41 results on '"Feuer, Eric J"'
Search Results
2. Weighted normal spatial scan statistic for heterogeneous population data
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Huang, Lan, Tiwari, Ram C., Zou, Zhaohui, Kulldorff, Martin, and Feuer, Eric J.
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Cancer survivors -- Health aspects ,Cancer survivors -- Reports ,Mortality -- Risk factors ,Mortality -- Statistics ,Prevalence studies (Epidemiology) -- Usage ,Prevalence studies (Epidemiology) -- Methods ,Scan statistics -- Usage ,Mathematics - Abstract
In geographical spatial epidemiology and disease surveillance, all the existing spatial scan methods for cluster detection using continuous data are designed for evaluating clusters of individuals and analyzing individual-level data. Motivated by growing demands to study the spatial heterogeneity of continuous measures in population data, such as mortality rates. survival rates, average body mass indexes and pollution at state, county, and census tract levels, we propose a weighted normal scan statistic for investigating the clusters of the cells (geographic units such as counties) with unusual high/low continuous regional measures. where the weights reflect the uncertainty of the regional measures or sample size (number of observed cases) in the cells. Power, precision, the effect of the weights, and the sensitivity of the proposed test statistic to data from various distributions are investigated through intensive simulation. The method is applied to 1988-2002 stage I and II lung cancer survival data in Los Angeles County in order to search for clusters of geographic units with high/low survival rates in a short-term/long-term survival after diagnosis, and to 1999-2003 breast cancer age-adjusted mortality rate data in the U.S. collected by the Surveillance. Epidemiology and End Results (SEER) program in order to evaluate the clustering pattern of counties with high mortality rate. The proposed method is included in the latest release of the SaTScan software (www.satscan.org). KEY WORDS: Breast cancer mortality; Cluster detection; Continuous regional data; Geographic variation; Lung cancer survival: Weighted normal spatial scan statistic.
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- 2009
3. Risk prediction models for selection of lung cancer screening candidates: A retrospective validation study
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ten Haaf, Kevin, Jeon, Jihyoun, Tammemägi, Martin C., Han, Summer S., Kong, Chung Yin, Plevritis, Sylvia K., Feuer, Eric J., de Koning, Harry J., Steyerberg, Ewout W., and Meza, Rafael
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Cigarettes -- Health aspects -- Research ,Lung cancer -- Diagnosis -- Risk factors -- Research ,Cancer screening -- Health aspects -- Research ,Chronic obstructive lung disease -- Risk factors -- Research ,Biological sciences - Abstract
Background Selection of candidates for lung cancer screening based on individual risk has been proposed as an alternative to criteria based on age and cumulative smoking exposure (pack-years). Nine previously established risk models were assessed for their ability to identify those most likely to develop or die from lung cancer. All models considered age and various aspects of smoking exposure (smoking status, smoking duration, cigarettes per day, pack-years smoked, time since smoking cessation) as risk predictors. In addition, some models considered factors such as gender, race, ethnicity, education, body mass index, chronic obstructive pulmonary disease, emphysema, personal history of cancer, personal history of pneumonia, and family history of lung cancer. Methods and findings Retrospective analyses were performed on 53,452 National Lung Screening Trial (NLST) participants (1,925 lung cancer cases and 884 lung cancer deaths) and 80,672 Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) ever-smoking participants (1,463 lung cancer cases and 915 lung cancer deaths). Six-year lung cancer incidence and mortality risk predictions were assessed for (1) calibration (graphically) by comparing the agreement between the predicted and the observed risks, (2) discrimination (area under the receiver operating characteristic curve [AUC]) between individuals with and without lung cancer (death), and (3) clinical usefulness (net benefit in decision curve analysis) by identifying risk thresholds at which applying risk-based eligibility would improve lung cancer screening efficacy. To further assess performance, risk model sensitivities and specificities in the PLCO were compared to those based on the NLST eligibility criteria. Calibration was satisfactory, but discrimination ranged widely (AUCs from 0.61 to 0.81). The models outperformed the NLST eligibility criteria over a substantial range of risk thresholds in decision curve analysis, with a higher sensitivity for all models and a slightly higher specificity for some models. The PLCOm2012, Bach, and Two-Stage Clonal Expansion incidence models had the best overall performance, with AUCs >0.68 in the NLST and >0.77 in the PLCO. These three models had the highest sensitivity and specificity for predicting 6-y lung cancer incidence in the PLCO chest radiography arm, with sensitivities >79.8% and specificities >62.3%. In contrast, the NLST eligibility criteria yielded a sensitivity of 71.4% and a specificity of 62.2%. Limitations of this study include the lack of identification of optimal risk thresholds, as this requires additional information on the long-term benefits (e.g., life-years gained and mortality reduction) and harms (e.g., overdiagnosis) of risk-based screening strategies using these models. In addition, information on some predictor variables included in the risk prediction models was not available. Conclusions Selection of individuals for lung cancer screening using individual risk is superior to selection criteria based on age and pack-years alone. The benefits, harms, and feasibility of implementing lung cancer screening policies based on risk prediction models should be assessed and compared with those of current recommendations., Author(s): Kevin ten Haaf 1,*, Jihyoun Jeon 2, Martin C. Tammemägi 3, Summer S. Han 4,5, Chung Yin Kong 6, Sylvia K. Plevritis 4, Eric J. Feuer 7, Harry J. [...]
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- 2017
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4. Combining information from two surveys to estimate county-level prevalence rates of cancer risk factors and screening
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Raghunathan, Trivellore E., Xie, Dawei, Schenker, Nathaniel, Parsons, Van L., Davis, William W., Dodd, Kevin W., and Feuer, Eric J.
