ArticleCancer causes & control : CCC2024
Avoiding lead-time bias by estimating stage-specific proportions of cancer and non-cancer deaths.
Article in Cancer causes & control : CCC, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Cancer incidence in endogenous hypercortisolism.Journal of endocrinological investigation · 2026Article
- Prospective Analysis of Mesotheliomas in Subjects With BAP1 Cancer Syndrome: Clinical Characteristics and Epigenetic Correlates of Disease.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2025Observational
- The global, regional, and national brain and CNS cancers burden and trends from 1990 to 2021.Scientific reports · 2025Article
- Early prediction of mortality upon intensive care unit admission.BMC medical informatics and decision making · 2024Article
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5 authors.
Funding
Abstract
purposeUnderstanding how stage at cancer diagnosis influences cause of death, an endpoint that is not susceptible to lead-time bias, can inform population-level outcomes of cancer screening.
methodsUsing data from 17 US Surveillance, Epidemiology, and End Results registries for 1,154,515 persons aged 50-84 years at cancer diagnosis in 2006-2010, we evaluated proportional causes of death by cancer type and uniformly classified stage, following or extrapolating all patients until death through 2020.
resultsMost cancer patients diagnosed at stages I-II did not go on to die from their index cancer, whereas most patients diagnosed at stage IV did. For patients diagnosed with any cancer at stages I-II, an estimated 26% of deaths were due to the index cancer, 63% due to non-cancer causes, and 12% due to a subsequent primary (non-index) cancer. In contrast, for patients diagnosed with any stage IV cancer, 85% of deaths were attributed to the index cancer, with 13% non-cancer and 2% non-index-cancer deaths. Index cancer mortality from stages I-II cancer was proportionally lowest for thyroid, melanoma, uterus, prostate, and breast, and highest for pancreas, liver, esophagus, lung, and stomach.
conclusionAcross all cancer types, the percentage of patients who went on to die from their cancer was over three times greater when the cancer was diagnosed at stage IV than stages I-II. As mortality patterns are not influenced by lead-time bias, these data suggest that earlier detection is likely to improve outcomes across cancer types, including those currently unscreened.
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