Working Paper: NBER ID: w16051
Authors: Frank R. Lichtenberg
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. \n \nWe reexamine the question of whether increasing 5-year survival rates constitute evidence of success against cancer, using data from both the U.S. and Australia. When incidence growth is controlled for, there is a highly significant correlation, in both countries, 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. \n \nWhile 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.
Keywords: cancer; survival rates; mortality; incidence
JEL Codes: C21; I12; J11; O4
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| change in incidence (H22) | change in 5-year survival rates (C41) |
| change in 5-year survival rates (C41) | change in tumor-related mortality rates (J11) |
| change in incidence (H22) | change in tumor-related mortality rates (J11) |
| change in 5-year survival rates (C41) | unconditional mortality rates (I12) |