Errors in determination of net survival: cause-specific and relative survival settings

Chloe Bright*, Adam R. Brentnall, Kate Wooldrage, Jonathon Myles, Peter Sasieni, Stephen W. Duffy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Background: Cause-specific and relative survival estimates differ. We aimed to examine these differences in common cancers where by possible identifying the most plausible sources of error in each estimate. Methods: Ten-year cause-specific and relative survival were estimated for lung, breast, prostate, ovary, oesophagus and colorectal cancers. The cause-specific survival was corrected for misclassification of cause of death. The Pohar-Perme relative survival estimator was modified by (1) correcting for differences in deaths from ischaemic heart disease (IHD) between cancers and general population; or (2) correcting the population hazard for smoking (lung cancer only). Results: For all cancers except breast and prostate, relative survival was lower than cause-specific. Correction for published error rates in cause of death gave implausible results. Correction for rates of IHD death gave slightly different relative survival estimates for lung, oesophagus and colorectal cancers. For lung cancer, when the population hazard was inflated for smoking, survival estimates were increased. Conclusion: Results agreed with the consensus that relative survival is usually preferable. However, for some cancers, relative survival might be inaccurate (e.g. lung and prostate). Likely solutions include enhancing life tables to include other demographic variables than age and sex, and to stratify relative survival calculation by cause of death.

Original languageEnglish
Pages (from-to)1094-1101
Number of pages8
JournalBritish Journal of Cancer
Issue number7
Publication statusPublished - 31 Mar 2020

Bibliographical note

Publisher Copyright:
© 2020, Crown.


Dive into the research topics of 'Errors in determination of net survival: cause-specific and relative survival settings'. Together they form a unique fingerprint.

Cite this