Larry F Ellison

Statistics Canada, Ottawa, Ontario, Canada

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Publications (28)105.38 Total impact

  • Larry F Ellison
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    ABSTRACT: In theory, expected survival probabilities used in the derivation of relative survival ratios (RSR) are determined from a control group free of the cancer under study. In practice, expected survival is typically estimated from general population life tables-which include people previously diagnosed with cancer-potentially leading to an overestimation of relative survival. Data are from the Canadian Cancer Registry with mortality follow-up through record linkage to the Canadian Vital Statistics Death Database. Period method RSRs for 2006-to-2008 were derived using general population life tables adjusted for cancer mortality and then compared with estimates derived using corresponding unadjusted life tables. For all cancers combined, the use of general population life tables to derive expected survival probabilities overestimated RSRs by 0.6 (1-year), 2.4 (5-year) and 4.6 (10-year) percentage units. Biases in 5-year survival were highest among males (3.0) and among people aged 75 to 99 at diagnosis (4.1). The bias was negligible for most individual cancers; biases were highest for prostate cancer, followed by colorectal and female breast cancer. Canadian estimates of relative survival for all cancers combined calculated using general life tables warrant adjustment for cancer mortality. Consideration of adjustment for cancer mortality is recommended for estimates of colorectal, female breast and especially prostate cancer.
    No preview · Article · Nov 2014 · Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé
  • P De · L Kachuri · L F Ellison · R Semenciw

    No preview · Article · Nov 2014 · Chronic Diseases and Injuries in Canada
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    ABSTRACT: Purpose: Kidney cancer is one of the fastest rising cancers worldwide. We aimed to examine the trends in incidence, mortality, and survival for this cancer in Canada. Methods: Incidence data for kidney cancer for 1986-2010 were from the Canadian Cancer Registry and the National Cancer Incidence Reporting System. These data were only available up to 2007 for the province of Quebec and consequently for the same year nationally, for Canada. Mortality data for 1986-2009 were from the Canadian Vital Statistics Death Database. Changes in age-standardized rates were analyzed by Joinpoint regression. Incidence rates were projected to 2025 using a Nordpred age-period-cohort model. Five-year relative survival ratios (RSR) were analyzed for 2004-2008 and earlier periods. Results: Between 1986 and 2007, the age-standardized incidence rate (ASIR) per 100,000 rose from 13.4 to 17.9 in males and 7.7 to 10.3 in females. Annual increases in ASIR were greatest for age groups <65 years (males) and ≥65 years (females). The ASIRs increased significantly over time in both sexes for renal cell carcinoma (RCC) but not for other kidney cancer types. RCC rates are projected to increase until at least 2025. Mortality rates decreased only slightly in each sex since 1986 (0.4%/year in males; 0.8%/year in females). The 5-year RSR for kidney cancer was 68% but differed largely by morphology and age, and has increased slightly over time. Conclusions: The incidence rate of kidney cancer in Canada has risen since at least 1986, led largely by RCC. Increasing detection of incidental tumors, and growing obesity and hypertension rates are possible factors associated with this increase. Greater prevention of modifiable risk factors for kidney cancer is needed.
    Full-text · Article · Jul 2014 · Cancer Causes and Control
  • Larry F Ellison
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    ABSTRACT: Relative survival analyses of cancer data often incorporate outdated information about expected survival when current information is not readily available. The assumption is that any bias introduced into the estimation of expected survival, and hence, into the estimate of relative survival, will be negligible. However, empirical studies of potential bias have yet to be published. Data are from the Canadian Cancer Registry with mortality follow-up through record linkage to the Canadian Vital Statistics Death Database. Period method relative survival ratios (RSRs) for 2005-2007 were derived using life tables centred on the 2006 Census of Population to estimate expected survival. The analysis was repeated using life tables from 5 and 10 years earlier. Deriving expected survival from life tables 5 years out of date resulted in increases in RSRs for all cancers. These increases became greater with lengthening survival duration. For example, increases in 1-, 5- and 10-year RSRs were 0.2, 0.8 and 1.7 percentage units, respectively, for all cancers combined. Increases in 5-year survival were highest for prostate (2.0) and bladder cancer (1.6); among males (1.2); and among people aged 75 to 99 at diagnosis (1.9). Differences were approximately double when life tables 10 years out of date were used. The use of historical rather than current expected survival data in calculating RSRs for cancer may lead to consequential overestimation of survival.
    No preview · Article · Feb 2014 · Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé
  • Lorraine Shack · Heather Bryant · Gina Lockwood · Larry F Ellison