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United States. Centers for Disease Control and Prevention -- Surveys ,United States. National Center for Health Statistics -- Surveys ,Monte Carlo method -- Health aspects ,Monte Carlo method -- Surveys ,Mammography -- Health aspects ,Mammography -- Surveys ,Oncology, Experimental -- Health aspects ,Oncology, Experimental -- Surveys ,Cancer -- Health aspects ,Cancer -- Surveys ,Cancer -- Research ,Mathematics ,American Statistical Association -- Surveys - Abstract
Cancer surveillance research requires estimates of the prevalence of cancer risk factors and screening for small areas such as counties. Two popular data sources are the Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey conducted by state agencies, and the National Health Interview Survey (NHIS), an area probability sample survey conducted through face-to-face interviews. Both data sources have advantages and disadvantages. The BRFSS is a larger survey and almost every county is included in the survey, but it has lower response rates as is typical with telephone surveys and it does not include subjects who live in households with no telephones. On the other hand, the NHIS is a smaller survey, with the majority of counties not included; but it includes both telephone and nontelephone households, and has higher response rates. A preliminary analysis shows that the distributions of cancer screening and risk factors are different for telephone and nontelephone households. Thus, information from the two surveys may be combined to address both nonresponse and noncoverage errors. A hierarchical Bayesian approach that combines information from both surveys is used to construct county-level estimates. The proposed model incorporates potential noncoverage and nonresponse biases in the BRFSS as well as complex sample design features of both surveys. A Markov chain Monte Carlo method is used to simulate draws from the joint posterior distribution of unknown quantities in the model that uses design-based direct estimates and county-level covariates. Yearly prevalence estimates at the county level for 49 states, as well as for the entire state of Alaska and the District of Columbia, are developed for six outcomes using BRFSS and NHIS data from the years 1997-2000. The outcomes include smoking and use of common cancer screening procedures. The NHIS/BRFSS combined county-level estimates are substantially different from those based on the BRFSS alone. KEY WORDS: BRFSS; Cancer screening; Complex sample survey; Gibbs sampling; Hierarchical model; Mammography; NHIS; Pap smear; Simulation; Smoking.
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- 2007
5. The decrease in breast-cancer incidence in 2003 in the United States
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Ravdin, Peter M., Cronin, Kathleen A., Howlader, Nadia, Berg, Christine D., Chlebowski, Rowan T., Feuer, Eric J., Edwards, Brenda K., and Berry, Donald A.
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Breast cancer -- Development and progression ,Breast cancer -- Statistics ,Cancer patients -- Statistics ,Cancer patients -- Surveys - Abstract
The information from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registries on analysis reveals a fall in the age-adjusted incidence rate of breast cancer in women in the U.S. in 2003 by almost 6.7%. It is believed that the fall in the breast cancer events is sequentially associated to the Women's Health Initiative's first report and the resultant decrease in the hormone-replacement therapy among postmenopausal women in the United States.
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- 2007
6. Effect of screening and adjuvant therapy on mortality from breast cancer
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Berry, Donald A., Feuer, Eric J., Cronin, Kathleen A., Habbema, J. Dik F., Plevritis, Sylvia K., Yakovlev, Andrei Y., Fryback, Dennis G., Mandelblatt, Jeanne S., Clarke, Lauren, and Zelen, Marvin
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Breast cancer -- Diagnosis ,Breast cancer -- Drug therapy ,Mortality -- Risk factors ,Mortality -- United States ,Cancer -- Adjuvant treatment ,Cancer -- Health aspects - Abstract
The relative and absolute contributions of screening mammography and adjuvant treatment to the reduction in breast-cancer mortality in the US from 1975 to 2000 is assessed using modeling techniques. The statistical models reveal that both screening mammography and treatment have helped reduce the rate of death from breast cancer in the US.
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- 2005
7. Modeling reporting delays and reporting corrections in cancer registry data
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Midthune, Douglas N., Fay, Michael P., Clegg, Limin X., and Feuer, Eric J.
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Medical research -- Information management ,Medicine, Experimental -- Information management ,Oncology, Experimental -- Information management ,Cancer -- Research ,Cancer -- Information management ,Company systems management ,Mathematics - Abstract
The Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute is an authoritative source of cancer incidence statistics in the United States. The SEER program is a consortium of population-based cancer registries from different areas of the country. Each registry is charged with collecting data on all cancers that occur within its geographic area. As with any disease registry, there is a delay between the time that the disease (cancer) is first diagnosed and the time that it is reported to the registry. The SEER program has allowed for reporting delays of up to 19-months before releasing data for public use. Nevertheless, additional cases are discovered after the 19-month delay, and these cases are added in subsequent releases of the data. Further, any errors discovered are corrected in subsequent releases. Such reporting delays and corrections typically lead to underestimation of the cancer incidence rates in recent diagnosis years, making it difficult to monitor trends. In this article we study models that account for reporting delays and corrections in predicting eventual cancer counts for a diagnosis year from the preliminary counts. Previous models of this type have been studied, especially as applied to AIDS registries. We offer several additions to existing models. First, we explicitly model the reporting corrections. Second, we model the delay distribution with very general models, combining aspects of previous nonparametric-like models (i.e., models that have a separate parameter for each delay time) with more parametric models. Third, we allow random reporting-year effects in the model. Practical issues of model selection and how the data are classified are also discussed, particularly how the definition of a reporting correction may change depending on how subpopulations are defined. An example with SEER melanoma data is studied in detail. KEY WORDS: Cancer surveillance; Delay-adjusted rates; Incurred but not reported; Random effects; Surveillance, Epidemiology, and End Results program; Truncated data.
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- 2005
8. Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms
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Mandelblatt, Jeanne S., Cronin, Kathleen A., Bailey, Stephanie, Berry, Donald A., de Koning, Harry J., Draisma, Gerrit, Huang, Hui, Lee, Sandra J., Munsell, Mark, Plevritis, Sylvia K., Ravdin, Peter, Schechter, Clyde B., Sigal, Bronislava, Stoto, Michael A., Stout, Natasha K., van Ravesteyn, Nicolien T., Venier, John, Zelen, Marvin, and Feuer, Eric J.
