Is cancer stage data missing completely at random? A report from a large population-based cohort of non-small cell lung cancer
IntroductionPopulation-based datasets are often used to estimate changes in utilization or outcomes of novel therapies. Inclusion or exclusion of unstaged patients may impact on interpretation of these studies.MethodsA large population-based dataset in Ontario, Canada of non-small cell lung cancer p...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1146053/full |
| _version_ | 1797852655762014208 |
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| author | Andrew G. Robinson Andrew G. Robinson Paul Nguyen Catherine L. Goldie Matthew Jalink Matthew Jalink Timothy P. Hanna Timothy P. Hanna Timothy P. Hanna |
| author_facet | Andrew G. Robinson Andrew G. Robinson Paul Nguyen Catherine L. Goldie Matthew Jalink Matthew Jalink Timothy P. Hanna Timothy P. Hanna Timothy P. Hanna |
| author_sort | Andrew G. Robinson |
| collection | DOAJ |
| description | IntroductionPopulation-based datasets are often used to estimate changes in utilization or outcomes of novel therapies. Inclusion or exclusion of unstaged patients may impact on interpretation of these studies.MethodsA large population-based dataset in Ontario, Canada of non-small cell lung cancer patients was examined to evaluate the characteristics and outcomes of unstaged patients compared to staged patients. Multivariable Poisson regression was used to evaluate differences in patient-level characteristics between groups. Kaplan-Meier estimates of survival and log-rank statistics were utilized.ResultsIn our Ontario cohort of 51,152 patients with NSCLC, 11.2% (n=5,707) were unstaged, and there was evidence that stage data was not missing completely at random. Those without assigned stage were more likely than staged patients to be older (RR [95%CI]), (70-79 vs. 20-59: 1.51 [1.38-1.66]; 80+ vs. 20-59: 2.87 [2.62-3.15]), have a higher comorbidity index (Score 1-2 vs 0: 1.19 [1.12-1.27]; 3 vs. 0: 1.49 [1.38-1.60]), and have a lower socioeconomic class (4 vs. 1 (lowest): 0.91 [0.84-0.98]; 5 vs. 1 (lowest): 0.89 [0.83-0.97]). Overall survival of unstaged patients suggested a mixture of early and advanced stage, but with a large proportion that are probably stage IV patients with more rapid death than those with reported stage IV disease.ConclusionIn this case study, evaluation of stage-specific health care utilization and outcomes for staged patients with stage IV disease at the population level may have a bias as a distinct subset of stage IV patients with rapid death are likely among those without a documented stage in administrative data. |
| first_indexed | 2024-04-09T19:37:46Z |
| format | Article |
| id | doaj.art-73741dc992ff4e2f8cadb4c5d8f7d13a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T19:37:46Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-73741dc992ff4e2f8cadb4c5d8f7d13a2023-04-04T09:27:32ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-04-011310.3389/fonc.2023.11460531146053Is cancer stage data missing completely at random? A report from a large population-based cohort of non-small cell lung cancerAndrew G. Robinson0Andrew G. Robinson1Paul Nguyen2Catherine L. Goldie3Matthew Jalink4Matthew Jalink5Timothy P. Hanna6Timothy P. Hanna7Timothy P. Hanna8Division of Cancer Care and Epidemiology, Queen’s Cancer Research Institute, Kingston, ON, CanadaDepartment of Oncology, Queen’s University, Kingston, ON, CanadaICES, Queen’s University, Kingston, ON, CanadaSchool of Nursing, Queen’s University, Kingston, ON, CanadaDivision of Cancer Care and Epidemiology, Queen’s Cancer Research Institute, Kingston, ON, CanadaDepartment of Public Health Sciences, Queen’s University, Kingston, ON, CanadaDivision of Cancer Care and Epidemiology, Queen’s Cancer Research Institute, Kingston, ON, CanadaDepartment of Oncology, Queen’s University, Kingston, ON, CanadaDepartment of Public Health Sciences, Queen’s University, Kingston, ON, CanadaIntroductionPopulation-based datasets are often used to estimate changes in utilization or outcomes of novel therapies. Inclusion or exclusion of unstaged patients may impact on interpretation of these studies.MethodsA large population-based dataset in Ontario, Canada of non-small cell lung cancer patients was examined to evaluate the characteristics and outcomes of unstaged patients compared to staged patients. Multivariable Poisson regression was used to evaluate differences in patient-level characteristics between groups. Kaplan-Meier estimates of survival and log-rank statistics were utilized.ResultsIn our Ontario cohort of 51,152 patients with NSCLC, 11.2% (n=5,707) were unstaged, and there was evidence that stage data was not missing completely at random. Those without assigned stage were more likely than staged patients to be older (RR [95%CI]), (70-79 vs. 20-59: 1.51 [1.38-1.66]; 80+ vs. 20-59: 2.87 [2.62-3.15]), have a higher comorbidity index (Score 1-2 vs 0: 1.19 [1.12-1.27]; 3 vs. 0: 1.49 [1.38-1.60]), and have a lower socioeconomic class (4 vs. 1 (lowest): 0.91 [0.84-0.98]; 5 vs. 1 (lowest): 0.89 [0.83-0.97]). Overall survival of unstaged patients suggested a mixture of early and advanced stage, but with a large proportion that are probably stage IV patients with more rapid death than those with reported stage IV disease.ConclusionIn this case study, evaluation of stage-specific health care utilization and outcomes for staged patients with stage IV disease at the population level may have a bias as a distinct subset of stage IV patients with rapid death are likely among those without a documented stage in administrative data.https://www.frontiersin.org/articles/10.3389/fonc.2023.1146053/fullmissing datanon-small cell lung canceradministrative datapopulation-basedcancer stage |
| spellingShingle | Andrew G. Robinson Andrew G. Robinson Paul Nguyen Catherine L. Goldie Matthew Jalink Matthew Jalink Timothy P. Hanna Timothy P. Hanna Timothy P. Hanna Is cancer stage data missing completely at random? A report from a large population-based cohort of non-small cell lung cancer Frontiers in Oncology missing data non-small cell lung cancer administrative data population-based cancer stage |
| title | Is cancer stage data missing completely at random? A report from a large population-based cohort of non-small cell lung cancer |
| title_full | Is cancer stage data missing completely at random? A report from a large population-based cohort of non-small cell lung cancer |
| title_fullStr | Is cancer stage data missing completely at random? A report from a large population-based cohort of non-small cell lung cancer |
| title_full_unstemmed | Is cancer stage data missing completely at random? A report from a large population-based cohort of non-small cell lung cancer |
| title_short | Is cancer stage data missing completely at random? A report from a large population-based cohort of non-small cell lung cancer |
| title_sort | is cancer stage data missing completely at random a report from a large population based cohort of non small cell lung cancer |
| topic | missing data non-small cell lung cancer administrative data population-based cancer stage |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1146053/full |
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