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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Spatial variation in prostate cancer survival in the Northern and Yorkshire region of England using Bayesian relative survival smoothing
British Journal of Cancer, Volume 99, No. 11, Year 2008
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Description
Primary Care Trust (PCT) estimates of survival lack robustness as there are small numbers of deaths per year in each area, even when incidence is high. We assess PCT-level spatial variation in prostate cancer survival using Bayesian spatial models of excess mortality. We extracted data on men diagnosed with prostate cancer between 1990 and 1999 from the Northern and Yorkshire Cancer Registry and Information Service database. Models were adjusted for age at diagnosis, period of diagnosis and deprivation. All covariates had a significant association with excess mortality; men from more deprived areas, older age at diagnosis and diagnosed in 1990-1994 had higher excess mortality. The unadjusted relative excess risks (RER) of death by PCT ranged from 0.75 to 1.66. After adjustment, areas of high and low excess mortality were smoothed towards the mean, and the RERs ranged from 0.74 to 1.49. Using Bayesian smoothing techniques to model cancer survival by geographic area offers many advantages over traditional methods; estimates in areas with small populations or low incidence rates are stabilised and shrunk towards local and global risk estimates improving reliability and precision, complex models are easily handled and adjustment for covariates can be made. © 2008 Cancer Research.
Authors & Co-Authors
Fairley, Lesley
United Kingdom, Leeds
St James's University Hospital
Forman, David F.
United Kingdom, Leeds
St James's University Hospital
United Kingdom, Leeds
University of Leeds
West, Robert Michael
United Kingdom, Leeds
University of Leeds
Manda, Samuel Om M.
South Africa, Tygerberg
South African Medical Research Council
Statistics
Citations: 23
Authors: 4
Affiliations: 3
Identifiers
Doi:
10.1038/sj.bjc.6604757
e-ISSN:
15321827
Research Areas
Cancer
Study Design
Cohort Study
Participants Gender
Male