Long term survival analysis: the curability of breast cancer

Methods of survival analysis for long-term follow-up studies are illustrated by a study of mortality in 3878 breast cancer patients in Edinburgh followed for up to 20 years. The problems of life tables, advantages of hazard plots and difficulties in statistical modelling are demonstrated by studying the relationship between survival and both clinical stage and initial menopausal status at diagnosis. To assess the 'curability' of breast cancer, mortality by year of follow-up is compared with expected mortality using Scottish age-specific death rates. Techniques for analysing such relative survival data include age-corrected life tables, ratio of observed to expected deaths and excess death rates. Finally, an additive hazard model is developed to incorporate covariates in the analysis of relative survival and curability.