Correcting for Lead Time and Length Bias in Estimating the Effect of Screen Detection on Cancer Survival
Stephen W. Duffy(Cancer Research UK), Irıs D. Nagtegaal(Dutch Cancer Society), Matthew Wallis(Addenbrooke's Hospital), Fay Cafferty(Cancer Research UK), Nehmat Houssami(University of Sydney), Jane Warwick(Cancer Research UK), P C Allgood(Cancer Research UK), Olive Kearins(University of Birmingham), Nancy Tappenden(University of Birmingham), E O'Sullivan(University of Birmingham), Gill Lawrence(University of Birmingham)
Cited by 284Open Access
Abstract
Determination of survival time among persons with screen-detected cancer is subject to lead time and length biases. The authors propose a simple correction for lead time, assuming an exponential distribution of the preclinical screen-detectable period. Assuming two latent categories of tumors, one of which is more prone to screen detection and correspondingly less prone to death from the cancer in question, the authors have developed a strategy of sensitivity analysis for various magnitudes of length bias. Here they demonstrate these methods using a series of 25,962 breast cancer cases (1988-2004) from the West Midlands, United Kingdom.
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