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Breast cancer -- Diagnosis ,Breast cancer -- Prevention ,Mammography -- Usage ,Cancer -- Diagnosis ,Cancer -- Methods ,Health - Abstract
Background: Despite trials of mammography and widespread use, optimal screening policy is controversial. Objective: To evaluate U.S. breast cancer screening strategies. Design: 6 models using common data elements. Data Sources: National data on age-specific incidence, competing mortality, mamography characteristics, and treatment effects. Target Population: A contemporary population cohort. Time Horizon: Lifetime. Perspective: Societal. Interventions: 20 screening strategies with varying initiation and cessation ages applied annually or biennially. Outcome Measures: Number of mammograms, reduction in deaths from breast cancer or life-years gained (vs. no screening), false-positive results, unnecessary biopsies, and overdiagnosis. Results of Base-Case Analysis: The 6 models produced consistent rankings of screening strategies. Screening biennially maintained an average of 81% (range across strategies and models, 67% to 99%) of the benefit of annual screening with almost half the number of false-positive results. Screening biennially from ages 50 to 69 years achieved a median 16.5% (range, 15% to 23%) reduction in breast cancer deaths versus no screening. Initiating biennial screening at age 40 years (vs. 50 years) reduced mortality by an additional 3% (range, 1% to 6%), consumed more resources, and yielded more false-positive results. Biennial screening after age 69 years yielded some additional mortality reduction in all models, but overdiagnosis increased most substantially at older ages. Results of Sensitivity Analysis: Varying test sensitivity or treatment patterns did not change conclusions. Limitation: Results do not include morbidity from false-positive results, patient knowledge of earlier diagnosis, or unnecessary treatment. Conclusion: Biennial screening achieves most of the benefit of annual screening with less harm. Decisions about the best strategy depend on program and individual objectives and the weight placed on benefits, harms, and resource considerations. Primary Funding Source: National Cancer Institute.
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- 2009
9. Breast cancer survivors in the United States: geographic variability and time trends, 2005-2015
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De Angelis, Roberta, Tavilla, Andrea, Verdecchia, Arduino, Scoppa, Steve, Hachey, Mark, Feuer, Eric J., and Mariotto, Angela B.
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Breast cancer -- Distribution ,Breast cancer -- Patient outcomes ,Breast cancer -- Forecasts and trends ,Breast cancer -- Research ,Cancer survivors -- Forecasts and trends ,Cancer survivors -- Demographic aspects ,Cancer survivors -- Research ,Company distribution practices ,Market trend/market analysis ,Health - Published
- 2009
10. Productivity costs of cancer mortality in the United States: 2000-2020
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Bradley, Cathy J., Yabroff, K. Robin, Dahman, Bassam, Feuer, Eric J., Mariotto, Angela, and Brown, Martin L.
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Cancer -- Patient outcomes ,Mortality -- United States ,Mortality -- Economic aspects ,Mortality -- Forecasts and trends ,Market trend/market analysis ,Health - Abstract
Background A model that predicts the economic benefit of reduced cancer mortality provides critical information for allocating scarce resources to the interventions with the greatest benefits. Methods We developed models using the human capital approach, which relies on earnings as a measure of productivity, to estimate the value of productivity lost as a result of cancer mortality. The base model aggregated age- and sex-specific data from four primary sources: 1) the US Bureau of the Census, 2) US death certificate data for 1999-2003, 3) cohort life tables from the Berkeley Mortality Database for 1900-2000, and 4) the Bureau of Labor Statistics Current Population Survey. In a model that included costs of caregiving and household work, data from the National Human Activity Pattern Survey and the Caregiving in the U.S. study were used. Sensitivity analyses were performed using six types of cancer assuming a 1% decline in cancer mortality rates. The values of forgone earnings for employed individuals and imputed forgone earnings for informal caregiving were then estimated for the years 2000-2020. Results The annual productivity cost from cancer mortality in the base model was approximately $115.8 billion in 2000; the projected value was $147.6 billion for 2020. Death from lung cancer accounted for more than 27% of productivity costs. A 1% annual reduction in lung, colorectal, breast, leukemia, pancreatic, and brain cancer mortality lowered productivity costs by $814 million per year. Including imputed earnings lost due to caregiving and household activity increased the base model total productivity cost to $232.4 billion in 2000 and to $308 billion in 2020. Conclusions Investments in programs that target the cancers with high incidence and/or cancers that occur in younger, working-age individuals are likely to yield the greatest reductions in productivity losses to society.
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- 2008
11. Estimates and projections of value of life lost from cancer deaths in the United States
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Yabroff, K. Robin, Bradley, Cathy J., Mariotto, Angela B., Brown, Martin L., and Feuer, Eric J.
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Cancer -- Patient outcomes ,Mortality -- United States ,Mortality -- Forecasts and trends ,Market trend/market analysis ,Health - Abstract
Background Value-of-life methods are increasingly used in policy analyses of the economic burden of disease. The purpose of this study was to estimate and project the value of life lost from cancer deaths in the United States. Methods We estimated and projected US age-specific mortality rates for all cancers and for 16 types of cancer in men and 18 cancers in women in the years 2000-2020 and applied them to US population projections to estimate the number of deaths in each year. Cohort life tables were used to calculate the remaining life expectancy in the absence of cancer deaths--the person-years of life lost (PYLL). We used a willingness-to-pay approach in which the value of life lost due to cancer death was calculated by multiplying PYLL by an estimate of the value of 1 year of life ($150000). We performed sensitivity analyses for female breast, colorectal, lung, and prostate cancers using varying assumptions about future cancer mortality rates through the year 2020. Results The value of life lost from all cancer deaths in the year 2000 was $960.6 billion; lung cancer alone represented more than 25% of this value. Projections for the year 2020 with current cancer mortality rates showed a 53% increase in the total value of life lost ($1472.5 billion). Projected annual decreases of cancer mortality rates of 2% reduced the expected value of life lost in the year 2020 from $121.0 billion to $80.7 billion for breast cancer, $140.1 billion to $93.5 billion for colorectal cancer, from $433.4 billion to $289.4 billion for lung cancer, and from $58.4 billion to $39.0 billion for prostate cancer. Conclusions Estimated value of life lost due to cancer deaths in the United States is substantial and expected to increase dramatically, even if mortality rates remain constant, because of expected population changes. These estimates and projections may help target investments in cancer control strategies to tumor sites that are likely to result in the greatest burden of disease and to interventions that are the most cost-effective.
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- 2008
12. Improved survival time: what can survival cure models tell us about population-based survival improvements in late-stage colorectal, ovarian, and testicular cancer?
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Huang, Lan, Cronin, Kathleen A., Johnson, Karen A., Mariotto, Angela B., and Feuer, Eric J.
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Ovarian cancer -- Patient outcomes ,Colorectal cancer -- Patient outcomes ,Testicular cancer -- Patient outcomes ,Life expectancy -- Research ,Cancer -- Care and treatment ,Cancer -- Models ,Cancer -- Patient outcomes ,Cancer -- Research ,Health - Published
- 2008
13. Evaluating cluster alarms: a space-time scan statistic and brain cancer in Los Alamos, New Mexico
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Kulldorff, Martin, Athas, William F., Feuer, Eric J., Miller, Barry A., and Key, Charles R.
