Analyzing time trends in cancer patient survival using cure fraction models

In population based cancer studies, cure is said to occur when the mortality in the group of cancer patients returns to the same level as that expected in the general population. The cure fraction is of interest to patients and also a useful measure when analyzing trends in cancer patient survival. Recently models have been introduced, so called cure fraction models, that estimates the cure fraction as well as the survival time distribution for those uncured. In this paper cure fraction models are used to analyze time trends in patient survival for colon, rectal and prostate cancer in Finland. Data from the Finnish cancer registry are used. The aim is to evaluate the cure fraction models and compare these methods to other methods used to monitor time trends in cancer patient survival. Although there are some problems with the cure fractions models, they do give valuable information as long as it is reasonable to assume cure. One of the bene ts of these methods compared to other methods is that the cure fraction is not a ected by lead time bias. Acknowledgement. I want to thank my supervisor Dag Jonsson for your help and guidance. Enormous thanks to Paul Dickman at Karolinska Institutet for giving me this opportunity, and for spending precious time on helping me with this project. Many thanks to Paul Lambert at University of Leicester for letting me come to visit and discuss this paper. Also thanks to Sandra Eloranta for encouragement and support.