Original Articles

Schattauer 2009

periodR an R Package to Calculate

Long-term Cancer Survival
Estimates Using Period Analysis
B. Holleczek; A. Gondos; H. Brenner
Saarland Cancer Registry, Saarbrcken, Germany;
German Cancer Research Center, Division for Clinical Epidemiology and Aging Research,
Heidelberg, Germany

Keywords
Neoplasms, survival, period analysis, software
tool

Summary
Objective: In this paper, a software package
for the R language and system for statistical
computing is presented for computation of
long-term cancer survival estimates based on
the period analysis approach. The period
analysis approach provides up-to-date longterm survival estimates of concurrently diagnosed patients, enables early detection of recent changes in long-term prognosis of cancer
patients and provides better survival predictions for recently and currently diagnosed
patients than traditional cohort-based approaches.
Methods: Computation of absolute and
relative survival estimates (both conditional
follow-up year-specific and cumulative survival estimates) and their standard errors is
based on standard actuarial methodology. For

Correspondence to:
Dipl.-Inform. Med. Bernd Holleczek
Saarland Cancer Registry
Prsident-Baltz-Strasse 5
66119 Saarbrcken
Germany
E-mail: b.holleczek@gbe-ekr.saarland.de

relative survival estimation the Ederer II

and Hakulinen method were implemented.
Results: The package may be used for period
analysis as well as traditional cohort-based
survival estimation. The package further provides functions for the export of survival estimates for use with spreadsheet programs and
for plotting survival curves. The application of
period analysis is illustrated using stomach
cancer data included in the package.
Conclusion: Application of period analysis
has gradually increased in recent years but
continues to be limited by availability of affordable and easy-to-use software tools. The
presented R package aims at closing this gap
and will further facilitate the use of period
analysis for the research community working
with population-based cancer registry data.
The software is freely available for download
on the website of the Saarland Cancer Registry at http://www.krebsregister.saarland.de/
improve/periodR_en.html.

Methods Inf Med 2009; 48: 123128

doi: 10.3414/ME0563
received: April 15, 2008
accepted: September 13, 2008
prepublished: February 18, 2009

Introduction
Long-term survival is a key outcome measure
in monitoring cancer control. Survival is
typically reported as proportions of patients
still alive after a given time span after diagnosis. Most often long-term survival is reported in form of 5-year or 10-year survival
(e.g. [14]).

In population-based cancer monitoring

relative survival [5, 6] is frequently reported
with or instead of absolute survival. Relative
survival is derived as the ratio of observed
survival and expected survival in the absence
of the cancer of interest. The expected survival is estimated from available life table data
of the underlying population, generally with
respect to sex, age and calendar year [5, 7].

Relative survival is thus corrected for other

causes of death although detailed information about the cause of death is not required
for the cancer patients.
Period analysis was proposed twelve
years ago as an alternative approach of survival estimation [8, 9]. Period analysis provides more up-to-date estimates of long-term
survival of recently and concurrently diagnosed cancer patients than traditional cohort-based methods, as consistently shown in
a number of empirical evaluations [1014]. It
enables early detection of recent changes in
long-term survival. In recent years the application of period analysis has gradually increased (e.g. [14, 1520]), but continues to
be limited by availability of affordable and
easy-to-use software.
In this paper an add-on software package
for the R statistical programming language
called periodR is presented. The package
implements both traditional cohort-based
and period survival analysis for estimation of
absolute and relative survival. A brief overview of the methodology of period analysis
will be given and the package and its most relevant components will be presented followed
by a detailed empirical example of the use of
the package to compute 5-year relative cancer
survival estimates from a conventional cohort-based and a period analysis using data of
1963 cancer patients included in the package.

Cohort, Complete
and Period Analysis
Traditional cohort-based long-term survival
analysis measures survival of patients diagnosed within a defined calendar interval
many years ago and entirely followed up over
a defined time span since then. Thus, survival
estimates derived from cohort-based analysis
Methods Inf Med 2/2009

Downloaded from www.methods-online.com on 2014-05-11 | IP: 79.10.19.16

For personal or educational use only. No other uses without permission. All rights reserved.

