No Excess Mortality up to 10 Years in Early Stages of Breast Cancer in Women Adherent to Oral Endocrine Therapy: A Probabilistic Graphical Modeling Approach

Ramon Clèries, Maria Buxó, Mireia Vilardell, Alberto Ameijide, José Miguel Martínez, Rebeca Font, Rafael Marcos-Gragera, Montse Puigdemont, Gemma Viñas, Marià Carulla, Josep Alfons Espinàs, Jaume Galceran, Ángel Izquierdo and Josep Maria Borràs
Additional contact information
Ramon Clèries: Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain
Maria Buxó: Institut d’Investigació Biomèdica de Girona (IDIBGI), C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Girona, Spain
Mireia Vilardell: Independent Researcher, 08700 Barcelona, Spain
Alberto Ameijide: Registre de Càncer de Tarragona, Servei d’Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus (IISPV), 43204 Reus, Spain
José Miguel Martínez: Department de Estadística i Investigació Operativa, Universitat Politècnica de Catalunya (EDIFICI H), Diagonal 647, 08028 Barcelona, Spain
Rebeca Font: Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain
Rafael Marcos-Gragera: Institut d’Investigació Biomèdica de Girona (IDIBGI), C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Girona, Spain
Montse Puigdemont: Registre de Cáncer de Girona-Unitat d’Epidemiologia, Institut Català d’Oncología, 17005 Girona, Spain
Gemma Viñas: Servei d’Oncología Médica, Institut Català d’Oncología, Hospital Universitari de Girona “Doctor Josep Trueta”, 17005 Girona, Spain
Marià Carulla: Registre de Càncer de Tarragona, Servei d’Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus (IISPV), 43204 Reus, Spain
Josep Alfons Espinàs: Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain
Jaume Galceran: Registre de Càncer de Tarragona, Servei d’Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus (IISPV), 43204 Reus, Spain
Ángel Izquierdo: Registre de Cáncer de Girona-Unitat d’Epidemiologia, Institut Català d’Oncología, 17005 Girona, Spain
Josep Maria Borràs: Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain

IJERPH, 2022, vol. 19, issue 6, 1-17

Abstract: Breast cancer (BC) is globally the most frequent cancer in women. Adherence to endocrine therapy (ET) in hormone-receptor-positive BC patients is active and voluntary for the first five years after diagnosis. This study examines the impact of adherence to ET on 10-year excess mortality (EM) in patients diagnosed with Stages I to III BC (N = 2297). Since sample size is an issue for estimating age- and stage-specific survival indicators, we developed a method, ComSynSurData, for generating a large synthetic dataset (SynD) through probabilistic graphical modeling of the original cohort. We derived population-based survival indicators using a Bayesian relative survival model fitted to the SynD. Our modeling showed that hormone-receptor-positive BC patients diagnosed beyond 49 years of age at Stage I or beyond 59 years at Stage II do not have 10-year EM if they follow the prescribed ET regimen. This result calls for developing interventions to promote adherence to ET in patients with hormone receptor-positive BC and in turn improving cancer survival. The presented methodology here demonstrates the potential use of probabilistic graphical modeling for generating reliable synthetic datasets for validating population-based survival indicators when sample size is an issue.

Keywords: breast cancer; excess mortality; adherence; endocrine therapy; synthetic dataset; graphical modeling (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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