Age-Period-Cohort Models in Cancer Surveillance Research: Ready for Prime Time?

Authors' Affiliation: National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland.
Cancer Epidemiology Biomarkers & Prevention (Impact Factor: 4.13). 06/2011; 20(7):1263-8. DOI: 10.1158/1055-9965.EPI-11-0421
Source: PubMed


Standard descriptive methods for the analysis of cancer surveillance data include canonical plots based on the lexis diagram, directly age-standardized rates (ASR), estimated annual percentage change (EAPC), and joinpoint regression. The age-period-cohort (APC) model has been used less often. Here, we argue that it merits much broader use. First, we describe close connections between estimable functions of the model parameters and standard quantities such as the ASR, EAPC, and joinpoints. Estimable functions have the added value of being fully adjusted for period and cohort effects, and generally more precise. Second, the APC model provides the descriptive epidemiologist with powerful new tools, including rigorous statistical methods for comparative analyses, and the ability to project the future burden of cancer. We illustrate these principles by using invasive female breast cancer incidence in the United States, but these concepts apply equally well to other cancer sites for incidence or mortality.

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Available from: William F Anderson, Sep 09, 2014
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    • "The EAPC can be estimated through an age-drift model, and we can easily build a confidence interval for the EAPC using the standard error of the drift [13]. The age-drift model is a simplified version of the age-cohort model where the cohort effect is parameterized using only the linear component. "
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    ABSTRACT: Tobacco is currently the largest risk factor for cancers of the lung, lip/oral cavity/pharynx (LOCP) and esophagus. Variations in tobacco consumption over time have led to changes in cancer incidence in the general population. Data on the incidence of cancers at these sites in adults aged 20-44 years old are scarce. Our objective was to provide estimates of incidence trends for these cancers in France among this age group over the last 30 years. Observed incidence data over the period 1982-2010 for the 20-44 age group were provided from six cancer registries (eight for esophagus) covering approximately 6% of the French population. Age-period-cohort models were used on the observed period, and estimates of cancer incidence for France in 2012 were provided on the basis of short-term predictions. In men, a sharp decline was observed over time for LOCP and esophageal cancers, while lung cancer saw only a slight decline. In women, a large increase was seen in lung cancer incidence, while LOCP cancer incidence did not vary significantly. Smoking behaviors among adults aged 20-44 impact incidence trends in cancers of the lung, LOCP and esophagus, although other factors are involved, particularly in LOCP and esophageal cancers. Our results highlight the importance of preventative efforts which particularly target women aged 20-44. Efforts to curb tobacco smoking in men should also be pursued. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jul 2015
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    • "Amžiaus (A), periodo (P) ir kohortos (K) veiksniai bei jų kombinacijos buvo testuojami šia tvarka: A, P, K, AP, AK, PK, APK. Kadangi duomenys pasižymėjo didele dispersija, poveikiui įvertinti taikyta neigiama binominė regresija [15, 16]. Statistinei analizei atlikti ir duomenims tvarkyti naudota statistinė programa Stata (StataCorp. "

    Full-text · Article · Jan 2015
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    • "The period when death occurs may also reflect important changes in factors that affect mortality (e.g., introduction of new treatments). The cohort effect may indicate changes in exposures that are particular to specific generations [15,16]. "
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    ABSTRACT: Background Individuals who live in rural areas are at greater risk for brain cancer, and pesticide exposure may contribute to this increased risk. The aims of this research were to analyze the mortality trends and to estimate the age-period-cohort effects on mortality rates from brain cancer in two regions in Rio de Janeiro, Brazil. Methods This descriptive study examined brain cancer mortality patterns in individuals of both sexes, >19 years of age, who died between 1996 and 2010. They were residents of a rural (Serrana) or a non-rural (Metropolitan) area of Rio de Janeiro, Brazil. We estimated mortality trends using Joinpoint Regression analysis. Age-period-cohort models were estimated using Poisson regression analysis. Results The estimated annual percentage change in mortality caused by brain cancer was 3.8% in the Serrana Region (95% confidence interval (CI): 0.8–5.6) and -0.2% (95% CI: -1.2–0.7) in the Metropolitan Region. The results indicated that the relative risk was higher in the rural region for the more recent birth cohorts (1954 and later). Compared with the reference birth cohort (1945–49, Serrana Region), the relative risk was four times higher for individuals born between 1985 and 1989. Conclusions The results of this study indicate that there is an increasing trend in brain cancer mortality rates in the rural Serrana Region in Brazil. A cohort effect occurred in the birth cohorts born in this rural area after 1954. At the ecological level, different environmental factors, especially the use of pesticides, may explain regional disparities in the mortality patterns from brain cancers.
    Full-text · Article · May 2014 · BMC Cancer
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