123

124

B. Holleczek et al.: periodR an R Package to Calculate Long-term Cancer Survival Estimates Using Period Analysis

Fig. 1 Data used for estimating 5-year survival by cohort analysis for patients diagnosed in
19962000 (dashed frame) and by period analysis for the 20012005 period (closed frame). The
numbers within the cells indicate the years following diagnosis

data

a data frame (a list of coupled vectors of same length) of

mandatory variables as specified in section data requirements and table 2

duration of follow-up in years (e. g. k=5 for calculation of

5-year survival estimates)

surv.m

data frame of age- and calendar year specific survival

probabilities of males made up of numeric vectors of
length 100 providing conditional 1-year survival probabilities from age 0 to 99; survival probabilities of a particular
calendar year are accessed via the vectors names: if the
data frame consists of three vectors named 2000,
2003 and 2004, then the vector named 2000 will
be used to access survival probabilities of the calendar
years 2000 to 2002, 2003 for survival in 2003 and
2004 for survival in 2004 and onwards. Thus, a data
frame with at least one vector with its names value
<= perbeg (see below) must be provided. The conditional 1-year survival of a male aged 49 in 2001 may be
accessed by surv.m[[2000]][50] (the ith
component of an R vector is accessed with index i).

surv.f

age- and calendar year specific 1-year survival probabilities

of females; see surv.m for further details

perbeg

first calender year of period of interest (e.g. 2001)

perend

last calendar year of period of interest (e.g. 2005)

method

character string specifying the method for calculation of

relative survival; either hakulinen (default) or
edererII

Table 1
Specification of most
relevant arguments
of function period

can reflect possible recent progress in cancer

care (particularly in diagnosis and initial
treatment options) to a very limited extent
only and may lag behind the expected survival of recently diagnosed patients in case of
resulting improvement of prognosis. The
problem is reduced to some extent, but cannot be overcome by the complete analysis,
which additionally includes more recently
diagnosed patients regardless of the length of
completed follow-up.
The distinctive feature of period analysis is
the restriction of the analysis of observed survival experience to a defined calendar period
(e.g. the most recent calendar years for which
mortality follow-up data are available). In addition to right censoring of observations at
the end of the follow-up period, data are left
truncated at the beginning of the specified
period [8, 9].
Figure 1 illustrates how survival observed for different calendar years of diagnosis would be used to obtain the most up-todate 5-year survival estimates by cohort and
period analysis with a database up to and
including the year 2005 (using data of five
subsequent years of diagnosis and a period of
five calendar years respectively).
According to the period analysis approach, the contribution of each patient to
observed numbers of persons at risk and
numbers of deaths, as well as the expected
numbers of deaths in the absence of cancer
are determined for each follow-up year within the specified period, and contributions are
summed up as a basis for survival estimation.
Identical to traditional cohort or complete
analysis, estimates of expected survival,
which are required for calculation of relative
survival, are derived from life-table data of
the underlying population with respect to
sex, age and calendar year. Cumulative survival estimates and their standard errors are
derived from estimates of conditional survival probabilities of each subsequent followup interval using standard actuarial methodology [21, 22].

Add-on Package periodR

R is a programming language and software
environment for statistical computing and
visualizing data [23]. It implements the S language and is freely available under the GNU

Methods Inf Med 2/2009

Schattauer 2009

Downloaded from www.methods-online.com on 2014-05-11 | IP: 79.10.19.16

For personal or educational use only. No other uses without permission. All rights reserved.

B. Holleczek et al.: periodR an R Package to Calculate Long-term Cancer Survival Estimates Using Period Analysis

public license for all major operating systems.

The R software is extensible through add-on
packages, which are user-submitted libraries
providing functions, datasets and accompanying documentation for special purposes.
The add-on package periodR (version
1.0-4 which requires a release of R that is 2.4.1
or higher) implements and extends proposed
computer programs and existing SAS macros
for period analysis [24, 25] and will be available on the website of the Saarland Cancer
Registry [26].
The main component of the package is
function period for computation of period
survival estimates:
period(data, k, surv.m, surv.f,
perbeg, perend, method=c(
hakulinen, edererII))

The function computes estimates of absolute

and relative survival (both conditional survival probabilities for 1-year intervals following diagnosis and cumulative survival probabilities) by the life-table approach. Standard
errors of absolute and relative survival estimates are calculated according to Greenwoods method [22]. Two methods are implemented for the estimation of relative survival:
the Ederer II [27] and the Hakulinen
method [28]. Both methods yield very similar
results for survival rates up to ten years following diagnosis. For longer follow-up times,
the Hakulinen method is usually recommended as the EdererII method may provide too low estimates [28]. Besides computation of period survival estimates, other
strategies of analysis like cohort-based or
complete analysis may be performed as well
[24]. The specification of the most relevant
arguments of function period is presented in
Table 1 (it is also possible to calculate ageadjusted survival estimates based on a recently proposed approach [29]; for further
details refer to the integrated package documentation which will be installed along with
the package [26]). The function returns an
object which contains summed up person
years and deaths for each combination of
follow-up year and calendar year of period,
point estimates of survival and corresponding standard errors which may be plotted or
exported for further use with spreadsheet
programs (e. g. Excel) by auxiliary R functions of the package.

