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    Dutch DisMod for several types of cancer

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    Authors
    Hoogenveen RT
    Gijsen R
    Kruijshaar ME
    Type
    Report
    Language
    en
    
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    Title
    Dutch DisMod for several types of cancer
    Translated Title
    Nederlandse DisMod voor verschillende vormen van kanker
    Publiekssamenvatting
    Om te komen tot consistente verzamelingen van invoergegevens voor dynamische modellen van verschillende belangrijke vormen van kanker, hebben we de consistentie geanalyseerd van gegevens over incidentie, prevalentie en sterfte. Het gebruikte model betreft een zogenaamd 'two-state' transitiemodel. Dit model beschrijft de prevalentie en ziekte-specifieke sterfte van een cohort over de tijd als functie van de incidentie en ziekte-gerelateerde 'excess' sterfte. Regionale prevalentie- en overlevingsgegevens waren afkomstig van IKZ, landelijke incidentiegegevens van NKR, en landelijke geregistreerde sterftecijfers van CBS. We hebben de analyses uitgevoerd voor long-, endeldarm-, dikke darm, maag-, slokdarm-, borst- en prostaatkanker. De berekende en empirische prevalentiecijfers kwamen telkens goed overeen, behalve voor longkanker (vrouwen), borst- en prostaat-kanker. We hebben verschillende mogelijke verklaringen voor deze verschillen gevonden. Deze verklaringen waren: dubbeltellingen in geval van multipele tumoren, verschillen tussen regionale en landelijke ziektecijfers, en trends over de tijd in de incidentie. Correctie hiervoor leidde inderdaad tot kleinere verschillen voor de genoemde kankervormen.Ook de berekende en empirische sterftecijfers kwamen telkens goed overeen. Uitzonderingen hierop waren de minder letale vormen van kanker, i.e. endeldarm- en borstkanker. Hier werd de empirische sterfte overschat. Naast de drie eerdergenoemde mogelijke verklaringen kunnen hier ook concurrerende doodsoorzaken een rol spelen. Deze verklaring is voor de twee genoemde kankervormen ook in de literatuur teruggevonden.<br>
    Using the simulation model context we checked the consistency of incidence, prevalence and mortality data for specific types of cancer so as to construct an appropriate data set for chronic disease modelling. The data sources used were IKZ for regional cancer prevalence rates and survival proportions, NKR for national incidence rates, and CBS for national registered cause-specific mortality rates. Consistency checks were made for lung, rectal, colon, stomach, oesophagus, breast and prostate cancer. Using national incidence rates and regional survival proportions and a two-state transition model, we calculated prevalence and population mortality rates. We compared the calculated rates to empirical ones. For most types of cancer the calculated prevalence rates fitted well to the empirical ones, except for lung cancer (females), breast and prostate cancer. We found several possible explanations for these differences. The first one was double counts in case of multiple tumours. Based on data we corrected for double counts for breast cancer. The second explanation was differences between regional and national morbidity figures. This was confirmed for lung cancer (females) and prostate cancer. The third explanation was past trends in disease incidence. Correcting for these trends resulted in smaller differences for lung cancer (females), breast and prostate cancer. The calculated mortality rates fitted well to the empirical ones for the lethal types of cancer, but less well for those types of cancer with better prognosis, namely rectal, breast and prostate cancer. These differences could be explained by competing death risks. Several studies have confirmed this explanation.<br>
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
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