Morris, M

Rachet, B

Woods, LM

LSHTM Research Online

Morris, M; Woods, LM; Rachet, B (2014) Poster presentation: Anovel methodology for constructing ethnic-majority life tables for usein net cancer survival analysis. In: UNSPECIFIED.Downloaded from: http://researchonline.lshtm.ac.uk/2121350/DOI:Usage GuidelinesPlease refer to usage guidelines at http://researchonline.lshtm.ac.uk/policies.html or alterna-tively contact researchonline@lshtm.ac.uk.Available under license: Copyright the author(s)A novel methodology for constructing ethnic majority life tables: their importance for measuring inequalities in survivalMelanie MorrisCancer Research UK Cancer Survival GroupLondon School of Hygiene & Tropical MedicineImproving health worldwidewww.lshtm.ac.ukProject funded by the National Awareness and Early Diagnosis Initiative: a partnership between“…it is critical to use sub-population life-tablesfor estimating relative survival when those sub-populations have marked variation in background mortality rates. However, often only sex-specific life-tables are used.”Inequalities in survival – the importance of background mortality (using the right life table)Blakely T et al (2012). Bias in relative survival methods when using incorrect life-tables: lung and bladder cancer by smoking status and ethnicity in New Zealand. International journal of cancer 131(6): E974-82405060708090100Relative survival (%)0 1 2 3 4 5Years since diagnosisAffluentDeprivedNational LTInequalities in survival – the importance of background mortality (using the right life table)Deprivation-specific LTLife tables examine mortality by age and sexDerived from the interim life table for England and Wales 2003, females, www.gad.gov.ukAge Deaths Population Mortality Rate Life expectancy0 1327 279.8 0.00474 80.91 99 272.0 0.00037 80.32 57 272.4 0.00021 79.43 40 278.8 0.00015 78.44 40 286.1 0.00014 77.4…0 20 40 60 80 100                0                0                                               10AgeAge-specific mortality rate at each age 1.000000.100000.010000.001000.000100.00001Mortality rate (log scale)Mortality varies by various sub-populations – life tables can be stratifiedWoods LM, et al (2005) J Epidemiology Community Health5060708090100Affluent 2 3 4 DeprivedSocio-economic categorySurvival (%)expectedrelativeobservedInequalities in survival – the importance of background mortalityMeasures of ethnicity are necessarily ecologicalProportion of each ethnicity in each Output Area (population ~350)e.g. 97.0% White0.8% Black2.2% AsianRound to nearest 1%Maximum proportions:White 100%Asian 98%Black 73%sex age regional code deaths1 65 AAFQ 08 11 65 AAFQ 14 11 65 ABFY 24 31 65 ABFZ 01 11 65 ABFZ 27 11 65 ABFZ 29 21 65 ABGA 04 21 65 ABGA 19 11 65 ABGA 28 11 65 ABGB 21 11 65 ABGC 04 31 65 ABGC 16 11 65 ABGC 30 21 65 ABGD 06 11 65 ABGD 12 21 65 ABGE 02 11 65 ABGF 24 11 65 ABGF 25 11 65 ABGG 16 21 65 ABGH 06 31 65 ABGH 09 41 65 ABGH 22 31 65 ABGJ 21 11 65 ABGJ 23 11 65 ABGK 05 21 65 ABGK 15 11 65 ABGL 17 11 65 ABGL 23 11 65 ABGP 11 11 65 ABGP 19 11 65 ACFX 02 31 65 ACFX 03 21 65 ACFX 15 31 65 ACFX 18 21 65 ACFY 25 11 65 ACFY 27 11 65 ACFY 47 11 65 ACFZ 01 11 65 ACFZ 13 41 65 ACFZ 36 41 65 ACFZ 50 21 65 ACFZ 51 41 65 ACFZ 53 11 65 ACGA 33 11 65 ACGE 15 1Total deaths age 65 78sex age regional code % Asian deaths total deaths1 65 ABGB 21 10 11 65 ABGE 02 10 11 65 ABGF 24 10 11 65 ABGH 06 10 31 65 ABGJ 21 10 11 65 ABGJ 23 10 11 65 ACFX 03 10 21 65 ACFZ 01 10 11 65 ACGE 15 10 1 121 65 AAFQ 14 20 11 65 ABFZ 27 20 11 65 ABFZ 29 20 21 65 ABGA 28 20 11 65 ABGC 30 20 21 65 ABGD 06 20 11 65 ABGH 22 20 31 65 ABGK 15 20 11 65 ABGL 17 20 1 131 65 ABGA 04 30 21 65 ABGA 19 30 11 65 ABGH 09 