Statistical methods for cancer patient survival – Therese Andersson's research group

We develop and apply statistical methods for quantifying cancer patient survival, especially methods for estimating life expectancy following cancer and the loss in life expectancy. The focus of our work is on population-based measures, and we apply the methods to cancer registry data and other register-based data.

Our research

We are a group of biostatisticians who have an interest in survival analysis, and especially cancer patient survival. We develop statistical methods, and collaborate closely with clinicians and epidemiologists to answer important research questions using appropriate methodology. 

We work mainly in the area of relative survival, a framework where cancer patient survival is estimated without requiring cause of death information. Within this framework we also develop novel methods for estimating metrics with more intuitive interpretation compared to traditional measures  such as the life expectancy and loss in life expectancy for cancer patients. The data we use is primarily register-based, and we have extensive experience in cancer registry data from different countries. A large part of our work focuses on comparing cancer prognosis between different population groups and across countries.  

Publications

All publications from group members

Funding

Grants

  • Extensions and applications of excess hazards models and life expectancy estimation
    Swedish Cancer Society
    1 January 2026 - 31 December 2028
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2025 - 31 December 2027
    Research problem and specific questionsHealth economic evaluations constitute an important basis for decisions on the reimbursement and use of oncology drugs in Sweden. At the time of decision there is high degree of uncertainty in survival effects from a lifetime perspective, which needs to be predicted from clinical trials with short follow-up time.The project aim is to investigate the accuracy in health economic evaluations in the assessment of oncology drugs and to investigate how these evaluations can be improved to guide decisions on the reimbursement and use of these drugs. The research questions are:how accurate are long-term survival predictions for oncology drugs compared to outcomes in clinical practice?how can relevant information outside the clinical trial and statistical methods be used to improve survival predictions of oncology drugs in health economic evaluations?Data and methodA database with longitudinal data from Swedish registries is used to answer the research questions. Question 1 is answered by studying long-term survival in clinical practice in cancer patients who have used drugs previously assessed by the Dental and Pharmaceuticals benefits agency (TLV) to inform decisions on the reimbursement or use of drugs at hospitals as recommended by the New Therapies Council (NT-Rådet). At the time of the decision the predicted long-term survival effect of the drug will be compared to the long-term survival effect in clinical practice. Question 2 is answered by validating two statistical methods which use external data outside the clinical trial.Societal relev,ance and utilisationThe project contributes to improving health economic evaluations supporting decisions on the reimbursement and use of oncology drugs in Sweden. This benefits TLV, NT-rådet, and the health care system and will increase the opportunity to attain the highest level of health benefits for limited resources in society. The project results will be published in scientific journals and will be presented on seminars at NT-rådet and TLV, which will support the dissemination of the results of the project to a wider community, authorities and healthcare providers.Plan for project realisationThe project is part of a doctoral project and will be conducted in collaboration with TLV and between three research groups at Karolinska Institutet, providing extensive experience in health economic evaluation, biostatistics and cancer survival, and strong clinical experience in oncology.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2023 - 31 December 2024
  • Extensions and applications of loss in life expectancy for cancer patients
    Cancerfonden
    1 January 2023 - 31 December 2025
  • Swedish Cancer Society
    1 January 2023
    The prognosis for cancer patients is often measured using survival rates. Recently, however, there has been increased interest in presenting other measures of cancer patient survival, which are easier to interpret and which can provide a better understanding of the impact a cancer diagnosis has on an individual's lifespan. I have previously developed such methods, namely methods for estimating the average life expectancy of cancer patients and the loss in life expectancy (LLE) compared to cancer-free individuals. In order to further increase the usefulness of the measurements, they need to be further developed. The purpose of this project is to further develop and apply the methods. The new methods will be applied to cancer registry data, to answer research questions of clinical interest and which are important from a public health perspective. For example, to investigate socio-economic inequalities in survival in patients with malignant melanoma and colorectal cancer, to estimate the LLE for hematological cancers with an indolent course of disease, as well as for patients diagnosed with malignant melanoma at a young age. More specifically, I will: - Combining causal analysis and LLE to quantify the impact of potential causes behind socioeconomic disparities in cancer patient survival - Include uncertainty in general population mortality in the estimate of the LLE, so that confidence intervals for the LLE are correctly estimated - Examine assumptions made when estimating LLE, to see in which situations assumptions do not apply and design alternative assumptions
  • Inequalities in cancer prognosis across socioeconomic groups and how these arise
    Karolinska Institutet Research Grants 2021-2023
    1 January 2022 - 31 December 2023
  • Swedish Cancer Society
    1 January 2020
    To understand the disease progression and survival after a cancer diagnosis, it is important to fully capture the complex disease pathways that can occur. More advanced statistical methods are needed to be able to do this in the best way. MPN is a chronic blood tumor disease, with 400 new cases in Sweden annually. Despite efforts to optimize treatment and take preventive measures against complications, patients with MPN have poorer survival than the general population and a high risk of complications such as thromboembolism and bleeding. Within this project, I will develop statistical models for survival data with several time scales and several possible outcomes. A major focus will be to enable reporting of the results of complex analyzes in a way that is easy to understand and to develop user-friendly software so that others can use the methods. The utility of the methods will be demonstrated for myeloproliferative neoplasias (MPNs), with unanswered, clinically important research questions. I will use a population-based cohort of MPN patients with long follow-up time and with matched population controls. 1. Measure how the risk of thromboembolism and bleeding among MPN patients changes over time since diagnosis and changes due to the fact that patients age. Determine whether the risk of thromboembolism increases among patients who have had bleeding and whether the risk of bleeding increases among patients who have had thromboembolism. Describe the entire disease chain from MPN to complications of thromboembolism and bleeding, and finally death, and the proportion of patients who suffered from thromboembolism and bleeding, or both, and died over time. 4. Calculate the life expectancy of MPN patients and lost life years.
  • Swedish Research Council
    1 December 2019 - 31 December 2023

Staff and contact

Group leader

All members of the group

Visiting address

Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Nobels väg 12A, Stockholm, 171 77, Sweden

Postal address

Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, PO Box 281, Stockholm, 171 77, Sweden

Keywords:
Biostatistics Cancer and Oncology Epidemiology Probability Theory and Statistics (Statistics with medical aspects at 30118 and with social aspects at 50907) Public Health, Global Health and Social Medicine Statistics Survival Show all
Content reviewer:
04-09-2025