Statistiska metoder för cancerpatientöverlevnad – Therese Anderssons forskargrupp

Vi utvecklar och tillämpar statistiska metoder för att beräkna cancerpatienters överlevnad, särskilt metoder för att estimera medellivslängden efter cancer och förlusten i medellivslängd. Fokus i vårt arbete är befolkningsbaserade mått och vi använder oss av cancerregisterdata och andra registerbaserade data.

Vår forskning

Vi är en grupp biostatistiker som har ett intresse för överlevnadsanalys, och speciellt cancerpatientöverlevnad. Vi utvecklar statistiska metoder och har nära samarbete med kliniker och epidemiologer för att svara på viktiga forskningsfrågor med bra metodik.

Vi arbetar främst inom området relativ överlevnad, där cancerpatientöverlevnad beräknas utan att det krävs information om dödsorsak. Inom detta ramverk utvecklar vi även nya metoder för att beräkna mått med mer intuitiv tolkning jämfört med traditionella mått, som förväntad livslängd och förlust i förväntad livslängd för cancerpatienter. De data vi använder är huvudsakligen registerbaserade och vi har lång erfarenhet av cancerregisterdata från olika länder. En stor del av vårt arbete fokuserar på att jämföra cancerprognos mellan olika grupper och mellan länder.

Publikationer

Alla gruppmedlemmars publikationer

Finansiering

Forskningsbidrag

  • Extensions and applications of excess hazards models and life expectancy estimation
    Cancerfonden
    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.
  • 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
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2023 - 31 December 2024
  • 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

Medarbetare och kontakt

Gruppledare

Alla medarbetare i gruppen

Besöksadress

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

Postadress

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

Nyckelord:
Biostatistik Cancer och onkologi Epidemiologi Folkhälsovetenskap, global hälsa och socialmedicin Sannolikhetsteori och statistik (Statistik med medicinska aspekter under 30118 och samhällsvetenskapliga aspekter under 50907) Statistik [Publikationstyp] Överlevnad Visa alla
Innehållsgranskare:
2025-09-04