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Epidemiological research -- Methods ,Cluster analysis -- Usage ,Brain cancer -- Statistics ,Government ,Health care industry - Abstract
Objectives. This article presents a space-time scan statistic, useful for evaluating space4rne cluster alarms, and illustrates the method on a recent brain cancer cluster alarm in Los Alamos, NM. Methods. The space-time scan statistic accounts for the preselection bias and multiple testing inherent in a cluster alarm. Confounders and time trends can be adjusted for. Results. The observed excess of brain cancer in Los Alamos was not statistically significant. Conclusions. The space-time scan statistic is useful as a screening tool for evaluating which cluster alarms merit further investigation and which clusters are probably chance occurrences. (Am J Public Health. 1998;88:1377-1380)
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- 1998
14. Reconstructing PSA testing patterns between black and white men in the US from Medicare claims and the National Health Interview Survey
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Mariotto, Angela B., Etzioni, Ruth, Krapcho, Martin, and Feuer, Eric J.
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Prostate cancer -- Diagnosis ,Medicare -- Evaluation ,Immune system -- Testing ,Immune system -- Forecasts and trends ,Immune system -- Research ,Cancer -- Diagnosis ,Cancer -- Forecasts and trends ,Market trend/market analysis ,Health - Published
- 2007
15. A new method of estimating United States and state-level cancer incidence counts for the current calendar year
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Pickle, Linda W., Hao, Yongping, Jemal, Ahmedin, Zou, Zhaohui, Tiwari, Ram C., Ward, Elizabeth, Hachey, Mark, Howe, Holly L., and Feuer, Eric J.
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Cancer -- Reports ,Cancer -- Research ,Cancer -- Demographic aspects ,Mortality -- United States ,Mortality -- Reports ,Mortality -- Causes of ,Health ,American Cancer Society -- Reports - Published
- 2007
16. The effect of Medicare reimbursement for screening mammography on utilization and payment
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Breen, Nancy, Feuer, Eric J., Depuy, Scott, and Zapka, Jane
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Mammography -- Usage ,Health promotion -- Evaluation ,Medicare -- Usage - Abstract
In January 1991, when Medicare introduced a new benefit, reimbursement for mammograms used to screen for breast cancer, the National Cancer Institute (NCI) saw an opportunity to observe an unplanned […]
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- 1997
17. Estimates of long-term survival for newly diagnosed cancer patients: a projection approach
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Mariotto, Angela B., Wesley, Margaret N., Cronin, Kathleen A., Johnson, Karen A., and Feuer, Eric J.
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Cancer -- Patient outcomes ,Cancer patients -- Prognosis ,Health - Published
- 2006
18. Racial/ethnic patterns in lifetime and age-conditional risk estimates for selected cancers
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Miller, Barry A., Scoppa, Steven M., and Feuer, Eric J.
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Cancer -- Risk factors ,Cancer -- Demographic aspects ,Cancer patients -- Demographic aspects ,Ethnic groups -- Health aspects ,Ethnic groups -- Research ,Health - Published
- 2006
19. Cancer statistics, 2005
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Jemal, Ahmedin, Murray, Taylor, Ward, Elizabeth, Samuels, Alicia, Tiwari, Ram, Ghafoor Asma, Feuer, Eric J., and Thun, Michael J.
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Public health -- Statistics ,Mortality -- Statistics ,Mortality -- United States ,Cancer -- Statistics ,Health - Published
- 2005
20. A new method of predicting US and state-level cancer mortality counts for the current calendar year
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Tiwari, Ram C., Ghosh, Kaushik, Jemal, Ahmedin, Hachey, Mark, Ward, Elizabeth, Thun, Michael J., and Feuer, Eric J.
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Health - Published
- 2004
21. Cancer statistics, 2004
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Jemal, Ahmedin, Tiwari, Ram C., Murray, Taylor, Ghafoor, Asma, Samuels, Alicia, Ward, Elizabeth, Feuer, Eric J., and Thun, Michael J.
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Mortality -- Statistics ,Mortality -- United States ,Cancer -- Statistics ,Cancer -- Diagnosis ,Cancer -- Patient outcomes ,Health ,American Cancer Society -- Reports - Published
- 2004
22. The prevalence of patients with colorectal carcinoma under care in the U.S
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Mariotto, Angela, Warren, Joan L., Knopf, Kevin B., and Feuer, Eric J.
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Terminal care -- Reports ,Colorectal cancer -- Risk factors ,Colorectal cancer -- Care and treatment ,Health - Published
- 2003
23. On the use of cause-specific failure and conditional failure probabilities: examples from clinical oncology data
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Gaynor, Jeffrey J., Feuer, Eric J., Tan, Claire C., Wu, Danny H., Little, Claudia R., Straus, David J., Clarkson, Bayard D., and Brennan, Murray F.
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Cancer -- Prognosis ,Failure time data analysis -- Usage ,Prognosis -- Statistics ,Mathematics - Abstract
The use of various nonparametric techniques in the analysis of cause-specific failure time data as it pertains to examples from clinical oncology data is clarified. Problems in using one minus Kaplan-Meier (KM) estimator (1-KM) in analyzing data are examined. The use of a cause-specific estimate that does not require an independent assumption would be more practical in determining probabilities.
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- 1993
24. On the use of cause-specific failure and conditional failure probabilities: examples from clinical oncology data
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Gaynor, Jeffrey J., Feuer, Eric J., Tan, Claire C., Wu, Danny H., Little, Claudia R., Straus, David J., Clarkson, Bayard D., and Brennan, Murray F.
