{
  "abstract": "BACKGROUND: Apparent survival advantages for Hispanic and non-Hispanic Asian and Pacific Islander individuals, often labeled the \"Hispanic paradox\" or \"healthy immigrant effect,\" have been reported for multiple cancers compared with non-Hispanic White and non-Hispanic Black persons. Higher proportions of loss to follow-up among Hispanic and non-Hispanic Asian and Pacific Islander persons overestimate survival because of informative censoring. We developed a sensitivity analysis-based method to address potential impacts of differential loss to follow-up. METHODS: We estimated 5-year age-standardized cancer-specific survival for non-Hispanic White (reference), non-Hispanic Black, Hispanic, non-Hispanic Asian and Pacific Islander, Hispanic, and non-Hispanic American Indian or Alaska Native persons diagnosed between 2005 and 2019 in 22 Surveillance, Epidemiology, and End Results Program registries. Persons alive with less than 5 years or maximum possible follow-up were classified as lost to follow-up. For each cancer stage-race and ethnicity combination, for cases lost to follow-up exceeding levels for non-Hispanic White persons, we modeled 2 plausible scenarios relative to survival of non-Hispanic White patients: (1) \"lower\" survival and (2) \"higher\" survival. Across 1000 simulations, we constructed a sensitivity interval spanning the average lower 95% confidence bound of \"lower\" survival to the average upper 95% confidence bound of \"higher\" survival. RESULTS: Loss to follow-up was higher for Hispanic and non-Hispanic Asian and Pacific Islander persons and Hispanic individuals across cancer sites (range = 2.2%-20.7%) than for non-Hispanic White persons (range = 0.4%-5.4%). Sensitivity intervals were consistently wider than standard 95% CIs. After accounting for differential loss to follow-up, previously observed equivalent or higher survival disappeared for Hispanic and non-Hispanic Asian and Pacific Islander persons (eg, prostate cancer) and Hispanic persons (eg, lung cancer). CONCLUSIONS: Ignoring differential loss to follow-up overstates survival advantages among racial and ethnic minorities. Sensitivity analysis revealed that reported survival advantages are artifacts of higher loss to follow-up, underscoring the need to address this censoring bias in population-based survival studies.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "Theresa P Devasia",
      "orcid": "0000-0002-0348-1407"
    },
    {
      "name": "Paulo S Pinheiro"
    },
    {
      "name": "Mandi Yu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/35rq9v67h44qs.bib",
  "cited_by": 2,
  "doi": "10.1093/jnci/djag181",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13748751/",
  "id": "35rq9v67h44qs",
  "issns": [
    "0027-8874",
    "1460-2105"
  ],
  "landing_url": "https://doi.org/10.1093/jnci/djag181",
  "language": "en",
  "licence": "PDM-1.0",
  "licence_label": "Public domain",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/publicdomain/mark/1.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00010"
    ],
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2730|Global Cancer Incidence and Screening"
    ]
  ],
  "openalex": "W7163636332",
  "pdf_url": null,
  "pmcid": "PMC13748751",
  "pmid": "42244430",
  "published": "2026-06-04",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/35rq9v67h44qs.ris",
  "sources": [
    {
      "first_seen": "2026-11-13T12:26:51Z",
      "native_id": "PMC13748751",
      "source": "pmc",
      "url": "https://doi.org/10.1093/jnci/djag181"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Global Cancer Incidence and Screening",
      "subfield": "oncology"
    }
  ],
  "title": "Adjusting survival estimates for differential loss to follow-up by race and ethnicity: a SEER analysis",
  "title_text": "Adjusting survival estimates for differential loss to follow-up by race and ethnicity: a SEER analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:26:51Z",
  "url": "https://research.draconitic.com/paper/35rq9v67h44qs",
  "venue": "JNCI Journal of the National Cancer Institute",
  "versions": []
}