30 41 65 ABGP 19 30 11 65 ACFX 18 30 21 65 ACFY 47 30 11 65 ACFZ 50 30 21 65 ACFZ 53 30 11 65 ACGA 33 30 1 151 65 AAFQ 08 40 11 65 ABFY 24 40 31 65 ABGF 25 40 11 65 ABGG 16 40 21 65 ABGK 05 40 21 65 ABGL 23 40 11 65 ACFX 15 40 31 65 ACFY 25 40 11 65 ACFZ 51 40 4 181 65 ABFZ 01 50 11 65 ABGC 04 50 31 65 ABGC 16 50 11 65 ABGD 12 50 21 65 ABGP 11 50 11 65 ACFX 02 50 31 65 ACFY 27 50 11 65 ACFZ 13 50 41 65 ACFZ 36 50 4 2078sex age regional code % Asian deaths1 65 AAFQ 08 40 11 65 AAFQ 14 20 11 65 ABFY 24 40 31 65 ABFZ 01 50 11 65 ABFZ 27 20 11 65 ABFZ 29 20 21 65 ABGA 04 30 21 65 ABGA 19 30 11 65 ABGA 28 20 11 65 ABGB 21 10 11 65 ABGC 04 50 31 65 ABGC 16 50 11 65 ABGC 30 20 21 65 ABGD 06 20 11 65 ABGD 12 50 21 65 ABGE 02 10 11 65 ABGF 24 10 11 65 ABGF 25 40 11 65 ABGG 16 40 21 65 ABGH 06 10 31 65 ABGH 09 30 41 65 ABGH 22 20 31 65 ABGJ 21 10 11 65 ABGJ 23 10 11 65 ABGK 05 40 21 65 ABGK 15 20 11 65 ABGL 17 20 11 65 ABGL 23 40 11 65 ABGP 11 50 11 65 ABGP 19 30 11 65 ACFX 02 50 31 65 ACFX 03 10 21 65 ACFX 15 40 31 65 ACFX 18 30 21 65 ACFY 25 40 11 65 ACFY 27 50 11 65 ACFY 47 30 11 65 ACFZ 01 10 11 65 ACFZ 13 50 41 65 ACFZ 36 50 41 65 ACFZ 50 30 21 65 ACFZ 51 40 41 65 ACFZ 53 30 11 65 ACGA 33 30 11 65 ACGE 15 10 178Constructing the life tablesMerge mortality data with population data from censusCollapse data: deaths grouped by age and proportion of ethnic group Predict the mortality for each age and proportion of each ethnic group, adjusted for deprivationCreate life table for each ethnicity based on maximum proportion in any OA.1.2.3Predicted annual mortality rate (log scale)0 20 40 60 80 100Ageadjusted for deprivationDeciles of ethnic proportion: Black MaleThe results: mortality rates by deciles of ethnic proportion in Black males, adjusted f r deprivation.1.2.3Predicted annual mortality rate (log scale)0 20 40 60 80 100AgeOverall50% ethnic area60%70% 80%90%100%adjusted for deprivationDeciles of ethnic proportion: White FemaleThe results: mortality rates by ethnicity, adjusted for deprivation.1.2.3Predicted annual mortality rate (log scale)0 20 40 60 80 100AgeAll Ethnicities Male adjusted for deprivationMale FemaleMortality rate per 1000 pyrsAsian Black WhiteMen 9.1 16.3 10.1Women 4.7 10·3 6.1The results: Life expectancy by ethnicity (from 1 to 80 years)73% Black73% Black98% Asian98% Asian100% White100% White67 68 69 70 71 72 73 74 75 76Life expectancy from  age 1  to 80 (years)Life expectancy from age 1 to 80, by majority ethnic group, adjusted for deprivationFemalesMalesNational males National females• Novel ecological method of constructing ethnic majority life tables • Shows differences in mortality experiences for the main ethnic groups beyond the impact of deprivation • Diversity remains within these three broad ethnic groups• Watch out for the ecological fallacy!• Use to inform public health planning and in survival analysis for breast cancer project ConclusionsMelanie MorrisCancer Research UK Cancer Survival GroupLondon School of Hygiene & Tropical Medicinemelanie.morris@lshtm.ac.ukThanks to: Laura Woods and Bernard Rachet and members of the CSGImproving health worldwidewww.lshtm.ac.ukProject funded by the National Awareness and Early Diagnosis Initiative: a partnership between10%20%40%50%30%Proportion of Asians living in an area

Poster presentation: A novel methodology for constructing ethnic-majority life tables for use in net cancer survival analysis

http://researchonline.lshtm.ac.uk/2121350/1/HERON%20presentation_ethnic%20LTs_10thMay2014.pdf

Poster presentation: A novel methodology for constructing ethnic-majority life tables for use in net cancer survival analysis

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