Table 2 List of mandatory variables and data

types of argument data
sex

gender (numeric; 1 = males,

2 = females)

dm

month of diagnosis
(numeric: 112, e.g. 6 for June)

dy

year of diagnosis
(numeric: 4 digits, e.g. 2000)

diagage

age at diagnosis in years

(numeric; e.g. 67)

fm

month of end of follow-up

(numeric: 112)

fy

year of end of follow-up

(numeric: 4 digits)

vitstat

vital status at end of follow-up

(numeric; 1 = alive, 2 = dead)

Function period checks and coerces arguments prior to passing the data to subroutines
provided by a dynamically loaded library
which sum up observed and expected persons
at risk and deaths during the specified calendar period. Missing arguments and type mismatch result in error messages. In a next step,
the function calculates follow-up year-specific conditional and cumulative absolute and
relative survival estimates and standard errors. Finally, these data are rearranged and returned. The source code includes additional
comments and implementation details.

Data Requirements
For each observation to be included in the
analysis, argument data must at least contain
the following variables (variable names in
parenthesis): gender (sex), month and year
of diagnosis (dm and dy), age at diagnosis
(diagage), month and year when follow-up
ended (fm and fy) and vital status when follow-up ended (vitstat). A specification of
variable types and range is given in Table 2.
Records should be excluded if any of the
mandatory variables (sex, dm, dy, diagage,
fm, fy and vitstat) includes missing information.
For calculation of relative survival, separate data frames of age-specific survival
probabilities of the underlying population
must be prepared for each sex category. These
data frames consist of coupled vectors con-

taining age-specific 1-year survival probabilities from age 0 to 99 of relevant calendar

years as specified in Table 1. These probabilities are commonly provided as integral part
of period life tables by national or state statistical offices. If such data are not available, they
may be easily constructed from age- and sexspecific mortality rates as described in detail
in [30]. For individuals aged 100 years or
older, the survival probability of individuals
aged 99 years will be used. Since the proportion of these patients is usually very small, this
simplification has only a negligible impact.

Empirical Example
The comparison of age-group-specific 5-year
relative survival estimates derived from a
conventional cohort-based and a period
analysis will be used to illustrate the use of the
package. The most important steps of the
analysis will be presented the complete
source code is included as directly executable
examples in the documentation integrated in
the package.
For the analysis data of 1963 stomach
cancer patients included in the R package as
dataset stomach will be used. The data were
provided by the Saarland Cancer Registry
(Germany) which covers a population of almost 1.06 million residents [26]. The registry
provides high-quality data on cancer incidence and mortality since 1970 and meets
national and international standards in terms
of quality and completeness of data [31-33].
The dataset includes records of stomach
cancer patients diagnosed between 1996 and
2005 and followed up until end of 2005. Records of patients aged less than 15 at the time
of diagnosis, cancers notified by death certificate only or diagnosed by an autopsy and
multiple primary cancers have been excluded. The dataset consists of the variables
sex, diagage, dm, dy, fm, fy and vitstat as
specified in section Data Requirements and
Table 2. Prior to the analysis the patients are
grouped into two age categories: 15-64 and 65
years or older at the time of diagnosis this
information is stored in variable agr of data
frame sto.agr (agr = 0 for the younger
group and agr = 1 for patients aged 65 or
older). Age- and calendar-year-specific survival probabilities of the German population during the calendar years 1996 to 2005

Schattauer 2009

Methods Inf Med 2/2009

Downloaded from www.methods-online.com on 2014-05-11 | IP: 79.10.19.16

For personal or educational use only. No other uses without permission. All rights reserved.

