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The International Journal of Biostatistics

Ed. by Chambaz, Antoine / Hubbard, Alan E. / van der Laan, Mark J.

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Online
ISSN
1557-4679
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The Lead Time Distribution When Lifetime is Subject to Competing Risks in Cancer Screening

Dongfeng Wu
  • University of Louisville
/ Karen Kafadar
  • Indiana University, Bloomington
/ Gary L. Rosner
  • Sidney Kimmel Comprehensive Cancer Center
/ Lyle D. Broemeling
  • Broemeling and Associates Inc.
Published Online: 2012-04-20 | DOI: https://doi.org/10.1515/1557-4679.1363

This paper extends the previous probability model for the distribution of lead time in periodic cancer screening exams, namely, in that the lifetime T is treated as a random variable, instead of a fixed value. Hence the number of screens for a given individual is a random variable as well. We use the actuarial life table from the Social Security Administration to obtain the lifetime distribution, and then use this information to project the lead time distribution for someone with a future screening schedule. Simulation studies using the HIP study group data provide estimates of the lead time under different screening frequencies. The projected lead time has two components: a point mass at zero (corresponding to interval cases detected between screening exams) and a continuous probability density. We present estimates of the projected lead time for participants in a breast cancer screening program. The model is more realistic and can inform optimal screening frequency. This study focuses on breast cancer screening, but is applicable to other kinds of cancer screening also.

Keywords: lead time; sensitivity; sojourn time; transition probability density; lifetime; cancer screening

About the article

Published Online: 2012-04-20



Citation Information: The International Journal of Biostatistics, ISSN (Online) 1557-4679, DOI: https://doi.org/10.1515/1557-4679.1363. Export Citation

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[1]
Hyejeong Jang, Seongho Kim, and Dongfeng Wu
Journal of Epidemiology and Global Health, 2013, Volume 3, Number 3, Page 157

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