    No preview · Article · Apr 2013
  • L Kachuri · P De · L.F. Ellison · R Semenciw
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    ABSTRACT: Monitoring cancer trends can help evaluate progress in cancer control while reinforcing prevention activities. This analysis examines long-term trends for selected cancers in Canada using data from national databases. Annual changes in trends for age-standardized incidence and mortality rates between 1970 and 2007 were examined by sex for 1) all cancers combined, 2) the four most common cancers (prostate, breast, lung, colorectal) and 3) cancers that demonstrate the most recent notable changes in trend. Five-year relative survival for 1992-2007 was also calculated. Incidence rates for all primary cancer cases combined increased 0.9% per year in males and 0.8% per year in females over the study period, with varying degrees of increase for melanoma, thyroid, liver, prostate, kidney, colorectal, lung, breast, and bladder cancers and decrease for larynx, oral, stomach and cervical cancers. Mortality rates were characterized by significant declines for all cancers combined and for most cancers examined except for melanoma and female lung cancer. The largest improvements in cancer survival were for prostate, liver, colorectal and kidney cancers. While the overall trends in mortality rates and survival point to notable successes in cancer control, the increasing trend in incidence rates for some cancers emphasize the need for continued efforts in prevention.
    No preview · Article · Mar 2013 · Chronic Diseases and Injuries in Canada
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    ABSTRACT: Esophageal adenocarcinoma has one of the fastest rising incidence rates and one of the lowest survival rates of any cancer type in the Western world. However, in many countries, trends in esophageal cancer differ according to tumour morphology and anatomical location. In Canada, incidence and survival trends for esophageal cancer subtypes are poorly known. Cancer incidence and mortality rates were obtained from the Canadian Cancer Registry, the National Cancer Incidence Reporting System and the Canadian Vital Statistics Death databases for the period from 1986 to 2006. Observed trends (annual per cent change) and five-year relative survival ratios were estimated separately for esophageal adenocarcinoma and squamous cell carcinoma, and according to location (upper, middle, or lower one-third of the esophagus). Incidence rates were projected up to the year 2026. Annual age-standardized incidence rates for esophageal cancer in 2004 to 2006 were 6.1 and 1.7 per 100,000 for males and females, respectively. Esophageal adenocarcinoma incidence rose by 3.9% (males) and 3.6% (females) per year for the period 1986 to 2006, with the steepest increase in the lower one-third of the esophagus (4.8% and 5.0% per year among males and females, respectively). In contrast, squamous cell carcinoma incidence declined by 3.3% (males) and 3.2% (females) per year since the early 1990s. The five-year relative survival ratio for esophageal cancer was 13% between 2004 and 2006, approximately a 3% increase since the period from 1992 to 1994. Projected incidence rates showed increases of 40% to 50% for esophageal adenocarcinoma and decreases of 30% for squamous cell carcinoma by 2026. Although esophageal cancer is rare in Canada, the incidence of esophageal adenocarcinoma has doubled in the past 20 years, which may reflect the increasing prevalence of obesity and gastroesophageal reflux disease. Declines in squamous cell carcinoma may be the result of the decreases in the prevalence of smoking in Canada. Given the low survival rates and the potential for further increases in incidence, esophageal adenocarcinoma warrants close attention.
    No preview · Article · Oct 2012 · Canadian journal of gastroenterology = Journal canadien de gastroenterologie
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    H Bryant · G Lockwood · R Rahal · L Ellison

