Metachronous colorectal cancer: A competing risks analysis with consideration for a stratified approach to surveillance colonoscopy

Background The data about whether patients with a prior urothelial cancer (uca) are at increased risk of colorectal cancer (crc) are conflicting. We used a competing risks analysis to determine the risk of crc after uca.Methods Historical cohorts were assembled by record linkage of Manitoba Cancer Registry and Manitoba Health databases. The incidence of crc for individuals with uca as their first cancer between 1987 and 2009 was compared with the incidence for randomly selected age- and sex-matched individuals without a cancer diagnosis at the index date (uca diagnosis date). Three competing outcomes (crc, another primary cancer, and death) were evaluated by competing risks proportional hazards models with adjustment for relevant confounders.Results The cohorts of 4591 patients with uca and 22,312 without uca were followed for a total of 179,287 person– years (py). After uca, the rate of subsequent colon cancer in uca patients was 4.5 per 1000 py compared with 3.6 per 1000 py in the non-cancer cohort. In the multivariable analysis, no overall increase in crc risk was observed for patients first diagnosed with uca (hazard ratio: 0.88; 95% confidence interval: 0.70 to 1.1; p = 0.26).Conclusions Because of similar crc risk, a similar crc screening strategy should be applied for individuals with and without uca.

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Competing risks analysis of microsatellite instability as a prognostic factor in colorectal cancer

British Journal of Surgery ◽

10.1002/bjs.10542 ◽

2017 ◽

Vol 104 (9) ◽

pp. 1250-1259 ◽

Cited By ~ 5

Author(s):

J. Toh ◽

P. H. Chapuis ◽

L. Bokey ◽

C. Chan ◽

K. J. Spring ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Factor ◽

Microsatellite Instability ◽

Competing Risks ◽

Competing Risks Analysis

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Multiple imputation strategies for a bounded outcome variable in a competing risks analysis

Statistics in Medicine ◽

10.1002/sim.8879 ◽

2021 ◽

Author(s):

Elinor Curnow ◽

Rachael A. Hughes ◽

Kate Birnie ◽

Michael J. Crowther ◽

Margaret T. May ◽

...

Keyword(s):

Multiple Imputation ◽

Competing Risks ◽

Outcome Variable ◽

Competing Risks Analysis

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Voluntary Withdrawals, Forced Resignations, Collective Retirements or Just Bad Fortune? A Competing Risks Analysis of Ministerial Turnover in the German Länder (1990-2010)

German Politics & Society ◽

10.3167/gps.2016.340103 ◽

2016 ◽

Vol 34 (1) ◽

pp. 54-76

Author(s):

Sebastian Jäckle

Keyword(s):

Competing Risks ◽

Prime Minister ◽

The Other ◽

Cox Models ◽

Coalition Governments ◽

German Länder ◽

Competing Risks Analysis ◽

Terminal Events ◽

Hiring And Firing ◽

High Level

This paper explores the determinants of ministerial duration within the German Länder between 1990 and 2010. In arguing that different terminal events ceasing ministerial tenures should be analyzed separately, it distinguishes four exit types: voluntary, forced, collective (ministers leaving office because their whole party does so) and exits that are neither volitional acts of the minister nor politically induced. Depending on the exit type, competing-risks Cox-models show different effects for one and the same variable on the hazard for ministerial turnover. Seniority in high-level politics for example helps not to be forced out of office while it has no effect on voluntary or collective exits. Heading an important ministry on the other hand increases the chances to rise to other positions in high politics or private business, but does not impact the other two hazards. The analysis furthermore shows that the principal-agent-logic known from Westminster systems with the prime minister being largely sovereign in hiring and firing cabinet members must be adapted to the German context of frequent coalition governments. In coalition governments, only ministers from the same party as the prime minister exhibit higher hazards for forced exits, while ministers from other coalition partners are much safer in that regard.

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Impact of Increasing Age on Cause-Specific Mortality and Morbidity in Patients With Stage I Non–Small-Cell Lung Cancer: A Competing Risks Analysis

Journal of Clinical Oncology ◽

10.1200/jco.2016.69.0834 ◽

2017 ◽

Vol 35 (3) ◽

pp. 281-290 ◽

Cited By ~ 83

Author(s):

Takashi Eguchi ◽

Sarina Bains ◽

Ming-Ching Lee ◽

Kay See Tan ◽

Boris Hristov ◽

...

Keyword(s):

Lung Cancer ◽

Competing Risks ◽

Independent Predictor ◽

Forced Expiratory Volume ◽

Stage I ◽

Diffusing Capacity ◽

Curative Intent ◽

Mortality And Morbidity ◽

Competing Risks Analysis ◽

Specific Mortality

Purpose To perform competing risks analysis and determine short- and long-term cancer- and noncancer-specific mortality and morbidity in patients who had undergone resection for stage I non–small-cell lung cancer (NSCLC). Patients and Methods Of 5,371 consecutive patients who had undergone curative-intent resection of primary lung cancer at our institution (2000 to 2011), 2,186 with pathologic stage I NSCLC were included in the analysis. All preoperative clinical variables known to affect outcomes were included in the analysis, specifically, Charlson comorbidity index, predicted postoperative (ppo) diffusing capacity of the lung for carbon monoxide, and ppo forced expiratory volume in 1 second. Cause-specific mortality analysis was performed with competing risks analysis. Results Of 2,186 patients, 1,532 (70.1%) were ≥ 65 years of age, including 638 (29.2%) ≥ 75 years of age. In patients < 65, 65 to 74, and ≥ 75 years of age, 5-year lung cancer–specific cumulative incidence of death (CID) was 7.5%, 10.7%, and 13.2%, respectively (overall, 10.4%); noncancer-specific CID was 1.8%, 4.9%, and 9.0%, respectively (overall, 5.3%). In patients ≥ 65 years of age, for up to 2.5 years after resection, noncancer-specific CID was higher than lung cancer–specific CID; the higher noncancer-specific, early-phase mortality was enhanced in patients ≥ 75 years of age than in those 65 to 74 years of age. Multivariable analysis showed that low ppo diffusing capacity of lung for carbon monoxide was an independent predictor of severe morbidity ( P < .001), 1-year mortality ( P < .001), and noncancer-specific mortality ( P < .001), whereas low ppo forced expiratory volume in 1 second was an independent predictor of lung cancer–specific mortality ( P = .002). Conclusion In patients who undergo curative-intent resection of stage I NSCLC, noncancer-specific mortality is a significant competing event, with an increasing impact as patient age increases.

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