125

126

B. Holleczek et al.: periodR an R Package to Calculate Long-term Cancer Survival Estimates Using Period Analysis

Table 3 Conditional and cumulative relative survival estimates of stomach cancer patients grouped into two age categories (in percent with standard
errors in parenthesis) for five years of follow up calculated for the cohorts of patients diagnosed in 19962000 (followed up until end of 2005) and for period
20012005

follow-up age at diagnosis

year
< 65

age at diagnosis
>= 65

cohort (diagnosis in 1996 to 2000) period 2001 to 2005

cohort (diagnosis in 1996 to 2000) period 2001 to 2005

conditional

cumulative

conditional

cumulative

conditional

cumulative

conditional

cumulative

62.4 (2.7)

62.4 (2.7)

63.1 (2.8)

63.1 (2.8)

41.6 (2.0)

41.6 (2.0)

49.5 (2.1)

49.5 (2.1)

77.9 (3.0)

48.6 (2.8)

78.1 (3.0)

49.2 (2.9)

72.6 (2.9)

31.7 (1.9)

80.8 (2.6)

40.0 (2.2)

89.9 (2.5)

43.7 (2.8)

86.7 (2.8)

42.7 (2.9)

84.0 (3.1)

26.6 (1.9)

84.8 (2.9)

33.9 (2.2)

97.3 (1.6)

42.5 (2.8)

96.3 (1.8)

41.1 (2.9)

89.8 (3.1)

23.9 (1.9)

90.0 (3.1)

30.5 (2.2)

96.5 (1.8)

41.0 (2.8).

96.3 (1.8)

39.6 (2.9)

98.6 (2.6)

23.6 (2.0)

99.4 (2.5)

30.3 (2.3)

Fig. 2
Plotted curves of follow-up year-specific
relative survival of
stomach cancer patients aged 65 years
or older as produced
by the R package.
Saarland Cancer
Registry, 19962000
cohort and
20012005 period
analysis

Fig. 3
Age-group-specific
cumulative relative
survival curves of
stomach cancer patients as produced by
the R package. Saarland Cancer Registry,
20012005 period
analysis

are provided by surv.probs.males and

surv.probs.females respectively [34].
Computation of age-group-specific conventional cohort estimates of absolute and
relative 5-year survival (both conditional and
cumulative survival estimates) of patients
diagnosed between 1996 and 2000 which
would be available at the end of 2005 is performed as follows:
> period(subset(sto.agr, agr==0
& dy>=1996 & dy<=2000), 5,
surv.probs.males,
surv.probs.females, 1996, 2005,
method=edererII)
> period(subset(sto.agr, agr==1
& dy>=1996 & dy<=2000), 5,
surv.probs.males,
surv.probs.females, 1996, 2005,
method=edererII)

The data used for the analyses are primarily

defined by years of diagnosis of the cohort, as
illustrated in Figure 1.
Estimates of conditional and cumulative
absolute and relative 5-year period survival
for period 2001 to 2005 are computed for
both age-groups as follows (the results are
stored in the objects period.result.agr0
and period.result.agr1 for plotting survival curves):
> period.result.agr0 <period(subset(sto.agr, agr==0),
5, surv.probs.males,
surv.probs.females, 2001, 2005,
method=edererII)

Methods Inf Med 2/2009

Schattauer 2009

Downloaded from www.methods-online.com on 2014-05-11 | IP: 79.10.19.16

For personal or educational use only. No other uses without permission. All rights reserved.

B. Holleczek et al.: periodR an R Package to Calculate Long-term Cancer Survival Estimates Using Period Analysis

> period.result.agr1 <period(subset(sto.agr, agr==1),

5, surv.probs.males,
surv.probs.females, 2001, 2005,
method=edererII)

As illustrated in Figure 1, the data used for

period analysis are primarily defined by the
calendar year of follow up with no restriction
on the years of diagnosis.
Table 3 presents calculated conditional
and 5-year cumulative relative survival estimates of the cohort of patients diagnosed between 1996 and 2000 and of period 2001 to
2005 for both age-groups. Figure 2 presents curves of conditional relative survival of
patients aged 65 or older derived from the cohort and period analysis. Figure 3 shows
plotted cumulative 5-year relative survival of
period 2001 to 2005 for both age categories
which is generated by the R code shown
below:
> plot(period.result.agr0,
cumulative=TRUE, main=)
> lines(period.result.agr1,
cumulative=TRUE)
> legend(0, 20, c(age at
diagnosis <65, age >=65),
lty=c(1:2), lwd=2, bty=n)

The cumulative relative 5-year survival estimates of the group of patients aged 64 or less
at time of diagnosis which would be available
end of 2005 are almost identical for the cohort of patients diagnosed in 1996 to 2000
and for period 2001 to 2005. In the group of
patients aged 65 years or older the period
analysis reveals major interim improvement
in relative 5-year survival. Here, the estimated
cumulative survival of the 19962000 cohort
is 23.6 percent compared to 30.3 percent of
survival in period 2001 to 2005. As Table 3
and Figure 2 illustrate, this improvement primarily results from improved survival during
the first two years following diagnosis.

