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International Journal of Epidemiology 2001;30:102-103
© International Epidemiological Association 2001

Theory and Methods

Commentary: Secular trends in the context of competing risks

Jan Wohlfahrt and Per Kragh Andersen

Department of Epidemiology Research, Danish Epidemiology Science Center, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark. E-mail: jaw@ssi.dk

Cancer mortality is increasing while the mortality rates of ischaemic heart disease (IHD) and cerebro-vascular disease (CVD) are decreasing, so it is natural to speculate that the increase in cancer mortality may partly be explained by new cancer cases among those avoiding or surviving IHD and CVD. Llorca and Delgado-Rodríguez present an approach based on Markov chains to evaluate this question of competing risks.1 The statistical theory behind the use of Markov chains in the analyses of competing risks is well described2 (textbox). The merit of their paper is therefore to illustrate that the different approaches previously used on this subject in the epidemiological literature can be unified. They analyse the secular trend of cancer mortality from 1981 to 1994 in Spain in the context of competing risks from . . . [Full Text of this Article]

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