Search arXiv⌕ Search

arXiv · 2603.19945

Cancer Survival Rates Are Misleading

Abstract

Five-year cancer survival rates are widely reported and often interpreted to mean that early detection saves lives, that a late fatal diagnosis would have been prevented by earlier detection, and that increasing survival over time proves better treatment. This expository article explains why such inferences are not supported by survival statistics alone. A simple Markov model of tumor progression, calibrated to patterns like those in SEER data, shows that high survival after early diagnosis, large gaps between early and late stage, and improving survival can all appear even when treatment is ineffective and screening does not reduce mortality. The discussion ties these points to the clinical literature and argues that randomized trials and mortality outcomes are needed to support screening and treatment claims; five-year survival alone provides little actionable evidence and is easily misread.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Allen B. Downey. 2026-03-20. Cancer Survival Rates Are Misleading. https://arxiv.org/abs/2603.19945

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

Bridging Impulse Control of Piecewise Deterministic Markov Processes and Markov Decision Processes: Frameworks, Extensions, and Open Challenges

Control theory plays a pivotal role in understanding and optimizing the behavior of complex dynamical systems across various scientific and engineering disciplines. Two key frameworks that have emerged for modeling and solving control problems in stochastic systems are piecewise deterministic Markov processes (PDMPs) and Markov decision processes (MDPs). Each framework has its unique strengths, and their intersection offers promising opportunities for tackling a broad class of problems, particularly in the context of impulse controls and decision-making in complex systems. The relationship between PDMPs and MDPs is a natural subject of exploration, as embedding impulse control problems for PDMPs into the MDP framework could open new avenues for their analysis and resolution. Specifically, this integration would allow leveraging the computational and theoretical tools developed for MDPs to address the challenges inherent in PDMPs. On the other hand, PDMPs can offer a versatile and simple paradigm to model continuous time problems that are often described as discrete-time MDPs parametrized by complex transition kernels. This transformation has the potential to bridge the gap between the two frameworks, enabling solutions to previously intractable problems and expanding the scope of both fields. This paper presents a comprehensive review of two research domains, illustrated through a recurring medical example. The example is revisited and progressively formalized within the framework of thevarious concepts and objects introduced

stat.ME↗

Decision Theoretic Subgroup Detection With Bayesian Machine Learning

We consider the problem of identifying promising subpopulations in terms of treatment effectiveness or treatment effect heterogeneity, from a Bayesian decision theoretic perspective. We first show that a straight-forward application of Bayesian decision theory to subgroup detection leads to a counter-intuitive risk-seeking (RS) behavior. Motivated by this observation, we introduce the Bayesian Risk-Aware Inference and Detection of Subgroups (BRAIDS) utility and use it to perform subgroup selection and post selection inference. The BRAIDS utility interpolates between risk-seeking (RS) and risk-averse (RA) identifications of subgroups, with a variant of the virtual twins algorithm as its risk-neutral midpoint. We also argue that effective subgroup estimation and inference requires the use of regularization priors to safeguard inferences from the winner's curse. We provide empirical evidence that posterior credible intervals for subgroup effects can still obtain nominal coverage levels, provided that an appropriate prior distribution is chosen. The proposed framework is illustrated on data from clinical trial assessing the efficacy of canagliflozin as a treatment for type 2 diabetes.

stat.ME↗

Modeling cyclostationarity in time series using ASCA

Modern data analysis across diverse disciplines increasingly relies on time series. Many of these datasets exhibit cyclostationarity, where patterns approximately repeat in a regular manner, often across multiple time scales, such as daily, weekly or yearly cycles. In this context, statistical inference is essential to distinguish genuine underlying effects from random variability. While tools like Analysis of Variance (ANOVA) provide such inference, they often lack interpretability and struggle with the complexities of multivariate data. To address these limitations, we propose a unified pipeline for the exploratory analysis of cyclostationary times series using ANOVA Simultaneous Component Analysis (ASCA). ASCA is an extension of ANOVA that is able to work in both univariate and multivariate cases. Combining inference with the visualization capabilities of Principal Component Analysis (PCA), ASCA provides powerful options for interpretability. ASCA's capabilities have been well-established in the analysis of experimental data, but they remain largely unexplored for observational data like time series. Our workflow introduces an algorithmic approach to modeling time-dependent data using ASCA, enabling control over multiple cyclostationary time scales while also accounting for the specific challenges of this type of data, such as autocorrelation. Furthermore, we observed that ASCA provides a better separation of variability across factors than ANOVA in unbalanced designs due to its multivariate nature. We demonstrate the efficacy of this methodology through two real-world case studies: water temperature trends in mountain lakes in Sierra Nevada, Spain, and airborne pollen trends over 30 years recorded in the city of Granada, Spain.

stat.ME↗