The Lead Time Distribution When Lifetime is Subject to Competing Risks in Cancer Screening

Wu Dongfeng, Kafadar Karen, Rosner Gary L. and Broemeling Lyle D.
Additional contact information
Wu Dongfeng: University of Louisville
Kafadar Karen: Indiana University, Bloomington
Rosner Gary L.: Sidney Kimmel Comprehensive Cancer Center
Broemeling Lyle D.: Broemeling and Associates Inc.

The International Journal of Biostatistics, 2012, vol. 8, issue 1, 16

Abstract: This paper extends the previous probability model for the distribution of lead time in periodic cancer screening exams, namely, in that the lifetime T is treated as a random variable, instead of a fixed value. Hence the number of screens for a given individual is a random variable as well. We use the actuarial life table from the Social Security Administration to obtain the lifetime distribution, and then use this information to project the lead time distribution for someone with a future screening schedule. Simulation studies using the HIP study group data provide estimates of the lead time under different screening frequencies. The projected lead time has two components: a point mass at zero (corresponding to interval cases detected between screening exams) and a continuous probability density. We present estimates of the projected lead time for participants in a breast cancer screening program. The model is more realistic and can inform optimal screening frequency. This study focuses on breast cancer screening, but is applicable to other kinds of cancer screening also.

Keywords: lead time; sensitivity; sojourn time; transition probability density; lifetime; cancer screening (search for similar items in EconPapers)
Date: 2012
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Citations: View citations in EconPapers (1)

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DOI: 10.1515/1557-4679.1363

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