Outlook
In this paper we present an add-on package
for the R environment for statistical computing named periodR intended to facilitate
the use of period analysis for the estimation of
long-term cancer survival. The software

package may be used as a tool for the computation of up-to-date estimates of absolute
and relative survival and hence as a means to
report and to disclose changes of long term
cancer survival as early as possible.
The add-on package extends the range of
software currently available for period analysis. The software underwent intense empirical evaluation and thorough inspection of the
code to ensure its reliability. It will be available in a precompiled form for Windows platforms and as source package for other operating systems on the website of the Saarland
Cancer Registry [26].
The implementation of period analysis
software for the R environment which is well
established and widely used in the academic
setting features many benefits. The periodR
package will be freely available at no cost or
without any licensing. It can be installed
easily on all major operating systems, allows
for computation of different types of survival
estimates (cohort-based and period analysis)
and includes detailed documentation on all
components of the package, as well as directly
executable examples using a real cancer dataset.
The software does not support the computation of survival estimates for follow-up
intervals of different length (e.g. shorter intervals during the first years after diagnosis).
As long-term survival estimates derived by a
life-table-based method are typically at best
marginally affected by the choice of intervals,
this limitation might not be grave. The source
code of the package is available for and may
allow further refinements.
We hope that the presented add-on R
package periodR will meet a wide audience
in researchers dealing with data from population-based cancer registries, where availability of sophisticated commercial software
packages is often limited. Maintenance and
further development of the package is intended along with ongoing improvements of
the period analysis methodology in the future(e. g. model-based survival analysis [35]).

Acknowledgments
The software and publication were realized in
the framework of the IMPROVE project with
the support of the Deutsche Krebshilfe (German Cancer Aid), grant no. 70-3166-Br5.

References
1. Berrino F, De Angelis R, Sant M, Rosso S, BielskaLasota M, Coebergh JW et al. Survival for eight
major cancers and all cancers combined for European adults diagnosed in 1995-99: results of the
EUROCARE-4 study. Lancet Oncol 2007; 8:
773783.
2. Verdecchia A, Francisci S, Brenner H, Gatta G,
Micheli A, Mangone L, et al. Recent cancer survival
in Europe: a 2000-02 period analysis of
EUROCARE-4 data. Lancet Oncol 2007; 8:
784796.
3. Coleman MP, Rachet B, Woods LM, Mitry E, Riga
M, Cooper N, et al. Trends and socioeconomic
inequalities in cancer survival in England and Wales
up to 2001. Br J Cancer 2004; 90: 13671373.
4. Ellison LF, Gibbons L. Survival from cancer up-todate predictions using period analysis. Health Rep
2006; 17: 1930.
5. Ederer F, Axtell LM, Cutler SJ. The relative survival
rate: a statistical methodology. Natl Cancer Inst
Monogr 1961; 6: 101121.
6. Henson DE, Ries LA. The relative survival rate.
Cancer 1995; 76: 16871688.
7. Parkin DM, Hakulinen T. Cancer registration: principles and methods. Analysis of survival. IARC Sci
Publ 1991. pp 159176.
8. Brenner H, Gefeller O. An alternative approach to
monitoring cancer patient survival. Cancer 1996;
78: 20042010.
9. Brenner H, Gefeller O. Deriving more up-to-date
estimates of long-term patient survival. J Clin
Epidemiol 1997; 50: 211216.
10. Brenner H, Hakulinen T. Up-to-date long-term survival curves of patients with cancer by period analysis. J Clin Oncol 2002; 20: 826832.
11. Brenner H, Sderman B, Hakulinen T. Use of
period analysis for providing more up-to-date
estimates of long-term survival rates: empirical
evaluation among 370,000 cancer patients in
Finland. Int J Epidemiol 2002; 31: 456462.
12. Talbck M, Stenbeck M, Rosn M. Up-to-date longterm survival of cancer patients: an evaluation of
period analysis on Swedish Cancer Registry data.
Eur J Cancer 2004; 40: 13611372.
13. Ellison LF. An empirical evaluation of period survival analysis using data from the Canadian Cancer
Registry. Ann Epidemiol 2006; 16: 191196.
14. Brenner H, Gefeller O, Stegmaier C, Ziegler H. More
Up-To-Date Monitoring of Long-Term Survival
Rates by Cancer Registries: An Empirical Example.
Methods Inf Med 2001; 40; 248252.
15. Aareleid T, Brenner H. Trends in cancer patient survival in Estonia before and after the transition from
a Soviet republic to an open-market economy. Int J
Cancer 2002; 102: 4550.
16. Brenner H. Long-term survival rates of cancer patients achieved by the end of the 20th century: a
period analysis. Lancet 2002; 360: 11311135.
17. Talbck M, Rosn M, Stenbeck M, Dickman PW.
Cancer patient survival in Sweden at the beginning
of the third millennium predictions using period
analysis. Cancer Causes Control 2004; 15: 967976.
18. Brenner H, Stegmaier C, Ziegler H. Long-term survival of cancer patients in Germany achieved by the
beginning of the third millenium. Ann Oncol 2005;
16: 981986.

