Five-year survival rate

The five-year survival rate is a term used in medicine for estimating the prognosis of a particular disease.^[1]

Analysis performed against the Surveillance, Epidemiology, and End Results database (SEER) facilitates calculation of Five-year survival rates.^[2][3]

Lead time bias due to earlier diagnosis can affect interpretation of the five-year survival rate.^[4]

Relative and absolute rates

Five-year relative survival rates are more commonly cited in cancer statistics;^[5] five-year absolute survival rates may sometimes also be cited.^[6]

• Five-year absolute survival rates describe the percentage of patients that are alive five years after their disease is diagnosed.

• Five-year relative survival rates describe the percentage of patients with a disease that are alive five years after their disease is diagnosed divided by the percentage of the general population of corresponding sex and age that are alive after five years. Typically, cancer five-year relative survival rates are well below 100%, reflecting excess mortality among cancer patients compared to the general population. In contrast to five-year absolute survival rates, five-year relative survival rates may also equal or even exceed 100% if cancer patients have the same or even higher survival rates than the general population. This pattern may occur if cancer patients can generally be cured, or if patients diagnosed with cancer are otherwise more privileged (e.g., in terms of socioeconomic factors or access to medical care) than the general population.^[7]

The fact that relative survival rates above 100% were estimated for some groups of patients appears counter-intuitive on first view. It is unlikely that occurrence of prostate cancer would increase chances of survival compared to the general population. A more plausible explanation is that this pattern reflects a selection effect of PSA screening, as screening tests tend to be used less often by socially disadvantaged population groups, who, in general, also have higher mortality.^[7]

Uses

Five-year survival rates can be used to compare the effectiveness of treatments.

Use of 5-year survival statistics is more useful in aggressive diseases that have a shorter life expectancy following diagnosis (such as lung cancer) and less useful in cases with a long life expectancy such as prostate cancer.

Improvements in rates are sometimes attributed to improvements in diagnosis, rather than improvements in prognosis.^[8]

To compare treatments (independent of diagnostics) it is better to consider survival from reaching a certain stage of the disease.

References