TY - JOUR
T1 - Number of life-years lost at the time of diagnosis and several years post-diagnosis in patients with solid malignancies
T2 - a population-based study in the Netherlands, 1989–2019
AU - Maas, Carolien C.H.M.
AU - van Klaveren, David
AU - Visser, Otto
AU - Merkx, Matthias A.W.
AU - Lingsma, Hester F.
AU - Lemmens, Valery E.P.P.
AU - Dinmohamed, Avinash G.
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023/6
Y1 - 2023/6
N2 - Background: Loss of life expectancy (LOLE) may provide more intuitive information on the impact of cancer than relative survival over a fixed time horizon (e.g., 5-year relative survival). We aimed to assess the evolution of the LOLE using a nationwide, population-based cohort including patients diagnosed with one of 17 most frequent solid malignancies. Methods: From the Netherlands Cancer Registry, we selected adult patients diagnosed with one of the 17 most frequent solid malignancies in the Netherlands during 1989–2019, with survival follow-up until 2022. We used flexible parametric survival models to estimate the LOLE at diagnosis and the LOLE after surviving several years post-diagnosis (conditional LOLE; CLOLE) by cancer type, calendar year, age, sex, and disease stage. Findings: For all cancers combined, the LOLE consistently decreased from 1989 to 2019. This decrease was most pronounced for males with prostate cancer (e.g., from 6.9 [95% confidence interval [CI], 6.7–7.1] to 2.7 [95% CI, 2.5–3.0] for 65-year-olds) and females with breast cancer (e.g., from 6.6 [95% CI, 6.4–6.7] to 1.9 [95% CI, 1.8–2.0] for 65-year-olds). The LOLE among patients with cancers of the head and neck or the central nervous system remained constant over time. Overall, the CLOLE showed that the life years lost among patients with cancer decreased with each additional year survived post-diagnosis. For example, the LOLE at diagnosis for 65-year-old females diagnosed with breast cancer in 2019 was 1.9 [95% CI, 1.8–2.0] compared with 1.7 [95% CI, 1.6–1.8], 1.0 [95% CI, 0.9–1.1], and 0.5 [95% CI, 0.5–0.6] when surviving one, five, and ten years post-diagnosis, respectively. Estimates for other combinations of patient and tumour characteristics are available in a publicly available web-based application. Interpretation: Our findings suggested that the evolution of LOLE substantially varies across cancer type, age, and disease stage. LOLE estimates help patients better understand the impact of their specific cancer diagnosis on their life expectancy. Funding: None.
AB - Background: Loss of life expectancy (LOLE) may provide more intuitive information on the impact of cancer than relative survival over a fixed time horizon (e.g., 5-year relative survival). We aimed to assess the evolution of the LOLE using a nationwide, population-based cohort including patients diagnosed with one of 17 most frequent solid malignancies. Methods: From the Netherlands Cancer Registry, we selected adult patients diagnosed with one of the 17 most frequent solid malignancies in the Netherlands during 1989–2019, with survival follow-up until 2022. We used flexible parametric survival models to estimate the LOLE at diagnosis and the LOLE after surviving several years post-diagnosis (conditional LOLE; CLOLE) by cancer type, calendar year, age, sex, and disease stage. Findings: For all cancers combined, the LOLE consistently decreased from 1989 to 2019. This decrease was most pronounced for males with prostate cancer (e.g., from 6.9 [95% confidence interval [CI], 6.7–7.1] to 2.7 [95% CI, 2.5–3.0] for 65-year-olds) and females with breast cancer (e.g., from 6.6 [95% CI, 6.4–6.7] to 1.9 [95% CI, 1.8–2.0] for 65-year-olds). The LOLE among patients with cancers of the head and neck or the central nervous system remained constant over time. Overall, the CLOLE showed that the life years lost among patients with cancer decreased with each additional year survived post-diagnosis. For example, the LOLE at diagnosis for 65-year-old females diagnosed with breast cancer in 2019 was 1.9 [95% CI, 1.8–2.0] compared with 1.7 [95% CI, 1.6–1.8], 1.0 [95% CI, 0.9–1.1], and 0.5 [95% CI, 0.5–0.6] when surviving one, five, and ten years post-diagnosis, respectively. Estimates for other combinations of patient and tumour characteristics are available in a publicly available web-based application. Interpretation: Our findings suggested that the evolution of LOLE substantially varies across cancer type, age, and disease stage. LOLE estimates help patients better understand the impact of their specific cancer diagnosis on their life expectancy. Funding: None.
UR - http://www.scopus.com/inward/record.url?scp=85159400201&partnerID=8YFLogxK
U2 - 10.1016/j.eclinm.2023.101994
DO - 10.1016/j.eclinm.2023.101994
M3 - Article
C2 - 37214634
AN - SCOPUS:85159400201
SN - 2589-5370
VL - 60
JO - EClinicalMedicine
JF - EClinicalMedicine
M1 - 101994
ER -