(Tasks Related to the National Health Strategy (IV/651/2022/EKF).)
Population-based, age-standardized net survival estimates provide valuable insights
for comparing the effectiveness of cancer treatment and the prospects of cure in an
international context. Although numerous studies have previously assessed survival,
the choice of life tables may crucially impact the feasibility of such analyses. Therefore,
based on available studies, our aim was to understand the critical influence of life
tables on net survival estimates.Record-level data of approximately 50,000 breast,
cervical, and ovarian cancer patients were extracted from the Hungarian National Cancer
Registry. These patients were diagnosed between 2010 and 2014 and were followed up
until December 31, 2019. Life tables for the Hungarian female population were taken
from the Human Mortality Database, the Human Life-Table Database and were compiled
according to the EUROCARE, CONCORD both multivariable flexible and Ewbank methodology.
Regarding the last due to the lack of specific parameters, simulations were performed
to assess the missing values. The calculation of 5-year age-standardized net survival
using different life tables revealed limitations in the methodology, highlighting
the impact of life table selection on survival estimates.Minor biases were observed
in age-standardized net survival when using life tables from different international
databases. However, the net survival of breast cancer, which had the most favorable
prognosis of the studied malignancies, showed significant discrepancies. Moreover,
this research highlights the extreme sensitivity of the applied κ parameter in the
CONCORD Ewbank method, underscoring the need for careful consideration when applying
this approach.Present study shed light on how the choice of life tables can lead to
differences in survival estimates for the same cancer population. It also emphasizes
the importance of open methodological discussions to improve validity and accuracy
of international comparability.