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Sarcoma -- Care and treatment ,Leukemia -- Care and treatment ,Cancer -- Care and treatment ,Mathematics ,Memorial Sloan-Kettering Cancer Center - Abstract
Nonparametric maximum likelihood estimation of the probability of failing from a particular cause by time t in the presence of other acting causes (i.e., the cause-specific failure probability) is discussed. A commonly used incorrect approach is to take 1 minus the Kaplan-Meier (KM) estimator (1 - KM), whereby patients who fail of extraneous causes are treated as censored observations. Examples showing the extent of bias in using the 1-KM approach are presented using clinical oncology data. This bias can be quite large if the data are uncensored or if a large percentage of patients fail from extraneous causes prior to the occurrence of failures from the cause of interest. Each cause-specific failure probability is mathematically defined as a function of all of the cause-specific hazards. Therefore, nonparametric estimates of the cause-specific failure probabilities may not be able to identify categorized covariate effects on the cause-specific hazards. These effects would be correctly identified by cause-specific cumulative hazard or KM plots in which the extraneous causes of failure are treated as censored observations. Examples are provided. Finally, nonparametric graphical representation of the two distinct cause-specific failure components of the mixture model (i.e., the probability of ever failing from a particular cause and the time-to-failure distribution given that a patient will fail of that cause) are presented. The difficulty in extrapolating the nonparametric estimates beyond the range of observed failure times is highlighted. In addition, the mathematical relationship of a single covariate z and the two cause-specific failure components is shown for the case where z acts multiplicatively on the cause-specific hazards. Examples are considered using the important prognostic factors in adult soft tissue sarcoma (STS) of the extremity and adult acute lymphoblastic leukemia (ALL). In each of the mathematical and actual examples considered, the characteristic that was associated with a higher hazard rate of failure from the disease was also associated with a higher probability of ever failing from the disease as well as a shorter time-to-failure distribution given that failure due to the disease will occur. Thus it may be quite common in chronic disease situations to find prognosticators that are associated with both cause-specific failure components. KEY WORDS: Cause-specific failure probability; Cause-specific hazard; Conditional failure probability; Cumulative hazard; Mixture model; Nonparametric estimates., 1. INTRODUCTION Methods for the analysis of cause-specific failure data in a clinical or an epidemiological setting have been developed by Crowley and Hu (1977), Holt (1978), Prentice et al. [...]
- Published
- 1993
25. Trends in use of adjuvant multi-agent chemotherapy and tamoxifen for breast cancer in the United States: 1975-1999
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Mariotto, Angela, Feuer, Eric J., Harlan, Linda C., Wun, Lap-Ming, Johnson, Karen A., and Abrams, Jeffrey
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Breast cancer -- Care and treatment ,Tamoxifen -- Evaluation ,Tamoxifen -- Dosage and administration ,Communication in medicine -- Observations ,Health - Abstract
Background: Understanding trends in the dissemination of findings from clinical research can help in estimating their population-level benefits. We evaluated trends in the use of adjuvant multi-agent chemotherapy, tamoxifen, and the combination of both treatments for early-stage breast cancer in the United States from 1975 through 1999. Methods: Data on treatment of 217508 patients diagnosed from 1975 through 1999 with stages I, II, and IIIA breast cancer were obtained from eight registries of the Surveillance, Epidemiology, and End Results (SEER) Program. Models of dissemination were developed from these data after adjustment based on information from a series of population-based Patterns of Care (POC) studies that randomly selected case patients from the SEER registries. The POC studies included 7116 patients diagnosed from 1987 through 1991 and in 1995 who were eliminated from the SEER data used in this analysis. Results: The modeled disseminations were generally compatible with the POC-observed proportions of each treatment. The use of multi-agent chemotherapy was higher among premenopausal women, and the use of tamoxifen was higher among postmenopausal women. The use of multi-agent chemotherapy for postmenopausal women diagnosed with lymph node-positive stage II+ or stage IIIA cancer reached a peak in 1983 and then decreased through 1986, indicating its substitution with tamoxifen. After 1986, the combined use of multi-agent chemotherapy and tamoxifen increased for almost all stages and ages. After the early 1990s, tamoxifen use in postmenopausal women with stage II+ or stage III breast cancer declined. Conclusions: The observed dissemination patterns suggest that the results of clinical trials are disseminated fairly rapidly to community-based physicians and their patients. [J Natl Cancer Inst 2002;94:1626-34]
- Published
- 2002
26. Impact of reporting delay and reporting error on cancer incidence rates and trends
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Clegg, Limin X., Feuer, Eric J., Midthune, Douglas N., Fay, Michael P., and Hankey, Benjamin F.
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Cancer -- Diagnosis ,Health - Abstract
Background: Cancer incidence rates and trends are a measure of the cancer burden in the general population. We studied the impact of reporting delay and reporting error on incidence rates and trends for cancers of the female breast, colorectal, lung/bronchus, prostate, and melanoma. Methods: Based on statistical models, we obtained reporting-adjusted (i.e., adjusted for both reporting delay and reporting error) case counts for each diagnosis year beginning in 1981 using reporting information for patients diagnosed with cancer in 1981-1998 from nine cancer registries that participate in the Surveillance, Epidemiology, and End Results (SEER) program. Joinpoint linear regression was used for trend analysis. All statistical tests are two-sided. Results: Initial incidence case counts (i.e., after the standard 2-year delay) accounted for only 88%-97% of the estimated final counts; it would take 4-17 years for 99% or more of the cancer cases to be reported. The percent change between reporting-adjusted and unadjusted cancer incidence rates for the 1998 diagnosis year ranged from 3% for colorectal cancers to 14% for melanoma in whites and for prostate cancer in black males. Reporting-adjusted current incidence trends for breast cancer and lung/bronchus cancer in white females showed statistically significant increases (estimated annual percent change [EAPC] = 0.6%, 95% confidence interval [CI] = 0.1% to 1.2%) and 1.2%, 95% CI = 0.7% to 1.6%, respectively), whereas trends for these cancers using unadjusted incidence rates were not statistically significantly different from zero (EAPC = 0.4%, 95% CI = -0.1% to 0.9% and 0.5%, 95% CI = -0.1% to 1.1%, respectively). Reporting-adjusted melanoma incidence rates for white males showed a statistically significant increase since 1981 (EAPC = 4.1%, 95% CI = 3.8% to 4.4%) in contrast to the unadjusted incidence rate, which was most consistent with a flat or downward trend (EAPC = -4.2%, 95% CI = -11.1% to 3.3 %) after 1996. Conclusions: Reporting-adjusted cancer incidence rates are valuable in precisely determining current cancer incidence rates and trends and in monitoring the timeliness of data collection. Ignoring reporting delay and reporting error may produce downwardly biased cancer incidence trends, particularly in the most recent diagnosis years.
