014: 3 · 2013: 1
- FWCI
- 1.05
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- cancer survival trends, cohort analysis, period analysis, cancer registry, SEER database
- MeSH terms
- Demography, Female, Humans, Male, Neoplasms, Prognosis, Registries, Retrospective Studies, Time Factors, United States, Cohort Studies, Survival Rate, Databases, Factual, Survivors, SEER Program
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
