Estimating the change in life expectancy after a diagnosis of cancer among the Australian population.
Bottom Line: Flexible parametric models were used to estimate loss of life expectancy (LOLE), remaining life expectancy (RLE) and 10-year cumulative probability of cancer-specific death (1-relative survival).In contrast, younger people had lower estimated cumulative probabilities of cancer-specific death within 10 years (40 years: 21.5%, 21.4% to 22.1%) compared with older people (80 years: 55.4%, 55.0% to 55.9%).The LOLE and RLE measures provide complementary messages to standard relative survival estimates (expressed here in terms of cumulative probability of cancer-specific death).
Affiliation: Cancer Council Queensland, Brisbane, Queensland, Australia School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.Show MeSH
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Mentions: Conversely, the effect that age had on LOLE was substantially more pronounced and consistent. Australians diagnosed with cancer at younger ages had higher LOLE estimates than those diagnosed at an older age (table 2 and figure 3). LOLE depends on prognosis and, more importantly, on population life expectancy, which reduces with increasing age (table 2). To the extent that both change with age, LOLE patterns will be impacted. Using lung cancer as an example, a person diagnosed when at 40 years of age (10 years probability of death: 78.2%) faced losing on average 33 years of life expectancy (RLE=10 years), while a person aged 80 years at diagnosis (10 years probability of death: 92.0%) faced losing 7 years of life expectancy (RLE=1 year). When we calculated the LOLE as a proportion of population life expectancy, it increased steadily with age for all cancers combined (table 2). However, when examined within specific cancer types, proportional life expectancy was much more stable for each cancer type, indicating that the pattern seen with all cancer types resulted from the change in the mix of cancers seen at different ages. Differences between individual cancers by age reflected variation in prognosis by type of cancer, with modest variations by age within type (table 2).
Affiliation: Cancer Council Queensland, Brisbane, Queensland, Australia School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.