If cancer survival is reported to be worsening over time or inferior compared to other countries, politicians and health-care workers may get blamed because suboptimal care is presumed to be the cause. Yet, a variety of reasons exist for cancer survival statistics to change for the worse, of which deterioration of care is only one. Another explanation is that the improved diagnosis of premalignant lesions causes survival statistics to reflect only the most aggressive cancers-those with the poorest prognosis. In addition, deleterious changes in the distribution of prognostic factors and in the distribution of sociodemographic characteristics may negatively affect survival proportions. In this article, we identify the pitfalls that might be encountered in comparisons of published, population-based survival data from different time periods or populations.

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Keywords cancer, deterioration, diagnostic, survival
Persistent URL hdl.handle.net/1765/21020
Journal Nature Reviews Clinical Oncology
Note Accepted Manuscript
de Vries, E, Karim-Kos, H.E, Janssen-Heijnen, M.L.G, Soerjomataram, I, Kiemeney, L.A.L.M, & Coebergh, J.W.W. (2010). Why cancer survival may worsen. Nature Reviews Clinical Oncology, 1–14. Retrieved from http://hdl.handle.net/1765/21020