#376 Estimating mortality indices in gynecological cancer patients: A population-based analysis

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Estimating mortality indices in gynecological cancer patients: A population-based analysis
Globally, gynecological cancers account for between 10 to 15 percent of all cancers in women. These cancers rank high in incidence and can affect women of all ages. Cervical cancer is the second most common cancer in women worldwide and ovarian cancer is an important malignancy with a very high mortality rate. In Canada, cervical cancer affected approximately 1300 women in 2011, while ovarian cancer affects about 2600 women annually.

Knowing the mortality rate for a given disease is important from a health policy perspective as it provides a helpful indication about the relative success of protocols (screening, diagnosis, and/or treatment) and health care delivery processes. But calculating a measure of mortality in population-based cancer studies is challenging as it is difficult to distinguish between those who die from cancer and those who die from other causes. First, the underlying cause of death is not always correctly specified in death certificate which is used in cancer registries. Second, the accuracy of death certificate varies overtime and among countries. Third, it is difficult to assume that death happens because of only one definite cause; it tends to be multi-factorial where cancer might be only one contributing factor.

To overcome this problem, we used a flexible parametric model for relative survival to estimate three different mortality indices (excess mortality rate, net probabilities of death, and crude probabilities of death) in patients diagnosed with epithelial invasive gynecological cancers (ovary, uterine, and cervix) in Canada between 1992 and 2005, using the Canadian Cancer Registry dataset. In this approach the mortality rate in cancer patients is compared with the mortality rate in the general population and there is no need for having the actual cause of death. In this presentation we will discuss each of these indices with its application in national and international comparisons.

Advisor on Tap:

Dr. Noori Akhtar-Danesh, BSc, MSc, PhD
Associate Professor biostatistics,
School of Nursing and Department of Clinical Epidemiology & Biostatistics
McMaster University
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Dr. Noori Akhtar-Danesh received his PhD in medical statistics from the University of Newcastle upon Tyne, UK. He began his career at McMaster in 2003 and is currently an Associate Professor with the School of Nursing, McMaster University. He is also an associate member of the Department of Clinical Epidemiology and Biostatistics. His primary research interests include survival analysis and relative survival analysis for population-based large datasets. Dr. Akhtar-Danesh is also an associate editor for the journal of BMC Medical Research Methodology.
Selected Publications:
    Akhtar-Danesh N, Lytwyn A, Elit L. (2012) Five-year Trends in Mortality Indices Among Gynecological Cancer Patients in Canada. Gynecologic Oncology, (in press).
    Elit L, Lytwyn A, Akhtar-Danesh N. (2012) Long-term Trends in the Survival of Uterine Cancer Patients in Canada: A Population-based Study. Journal of Cancer Therapy, (in press).
    Akhtar-Danesh N, Elit L, Lytwyn A. (2012) Temporal Trends in the Relative Survival Among Women with Cervical Cancer in Canada: A Population-based Study. International Journal of Gynecological Cancer, 22(7):1208-13.
    Akhtar-Danesh N, Elit L, Lytwyn A. (2011) Temporal trends in the Proportion Cured Among Patients Diagnosed with Ovarian Cancer in Canada 1992-2005: A Population-based Study. Gynecologic Oncology, 123:192-195.

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