Open Access
September 2018 Estimating and comparing cancer progression risks under varying surveillance protocols
Jane M. Lange, Janet E. Cowan, Lawrence H. Klotz, Ruth Etzioni, Roman Gulati, Amy S. Leonardson, Daniel W. Lin, Lisa F. Newcomb, Bruce J. Trock, H. Ballentine Carter, Peter R. Carroll, Matthew R. Cooperberg
Ann. Appl. Stat. 12(3): 1773-1795 (September 2018). DOI: 10.1214/17-AOAS1130

Abstract

Outcomes after cancer diagnosis and treatment are often observed at discrete times via doctor-patient encounters or specialized diagnostic examinations. Despite their ubiquity as endpoints in cancer studies, such outcomes pose challenges for analysis. In particular, comparisons between studies or patient populations with different surveillance schema may be confounded by differences in visit frequencies. We present a statistical framework based on multistate and hidden Markov models that represents events on a continuous time scale given data with discrete observation times. To demonstrate this framework, we consider the problem of comparing risks of prostate cancer progression across multiple active surveillance cohorts with different surveillance frequencies. We show that the different surveillance schedules partially explain observed differences in the progression risks between cohorts. Our application permits the conclusion that differences in underlying cancer progression risks across cohorts persist after accounting for different surveillance frequencies.

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Jane M. Lange. Janet E. Cowan. Lawrence H. Klotz. Ruth Etzioni. Roman Gulati. Amy S. Leonardson. Daniel W. Lin. Lisa F. Newcomb. Bruce J. Trock. H. Ballentine Carter. Peter R. Carroll. Matthew R. Cooperberg. "Estimating and comparing cancer progression risks under varying surveillance protocols." Ann. Appl. Stat. 12 (3) 1773 - 1795, September 2018. https://doi.org/10.1214/17-AOAS1130

Information

Received: 1 May 2017; Revised: 1 September 2017; Published: September 2018
First available in Project Euclid: 11 September 2018

zbMATH: 06979651
MathSciNet: MR3852697
Digital Object Identifier: 10.1214/17-AOAS1130

Keywords: active surveillance , Hidden Markov model , multistate model , panel data , prostate cancer

Rights: Copyright © 2018 Institute of Mathematical Statistics

Vol.12 • No. 3 • September 2018
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