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Méthodes d'Estimation de la SUrvie RElative
Funder: French National Research Agency (ANR)Project code: ANR-09-BLAN-0357

Methods of estimation of additional mortality due to cancer aim at estimating and modelling the excess mortality to which a studied group of patient's cancer is subjected and at estimating their relative survival (i.e. the survival corrected for all the other causes of death). In this context, the objective of the modelling is to estimate the impact of prognostic factors on the excess mortality risk and to assess the cure rate in different subgroups of patients. These methods are used in order to produce statistics concerning survival of patients with cancer, estimated from population-based data collected by cancer registries. In France, population-based cancer registration is carried out on a Departmental level. These registries are grouped together in the FRANCIM network, for which one of the topic of its research program in cancer epidemiology focus on the estimation of the survival of cancer's patients in France. In order to achieve this, data of cancer registries have been pooled in a common database localised in the Service de Biostatistiques des Hospices Civils de Lyon. These statistics are analysed regularly and published by the different European countries and comparisons between countries are justified only if the methods used for that have taken into account bias relative of observational studies and if they are the result of a thought and a strategy adopted by all the partners. The development and the homogenisation of such methodology are totally justified in this context. The objective of this project is to provide a more complete set of analytic tools to estimate cancer survival and to assess the public health implications of these estimates. The research will produce a range of new clinical and public health insights from cancer survival data. We propose to explore and to address two complementary themes: - Improvements in cancer relative survival analysis methodology: extension of methods developed for censored data to the framework of relative survival analysis; - Creation of a 'standardized' approach for estimating cancer survival in France, or even in Europe, using Registry data. This project will allow for the creation of a network including 5 French partners, having complementarities and experience in the framework of the analysis of mortality due to cancer and the development of statistical methods. Two European partners and one Canadian, internationally known, will participate to this project as external members. The project is divided into 3 work packages: WP1: Comparison of the actual methods used to estimate relative survival WP2: Extension and development of statistical methods used to estimate relative survival. This necessitate (i) statistical researches to deal with the important remaining issues, and (ii) to develop statistical programs to perform relative survival analyses using approaches studied and developed in this project. WP3: Production of guidelines for cancer survival analysis with population-based data, answering to public health considerations The performances of the estimators of these new models will be assessed by simulations. Applications based on real data will be used to illustrate these new approaches and for the elaboration of guidelines. Data will be provided by some French cancer registries and by our European partners. Specific works are defined for each partner who will produce specific deliverables. If the project goes on well, it will allow to propose an adapted methodology in order to obtain correct estimates of the excess mortality due to cancer and to its determinants. This methodological approach is a preliminary condition for a rational management of such disease, on its medical and socio-economic aspects, that will be obtained from registries data.

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