Proportional hazards models and age-period-cohort analysis of cancer rates

Stat Med. 2010 May 20;29(11):1228-38. doi: 10.1002/sim.3865.


Age-period-cohort (APC) analysis is widely used in cancer epidemiology to model trends in cancer rates. We develop methods for comparative APC analysis of two independent cause-specific hazard rates assuming that an APC model holds for each one. We construct linear hypothesis tests to determine whether the two hazards are absolutely proportional or proportional after stratification by cohort, period, or age. When a given proportional hazards model appears adequate, we derive simple expressions for the relative hazards using identifiable APC parameters. To demonstrate the utility of these new methods, we analyze cancer incidence rates in the United States in blacks versus whites for selected cancers, using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. The examples illustrate that each type of proportionality may be encountered in practice.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • African Americans
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Colorectal Neoplasms / epidemiology*
  • European Continental Ancestry Group
  • Female
  • Humans
  • Incidence
  • Kidney Neoplasms / epidemiology*
  • Male
  • Middle Aged
  • Mouth Neoplasms / epidemiology*
  • Pancreatic Neoplasms / epidemiology*
  • Proportional Hazards Models*
  • United States
  • Urinary Bladder Neoplasms / epidemiology*
  • Young Adult