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- 2002
27. Modeling the impact of the decline in distant stage disease on prostate carcinoma mortality rates
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Feuer, Eric J., Mariotto, Angela, and Merrill, Ray
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Prostate cancer -- Patient outcomes ,Health - Published
- 2002
28. Overdiagnosis due to prostate-specific antigen screening: lessons from U.S. prostate cancer incidence trends
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Etzioni, Ruth, Penson, David F., Legler, Julie M., di Tommaso, Dante, Boer, Rob, Gann, Peter H., and Feuer, Eric J.
- Subjects
Prostate cancer -- Diagnosis ,Prostate-specific antigen ,Diagnostic errors -- Analysis ,Health - Abstract
Background: Overdiagnosis of clinically insignificant prostate cancer is considered a major potential drawback of prostate-specific antigen (PSA) screening. Quantitative estimates of the magnitude of this problem are, however, lacking. We estimated rates of prostate cancer overdiagnosis due to PSA testing that are consistent with the observed incidence of prostate cancer in the United States from 1988 through 1998. Overdiagnosis was defined as the detection of prostate cancer through PSA testing that otherwise would not have been diagnosed within the patient's lifetime. Methods: We developed a computer simulation model of PSA testing and subsequent prostate cancer diagnosis and death from prostate cancer among a hypothetical cohort of two million men who were 60-84 years old in 1988. Given values for the expected lead time--that is, the time by which the test advanced diagnosis--and the expected incidence of prostate cancer in the absence of PSA testing, the model projected the increase in population incidence of prostate cancer associated with PSA testing. By comparing the model-projected incidence with the observed incidence derived from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registry data, we determined the lead times and corresponding overdiagnosis rates that were consistent with the observed data. Results: SEER data on prostate cancer incidence from 1988 through 1998 were consistent with overdiagnosis rates of approximately 29% for whites and 44 % for blacks among men with prostate cancers detected by PSA screening. Conclusions: Among men with prostate cancer that would be detected only at autopsy, these rates correspond to overdiagnosis rates of, at most, 15% in whites and 37% in blacks. The observed trends in prostate cancer incidence are consistent with considerable overdiagnosis among PSA-detected cases. However, the results suggest that the majority of screen-detected cancers diagnosed between 1988 and 1998 would have presented clinically and that only a minority of cases found at autopsy would have been detected by PSA testing. [J Natl Cancer Inst 2002;94: 981-90]
- Published
- 2002
29. Changing area socioeconomic patterns in U.S. cancer mortality, 1950-1998: Part I--all cancers among men
- Author
-
Singh, Gopal K., Miller, Barry A., Hankey, Benjamin F., Feuer, Eric J., and Pickle, Linda W.
- Subjects
Cancer -- Patient outcomes ,Men -- Patient outcomes ,Prevalence studies (Epidemiology) -- Analysis ,Social status -- Health aspects ,Health - Abstract
Background: Area socioeconomic deprivation indices are widely used to monitor health disparities in Europe. However, such indices have not been used in cancer surveillance in the United States. We developed an area socioeconomic index to examine area socioeconomic patterns in all-cancer mortality among U.S. men between 1950 and 1998. Methods: Principal components analysis on 11 census variables was used to develop an area socioeconomic index that was then used to stratify all U.S. counties into one of five socioeconomic categories. The index was linked to 1950-1998 county mortality data to generate annual mortality rates for each area socioeconomic group. Joinpoint regression analysis was used to model mortality trends, and Poisson regression analysis was used to estimate socioeconomic gradients in mortality over time. Results: Area socioeconomic patterns in U.S. male cancer mortality changed dramatically between 1950 and 1998. Throughout the 1950s and 1960s, there was a positive socioeconomic gradient, with higher cancer mortality rates in high area socioeconomic groups than in low area socioeconomic groups. For example, in 1950-1952, cancer mortality was 49% (95% confidence interval [CI] = 41% to 59%) greater in the highest area socioeconomic group than in the lowest. The positive gradient narrowed in the 1970s, and by the late 1980s, socioeconomic differences in cancer mortality began to reverse and widen. In 1997-1998, cancer mortality was 19% (95% CI = 11% to 28%) higher in the lowest area socioeconomic group than in the highest. Gradients were steeper for men aged 25-64 years than for men aged 65 years or older. Conclusions: Socioeconomic patterns in male cancer mortality have reversed over time in the United States. Area socioeconomic indices could serve as a powerful surveillance tool for monitoring health disparities in cancer outcomes. [J Natl Cancer Inst 2002;94:904-15]
- Published
- 2002
30. Prognostic significance of in situ carcinoma associated with invasive breast carcinoma: a natural experiment in cancer immunology?
- Author
-
Black, Maurice M., Zachrau, Reinhard E., Hankey, Benjamin F., and Feuer, Eric J.
- Subjects
Breast cancer -- Prognosis ,Cancer -- Physiological aspects ,Health - Published
- 1996
31. The lifetime risk of developing breast cancer
- Author
-
Feuer, Eric J., Wun Lap-Ming, Boring, Catherine C., Flanders, W. Dana, Timmel, Marilyn J., and Tong, Tony
- Subjects
Breast cancer -- Risk factors ,Disease susceptibility -- Research ,Health - Abstract
Background: The lifetime risk of developing breast cancer in U.S. women, often quoted as one in nine, is a commonly cited cancer statistic. However, many estimates have used cancer rates derived from total rather than the cancer-free population and have not properly accounted for multiple cancers in the same individual. Purpose: Our purpose was to provide a revised method for calculating estimates of the lifetime risk of developing breast cancer and to aid in interpretation of the estimates. Methods: A multiple decrement life table was derived by applying age-specific incidence and mortality rates from cross-sectional data to a hypothetical cohort of women. Incidence, mortality, and population data from 1975-1988 were used, representing the geographic areas of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. The incidence rates reflected only the First breast primary cancer; mortality rates reflected causes other than breast cancer. The population denominator used in calculating incidence rates was adjusted to reflect only those women without previously diagnosed breast cancers in the hypothetical cohort. Results: Our calculations showed an overall lifetime risk for developing invasive breast cancer of approximately one in eight with use of 1987-1988 SEER data, although up to age 85, it was still the commonly quoted one in nine. Conclusion: Our estimate was calculated assuming constant age-specific rates derived from 1987-1988 SEER data. Because incidence and mortality rates change over time, conditional risk estimates over the short term (10 or 20 years) may be more reliable. A large portion of the rise in the lifetime risk of breast cancer estimated using 1975-1977 data (one in 10.6) to an estimate using 1987-1988 data (one in eight) may be attributed to 1) early detection of prevalent cases due to increased use of mammographic screening and 2) lower mortality due to causes other than breast cancer. A common misperception is that the lifetime risk estimate assumes that all women live to a particular age (e.g., 85 or 95). In fact, the calculation assumes that women can die from causes other than breast cancer at any possible age. Cutting off the lifetime risk calculation at age 85 assumes that no women develop breast cancer after that age. While the lifetime risk of developing breast cancer rose over the period 1976-1977 to 1987-1988, the lifetime risk of dying of breast cancer increased from one in 30 to one in 28, reflecting generally flat mortality trends.