    Full-text · Article · Aug 2012 · Current Oncology
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    Larry F Ellison · Kathryn Wilkins
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    ABSTRACT: Cancer prevalence trends are rarely reported in the published literature, and until now, have not been reported for Canada. Based on incidence data from the Canadian Cancer Registry linked with mortality data from the Canadian Vital Statistics Death Database, trends in prevalence proportions overtime were calculated by time since diagnosis for a large number of the most common cancers. Statistically significant increases in prevalence proportions were observed for most individual cancers, and most prevalence durations studied. Aging of the population contributed to these increases. Relatively large increases were observed for liver and thyroid cancer, while decreases occurred for cancers of the larynx and cervix uteri. Information on how and why trends vary by cancer can inform resource allocation planning.
    Preview · Article · Mar 2012 · Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé
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    Larry F Ellison · Heather Bryant · Gina Lockwood · Lorraine Shack
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    ABSTRACT: Survival estimates measured from the time cancer diagnosis become less informative after one or two years' survival. Using records from the Canadian Cancer Registry linked to the Canadian Vital Statistics Death Database, five-year conditional relative survival ratio (RSR) estimates were derived for a large number of cancers. For each cancer with an initial five-year RSR of at least 80% (except breast cancer), a conditional five-year RSR of 95% or more was achieved after five years' survival. Among cancers with initial five-year RSRs of 50% to 79%, a five-year conditional RSR of 95% or more was observed for cancers of the cervix uteri and colon after five years. There was no apparent improvement in survival prospects during the first five years after diagnosis for chronic lymphocytic leukemia (CLL). Despite initial prognoses of less than 50%, a conditional five-year RSR of at least 90% five years after diagnosis was achieved for stomach cancer and leukemia (excluding CLL).
    Full-text · Article · Jun 2011 · Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé
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    Full-text · Article · Nov 2010 · Canadian Medical Association Journal
  • Larry F Ellison
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    ABSTRACT: In survival analyses using cancer registry data, second and subsequent primary cancers diagnosed in individuals are typically excluded. However, this approach may lead to biased comparisons of survival between cancer registries, or over time within a single registry. Purpose: To examine the impact of including multiple primary cancers in the derivation of survival estimates using data from a population-based national cancer registry. Five-year relative survival estimates for persons aged 15-99 years at diagnosis were derived using all eligible primary cases from the Canadian Cancer Registry (CCR)-a population-based registry containing information on cases diagnosed from 1992 onward-and then again using first primary cases only. Any pre-1992 cancer history of persons on the CCR was obtained by using auxiliary information. The inclusion of multiple cancers resulted in lower estimates of 5-year relative survival for virtually all cancers studied. The effect was somewhat attenuated by age-standardization (e.g., from 1.3% to 1.0% for all cancers combined), and was greatest for bladder cancer (-2.4%) followed by oral cancer (-1.9%)-cancers that had the first and third lowest proportions of first cancers, respectively. For the majority of cancers the difference was less than 1.0%. Cancers for which there was virtually no difference (e.g., lung, pancreatic, ovarian and liver) tended to be those with a poor prognosis. Inclusion of second and subsequent primary cancers in the analysis tended to lower estimates of relative survival, the extent of which varied by cancer and age and depended in part on the proportion of first primary cancers.
    No preview · Article · Oct 2010
  • Larry F Ellison · Kathryn Wilkins
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    ABSTRACT: Statistics Canada routinely produces cohort-based estimates for cancer survival; the most recent were based on cases diagnosed from 1992-2000. This report provides predicted survival estimates for cases diagnosed more recently. Using records from the Canadian Cancer Registry linked to the Canadian Vital Statistics Death Data Base, cancer- and age-specific estimates of relative survival have been calculated for 2004-2006. The five-year relative survival ratio (RSR) for all cancers combined was 62%, and ranged from 6% for pancreatic cancer to 98% for cancer of the thyroid. The RSR was typically higher at younger than older ages, with exceptions for some common cancers. From 1992-1994 to 2004-2006, the five-year RSR for a number of cancers increased--usually slightly, but in some cases, appreciably (for example, the age-standardized RSR for non-Hodgkin lymphoma rose from 51% to 63%; for leukemia, from 44% to 54%; and for liver, 9% to 17%).
    No preview · Article · Sep 2010 · Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé
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    Larry F Ellison · Kathryn Wilkins
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    ABSTRACT: The rising numbers of cancer diagnoses, together with improvements in survival, have led to increases in the prevalence of cancer in Canada. This article provides more precise and detailed estimates of cancer prevalence than have been available previously. Based on incidence data from the Canadian Cancer Registry linked with mortality data from the Canadian Vital Statistics Death Database, direct estimates of cancer prevalence as of January 1, 2005 were calculated for an extensive list of cancers, by time since diagnosis, age and sex. Two-, five- and ten-year cancer prevalence counts were 217,089 (675 per 100,000), 454,149 (1,412 per 100,000) and 722,833 (2,248 per 100,000), respectively. Breast (20.6% of ten-year prevalent cases), prostate (18.7%) and colorectal cancer (12.9%) were the most prevalent, together accounting for just over half of all cases. Prevalence proportions for all cancers combined increased dramatically with age, peaking at ages 80 to 84; proportions were higher in females than in males before age 60, and higher in males thereafter. Prevalence data tabulated according to type of cancer, age and time since diagnoses provide important information about the demand for cancer-related health care and social services.
    Preview · Article · Apr 2009 · Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé
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    Larry F Ellison · Prithwish De · Leslie S Mery · Paul E Grundy