Schattauer 2009

Methods Inf Med 2/2009

Downloaded from www.methods-online.com on 2014-05-11 | IP: 79.10.19.16

For personal or educational use only. No other uses without permission. All rights reserved.

127

128

B. Holleczek et al.: periodR an R Package to Calculate Long-term Cancer Survival Estimates Using Period Analysis

19. Houterman S, Janssen-Heijnen ML, van de PollFranse LV, Brenner H, Coebergh JW. Higher longterm cancer survival rates in southeastern Netherlands using up-to-date period analysis. Ann Oncol
2006; 17: 709712.
20. Gondos A, Arndt V, Holleczek B, Stegmaier C,
Ziegler H, Brenner H. Cancer survival in Germany
and the United States at the beginning of the 21st
century: an up-to-date comparison by period
analysis. Int J Cancer 2007; 121: 395400.
21. Brenner H, Gefeller O, Hakulinen T. Period analysis
for up-to-date cancer survival data: theory, empirical evaluation, computational realisation and applications. Eur J Cancer 2004; 40: 326335.
22. Greenwood, M. The natural duration of cancer. In:
Reports on Public Health and Medical Subjects.
London: Her Majestys Stationery Office; 1926. pp
126.
23. R Development Core Team. R: A Language and Environment for Statistical Computing. 2007. URL:
http://www.r-project.org (26.08.2008 14:00 CET).

24. Brenner H, Gefeller O, Hakulinen T. A computer

program for period analysis of cancer patient survival. Eur J Cancer 2002; 38: 690695.
25. Web site of IMBE Statistical Software Archive Network. URL: http://www.imbe.med.uni-erlangen.
de/issan/issan.htm (26.08.2008 14:00 CET).
26. Web site of Saarland Cancer Registry. URL:
http://www.krebsregister.saarland.de/ improve/
periodR_en.html (09.09.2008 16:00 CET).
27. Ederer F, Heise H. Instructions to IBM 650 programmers in processing survival computations.
Methodological note No. 10, End Results Section.
Bethesda (MD): National Cancer Institute; 1959.
28. Hakulinen T. Cancer survival corrected for heterogeneity in patient withdrawal. Biometrics 1982;
38: 933942.
29. Brenner H, Arndt V, Gefeller O, Hakulinen T. An alternative approach to age adjustment of cancer survival rates. Eur J Cancer 2004; 40: 23172322.
30. Estve J, Benhamou E, Raymond L. Statistical methods in cancer research. Volume IV. Descriptive epidemiology. IARC Sci Publ 1994. pp 229245.

31. Brenner H, Stegmaier C, Ziegler, H. Estimating

completeness of cancer registration in Saarland/
Germany with capture-recapture methods. Eur J
Cancer 1994; 30A: 16591663.
32. Haberland J, Schn D, Bertz J, Grsch B. Vollzhligkeitsschtzungen von Krebsregisterdaten in
Deutschland. Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz 2003; 46: 770774.
33. Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas
DB, editors. Cancer incidence in five continents.
Volume VIII. IARC Sci Publ. 2002; 352353.
34. Federal Statistical Office Germany. Period life tables
for Germany 1871/1881 to 2004/2006. Wiesbaden:
Federal Statistical Office; 2008. URL: https://wwwec.destatis.de/csp/shop/sfgbpm.html.cms.cBroker.
cls?cmspath=struktur,vollanzeige.csp&ID=
1021889 (26.08.2008 14:00 CET)
35. Brenner H, Hakulinen T. Up-to-date and precise estimates of cancer patient survival: model-based
period analysis. Am J Epidemiol 2006; 164:
689696.

Methods Inf Med 2/2009

Schattauer 2009

Downloaded from www.methods-online.com on 2014-05-11 | IP: 79.10.19.16

For personal or educational use only. No other uses without permission. All rights reserved.