- Published
- 1993
32. Recent incidence trends for breast cancer in women and the relevance of early detection: an update
- Author
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Miller, Barry A., Feuer, Eric J., and Hankey, Benjamin F.
- Subjects
Breast cancer -- Statistics ,Health - Published
- 1993
33. Breast cancer screening among women from 65 to 74 years of age in 1987-88 and 1991
- Author
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Coleman, Elizabeth Ann and Feuer, Eric J.
- Subjects
Breast cancer -- Diagnosis ,Mammography -- Usage ,Health - Abstract
Mammography among older women aged 65 to 74 increased significantly from 1987-88 to 1991, but clinical breast examination decreased over the same period. While older women have twice the breast cancer mortality rate of younger women and although studies suggest breast cancer screening is more effective in older women, they are still less likely to undergo mammography and clinical breast examination than younger women. A study comparing surveys of mammography and clinical breast examination use among older women in five different areas of the US found mammography use increased from 19% to 33% in 1987-88 to 35% to 59% in 1988. However, clinical breast examination use decreased from 95% to 85% among women who had had a mammogram. To be most effective, breast cancer screening should include mammography, clinical breast examination and a third method not surveyed, breast self examination.
- Published
- 1992
34. Changing trends in U.S. prostate cancer incidence rates
- Author
-
Merrill, Ray M., Potosky, Arnold L., and Feuer, Eric J.
- Subjects
Prostate cancer -- Demographic aspects ,Health - Published
- 1996
35. Trends in the surgical treatment of ductal carcinoma in situ of the breast
- Author
-
Coleman, Elizabeth Ann, Kessler, Larry G., Wun, Lap-Ming, and Feuer, Eric J.
- Subjects
Breast cancer ,Mastectomy -- Statistics ,Lumpectomy -- Statistics ,Health - Published
- 1992
36. The Effect of Medicare Reimbursement for Screening Mammography on Utilization and Payment
- Author
-
Breen, Nancy, Feuer, Eric J., Depuy, Scott, and Zapka, Jane
- Abstract
In January 1991, when Medicare introduced a new benefit, reimbursement for mammograms used to screen for breast cancer, the National Cancer Institute (NCI) saw an opportunity to observe an unplanned […]
- Published
- 1997
37. Cancer Surveillance Series: Interpreting Trends in Prostate Cancer--Part I: Evidence of the Effects of Screening in Recent Prostate Cancer Incidence, Mortality, and Survival Rates
- Author
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Hankey, Benjamin F., Feuer, Eric J., Clegg, Limin X., Hayes, Richard B., Legler, Julie M., Prorok, Phillip C., Ries, Lynn A., Merrill, Ray M., and Kaplan, Richard S.
- Subjects
Prostate cancer -- Statistics ,Prostate-specific antigen ,Health - Abstract
Background: The prostate-specific antigen test was approved by the U.S. Food and Drug Administration in 1986 to monitor the disease status in patients with prostate cancer and, in 1994, to aid in prostate cancer detection. However, after 1986, the test was performed on many men who had not been previously diagnosed with prostate cancer, apparently resulting in the diagnosis of a substantial number of early tumors. Our purpose is to provide insight into the effect of screening on prostate cancer rates. Detailed data are presented for whites because the size of the population allows for calculating statistically reliable rates; however, similar overall trends are seen for African-Americans and other races. Methods: Prostate cancer incidence data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program and mortality data from the National Center for Health Statistics were analyzed. Results/ Conclusions: The following findings are consistent with a screening effect: 1) the recent decrease since 1991 in the incidence of distant stage disease, after not having been perturbed by screening; 2) the decline in the incidence of earlier stage disease beginning the following year (i.e., 1992); 3) the recent increases and decreases in prostate cancer incidence and mortality by age that appear to indicate a calendar period effect; and 4) trends in the incidence of distant stage disease by tumor grade and trends in the survival of patients with distant stage disease by calendar year that provide suggestive evidence of the tendency of screening to detect slower growing tumors. Implications: The decline in the incidence of distant stage disease holds the promise that testing for prostate-specific antigen may lead to a sustained decline in prostate cancer mortality. However, population data are complex, and it is difficult to confidently attribute relatively small changes in mortality to any one cause. [J Natl Cancer Inst 1999;91:1017-24]
- Published
- 1999
38. Cancer Surveillance Series: Interpreting Trends in Prostate Cancer--Part III: Quantifying the Link Between Population Prostate-Specific Antigen Testing and Recent Declines in Prostate Cancer Mortality
- Author
-
Etzioni, Ruth, Legler, Julie M., Feuer, Eric J., Merrill, Ray M., Cronin, Kathleen A., and Hankey, Benjamin F.