    Full-text · Article · Mar 2009 · Canadian Medical Association Journal
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    Loraine D Marrett · Larry F Ellison · Dagny Dryer

    Preview · Article · Apr 2008 · Canadian Medical Association Journal
  • Larry F Ellison · Lisa Pogany · Leslie S Mery
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    ABSTRACT: This study provides up-to-date estimates of childhood and adolescent (ages 0-19) cancer survival in Canada using data from the Canadian Cancer Registry (CCR). Cases were classified according to the third edition of the International Classification of Childhood Cancer classification scheme. Follow-up for vital status was determined through record linkage to the Canadian Mortality Data Base, and from information reported by provincial/territorial cancer registries. Observed survival proportions (OSPs) were based on period analysis (1999-2003). The 1-, 3- and 5-year OSPs for all cancers combined were 92%, 85% and 82%, respectively. Among diagnostic groups, five-year survival estimates were highest for retinoblastoma (99%), carcinomas and other malignant epithelial neoplasms and malignant melanomas (91%) and for renal tumours (91%); they were poorest for hepatic tumours (68%) and for malignant bone tumours (68%). Survival for childhood and adolescent cancer in Canada has improved substantially since last reported.
    No preview · Article · Oct 2007 · European Journal of Cancer
  • Larry F Ellison
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    ABSTRACT: To provide an empirical evaluation of the performance of period analysis in comparison to traditional methods of survival analysis for predicting future 5-year cancer survival using data from the Canadian Cancer Registry. 5-year relative survival estimates were derived by period and traditional methods of analysis using data available at the conclusion of 1997. The extent to which these estimates agreed with survival later observed for cancer cases diagnosed in 1997 was quantified by calculating the squared difference of the estimate to the corresponding relative survival ratio actually observed. Period analysis was observed to be superior to, or comparable with, cohort analysis in predicting the average 5-year relative survival observed later for virtually all individual cancer sites studied. The improvement in survival estimation was most pronounced for prostate cancer. Where period estimates did not match the eventually observed value, they were predominantly on the lower side. Complete analysis estimates were generally observed to be in between the cohort and period values. The period method of survival analysis provides more up-to-date estimates of 5-year survival than do traditional cohort-based methods.
    No preview · Article · Apr 2006 · Annals of Epidemiology
  • Larry F Ellison · Laurie Gibbons
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    ABSTRACT: Changes in five-year relative survival ratios for prostate, breast, colorectal and lung cancer cases are examined. Ratios for cases diagnosed in the 1985-1987 period are compared with those for 1992-1994. Incidence and mortality rates between 1985 and 1999 are compared with changes in relative survival. Data are from the Canadian Cancer Registry, the National Cancer Incidence Reporting System, the Canadian Mortality Data Base, and life tables. Analysis was conducted using the maximum likelihood method of Esteve. Age-standardized ratios for a given cancer were calculated by weighting age-specific ratios to the age distribution of patients diagnosed with that cancer. Statistical tests were used to compare corresponding age-specific and age-standardized ratios across the two periods. National estimates exclude Québec and New Brunswick. Between the 1985-1987 period and the 1992-1994 period, increases in five-year age-standardized relative survival ratios were dramatic for prostate cancer, large for breast cancer, and somewhat smaller for colorectal cancer. There was little absolute change in the ratios for lung cancer.
    No preview · Article · Apr 2004 · Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé
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    ABSTRACT: To determine breast cancer case counts, on a given data set, using both Surveillance, Epidemiology, and End Results (SEER) program and International Agency for Research on Cancer (IARC) multiple primary coding rules and to describe differences, if any, by age at diagnosis, histology, stage at diagnosis, laterality, and grade. SEER and IARC multiple primary coding rules were applied to a dataset provided by the North American Association of Central Cancer Registries. Only registries whose data met high quality data standards for the time period studied (1994-1998) and whose permission was obtained were included. Percentage differences were calculated using IARC counts as the base. Using IARC multiple primary rules resulted in 2.4% fewer cases. Among females, the highest percent changes by category were: age group - 80-84 year-olds (3.4%); histology - inflammatory breast cancer (4.6%); stage - distant (3.1%); grade - well differentiated (3.0%). Among males, the highest percent changes by category were: age group - 80-84 year-olds (1.7%); histology - for intraductal and lobular breast carcinoma in combination (4.8%); stage - distant (3.0%); grade - well differentiated (1.8%). Overall differences were generally unaffected when examined by laterality. Breast cancer case counts are dependent on the multiple primary coding rules used.
    No preview · Article · Apr 2004 · Cancer Causes and Control