An Empirical Comparison of Parametric and Semiparametric Cure Models

Abstract

Parametric and semiparametric cure models have been proposed for cure proportion estimation in cancer clinical research. In this paper, several parametric and semiparametric models are compared, and their estimation methods are discussed within the framework of the EM algorithm. We show that the semiparametric PH cure model can achieve efficiency levels similar to those of parametric cure models, provided that the failure time distribution is well specified and uncured patients have an increasing hazard rate. Therefore the semiparametric model is a viable alternative to parametric cure models. When the hazard rate of uncured patients is rapidly decreasing, the estimates from the semiparametric cure model tend to have large variations and biases. However, all other models also tend to have large variations and biases in this case.