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Competing risks analysis in mortality estimation for breast cancer patients from independent risk groups

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Abstract

This study quantifies breast cancer mortality in the presence of competing risks for complex patients. Breast cancer behaves differently in different patient populations, which can have significant implications for patient survival; hence these differences must be considered when making screening and treatment decisions. Mortality estimation for breast cancer patients has been a significant research question. Accurate estimation is critical for clinical decision making, including recommendations. In this study, a competing risks framework is built to analyze the effect of patient risk factors and cancer characteristics on breast cancer and other cause mortality. To estimate mortality probabilities from breast cancer and other causes as a function of not only the patient’s age or race but also biomarkers for estrogen and progesterone receptor status, a nonparametric cumulative incidence function is formulated using data from the community-based Carolina Mammography Registry. Based on the log(−log) transformation, confidence intervals are constructed for mortality estimates over time. To compare mortality probabilities in two independent risk groups at a given time, a method with improved power is formulated using the log(−log) transformation.

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Authors and Affiliations

  1. Department of Industrial Engineering, University of Arkansas, Fayetteville, AR, 72701, USA

    Shengfan Zhang

  2. Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, 27695, USA

    Julie S. Ivy & James R. Wilson

  3. Department of Surgery, Division of Surgery Oncology, University of Michigan Health Systems, Ann Arbor, MI, 48109, USA

    Kathleen M. Diehl

  4. Department of Radiology, School of Medicine, Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7510, USA

    Bonnie C. Yankaskas

Authors
  1. Shengfan Zhang
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  2. Julie S. Ivy
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  3. James R. Wilson
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  4. Kathleen M. Diehl
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  5. Bonnie C. Yankaskas
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Correspondence to Shengfan Zhang.

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Zhang, S., Ivy, J.S., Wilson, J.R. et al. Competing risks analysis in mortality estimation for breast cancer patients from independent risk groups. Health Care Manag Sci 17, 259–269 (2014). https://doi.org/10.1007/s10729-013-9255-x

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  • DOI: https://doi.org/10.1007/s10729-013-9255-x

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