- Subjects
Prostate-specific antigen ,Prostate cancer -- Patient outcomes ,Health - Abstract
Background: The objective of this study was to investigate the circumstances under which dissemination of prostate-specific antigen (PSA) testing, beginning in 1988, could plausibly explain the declines in prostate cancer mortality observed from 1992 through 1994. Methods: We developed a computer simulation model by use of information on population-based PSA testing patterns, cancer detection rates, average lead time (the time by which diagnosis is advanced by screening), and projected decreased risk of death associated with early diagnosis of prostate cancer through PSA testing. The model provides estimates of the number of deaths prevented by PSA testing for the 7-year period from 1988 through 1994 and projects what prostate cancer mortality for these years would have been in the absence of PSA testing. Results: Results were generated by assuming a level of screening efficacy similar to that hypothesized for the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Under this assumption, the projected mortality in the absence of PSA testing continued the increasing trend observed before 1991 only when it was assumed that the mean lead time was 3 years or less. Projected mortality trends in the absence of PSA screening were not consistent with pre-1991 increasing trends for lead times of 5 years and 7 years. Conclusions: When screening is assumed to be at least as efficacious as hypothesized in the PLCO trial, it is unlikely that the entire decline in prostate cancer mortality can be explained by PSA testing based on current beliefs concerning lead time. Only very short lead times,would produce a decline in mortality of the magnitude that has been observed. [J Natl Cancer Inst 1999;91:1033-9]
- Published
- 1999
39. Cancer Surveillance Series: Interpreting Trends in Prostate Cancer--Part II: Cause of Death Misclassification and the Recent Rise and Fall in Prostate Cancer Mortality
- Author
-
Feuer, Eric J., Merrill, Ray M., and Hankey, Benjamin F.
- Subjects
Prostate cancer -- Patient outcomes ,Health - Abstract
Background. The rise and fall of prostate cancer mortality correspond closely to the rise and fall of newly diagnosed cases. To understand this phenomenon, we explored the role that screening, treatment, iatrogenic (i.e., treatment-induced) deaths, and attribution bias (incorrect labeling of death from other causes as death from prostate cancer) have played in recent mortality trends. Methods. Join point regression is utilized to assess the recent rise and fall in mortality and the relationship of total U.S. trends to those areas served by the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Cancer Registry Program. Incidence-based mortality (IBM) is estimated with the use of prostate cancer data from the SEER Program to partition (from overall prostate cancer mortality trends) the contribution of cases diagnosed since the widespread use of prostate-specific antigen (PSA) testing starting in 1987. IBM is also used to examine the contribution of stage at diagnosis to the recent prostate cancer mortality trends. Results. IBM for cases diagnosed since 1987 rose above the pre-1987 secular (i.e., background) trend, peaked in the early 1990s, and almost returned to the secular trend by 1994. This rise and fall of IBM track with the pool of prevalent cases diagnosed within the prior 2 years. IBM for cases diagnosed with metastatic disease fell starting in 1991, while IBM for those diagnosed with localized/regional disease was relatively flat. Conclusions. The rise and fall in prostate cancer mortality observed since the introduction of PSA testing in the general population are consistent with a hypothesis that a fixed percent of the rising and falling pool of recently diagnosed patients who die of other causes may be mislabeled as dying of prostate cancer. The decline in IBM for distant stage disease and flat IBM trends for localized/regional disease provide some evidence of improved prognosis for screen-detected cases, although alternative interpretations are possible. [J Natl Cancer Inst 1999;91:1025-32]
- Published
- 1999
40. A statistical model validating triage for the peer review process: keeping the competitive applications in the review pipeline
- Author
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Vener, Kirt J., Feuer, Eric J., and Gorelic, Lester
- Subjects
Peer review -- Evaluation ,Peer review of research grant proposals -- Evaluation ,Business ,Evaluation - Abstract
Triage of grant applications at the National Institutes of Health (NIH) is a process whereby an initial screening of applications by a scientific peer review group eliminates applications that are not competitive for awards. The process of application triage has been limited to those applications submitted to the NIH in response to an RFA (Request for Applications). A hypergeometric model was developed to determine the extent to which five, six, seven, or eight member triage teams or subsets of 12- to 20-member full committees could provide a statistically defensible triage decision. Although the intent of triage is to remove from review those applications which are noncompetitive, the model was weighted in favor of the applicant to minimize the likelihood that highly competitive applications would be eliminated. Within the assumptions and rules developed, it was determined that there was little likelihood that the latter would occur. For example, in the worst case scenario, the greatest probability that a highly competitive application would be knocked out of competition is P [is less than or equal to] 0.014 in the case of a five-member triage subset of a 20-member committee. Using the latter case, the model was tested on a set of 73 applications that were submitted to the National Cancer Institute for action at the February 1993 National Cancer Advisory Board. The model selected for triage required that each application be assigned to five reviewers, that each reviewer be blinded to the review assignments of the other reviewers, and that four noncompetitive votes be registered to triage out an application. Each of 19 applications received four to five noncompetitive votes, and were triaged out of the review process. The remaining 54 applications were then reviewed according to the usual NIH review process. Four of the applications received three noncompetitive triage votes each and were either rated as not recommended for further consideration (NRF, n = 2) or received priority scores [is greater than or equal to] 250 (n = 2). (The smaller the priority score the better the technical merit.) Thirteen of the 53 applications received two noncompetitive votes. Of the latter, two were not recommended for further consideration and the remaining 11 received priority scores in excess of 200. The distribution of competitive applications was such that funding was limited to those applications with priority scores of less than 190. Thus, the data suggest that the conservative model is valid such that the likelihood of eliminating a highly competitive application from consideration for funding is remotely small. With this model, the process triage is fair to applicants on the one hand and is also effective in reducing consultant workloads on the other. The model could be applied to many different types of review situations (private sponsors as well as federal), especially when few awards are to be issued relative to the number of competing applications., Kirt J. Vener is chief of the Prevention, Epidemiology and Control Review Section, National Cancer Institute; Eric J. Feuer is mathematical statistician in the Division of Cancer Prevention and Control, [...]
- Published
- 1994
41. On the use of survival analysis techniques to estimate medical care costs
- Author
-
Etzioni, Ruth D., Feuer, Eric J., Sullivan, Sean D., Lin, Danyu, Hu, Chengcheng, and Ramsey, Scott D.
- Subjects
Health care industry -- Management ,Health services administration -- Methods ,Business ,Economics ,Health care industry - Abstract
Survival analysis techniques are inappropriate methods in estimating the cost of health care. The use of the technique can result in dependent censoring that will increase the cost estimates derived by the Kaplan-Meier method and prejudice the figures used in multivariate Cox regressions. Survival analysis, which tends to make Kaplan-Meier-derived costing hard to interpret when survival is over the maximal censoring time, could also violate basic assumptions in proportional hazards with the use of Cox regression models on medical cost data.
- Published
- 1999
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