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A likelihood ratio test for cancer screening trials

S G Self1, R Etzioni

  • 1Fred Hutchinson Cancer Research Center, Seattle, Washington 98104, USA.

Biometrics
|March 1, 1995
PubMed
Summary

A new likelihood ratio test improves cancer screening trial analysis by accounting for delayed mortality effects. This method offers better power than traditional log rank tests when screening benefits emerge over time.

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Area of Science:

  • Biostatistics
  • Epidemiology
  • Cancer Research

Background:

  • Cancer screening trials often show mortality rate differences that change over time.
  • Traditional log rank tests may be suboptimal due to the lag between screening and mortality impact.

Purpose of the Study:

  • To develop and evaluate a statistical test for cancer screening trials where mortality effects are not constant over time.
  • To address the limitations of the log rank test in such scenarios.

Main Methods:

  • A novel two-degree-of-freedom likelihood ratio test was developed.
  • The test is based on fitting a weakly structured full model.
  • Approximate significance levels were computed and justified using large sample theory.

Main Results:

  • The proposed likelihood ratio test demonstrated favorable size and power properties in simulations compared to other statistics.
  • The statistic was successfully applied to real-world data from the HIP Breast Cancer Screening Trial.

Conclusions:

  • The developed likelihood ratio test is a more powerful and appropriate tool for analyzing cancer screening trials with time-varying mortality effects.
  • This method enhances the statistical rigor for evaluating cancer screening interventions.

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