{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T08:54:44Z","timestamp":1762332884418,"version":"build-2065373602"},"reference-count":19,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Portuguese Foundation for Science and Technology","award":["UIDB\/00212\/2020","UIDB\/04630\/2020","UIDB\/00297\/2020"],"award-info":[{"award-number":["UIDB\/00212\/2020","UIDB\/04630\/2020","UIDB\/00297\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Stats"],"abstract":"<jats:p>Lung cancer remains one of the leading causes of death worldwide due to its high rates of illness and mortality. In this study, we applied a continuous-time multi-state Markov model to examine how lung cancer progresses through six clinically defined stages, using retrospective data from 576 patients. The model describes movements between disease stages and the final stage (death), providing estimates of how long patients typically remain in each stage and how quickly they move to the next. It also considers important demographic and clinical factors such as age, smoking history, hypertension, asthma, and gender, which influence survival outcomes. Our findings show slower changes at the beginning of the disease but faster decline in later stages, with clear differences across patient groups. This approach highlights the dynamic course of the illness and can help guide tailored follow-up, personalized treatment, and health policy decisions. The study is based on a secondary analysis of publicly available data and therefore did not require clinical trial registration.<\/jats:p>","DOI":"10.3390\/stats8040106","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T07:58:05Z","timestamp":1762329485000},"page":"106","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Multi-State Model for Lung Cancer Mortality in Survival Progression"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3815-2312","authenticated-orcid":false,"given":"Vinoth","family":"Raman","sequence":"first","affiliation":[{"name":"Deanship of Quality and Academic Accreditation, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9209-7772","authenticated-orcid":false,"given":"Sandra S.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Mathematics, University of Beira Interior, 6201-001 Covilh\u00e3, Portugal"},{"name":"Centre of Mathematics and Applications, University of Beira Interior, 6201-001 Covilh\u00e3, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9095-0947","authenticated-orcid":false,"given":"D\u00e1rio","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Mathematics, University of Beira Interior, 6201-001 Covilh\u00e3, Portugal"},{"name":"Centre of Mathematics and Applications, University of Beira Interior, 6201-001 Covilh\u00e3, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8282-3921","authenticated-orcid":false,"given":"Ayman","family":"Alzaatreh","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics, American University of Sharjah, Sharjah P.O. Box 26666, United Arab Emirates"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.14715\/cmb\/2020.66.6.17","article-title":"Exploration and analysis of the value of tumor-marker joint detection in the pathological type of lung cancer","volume":"99","author":"Gao","year":"2020","journal-title":"Cell. Mol. Biol."},{"key":"ref_2","unstructured":"World Health Organization (2024, September 21). Cancer. Fact Sheets. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/cancer."},{"key":"ref_3","unstructured":"World Cancer Research Fund International (2024, September 21). Lung Cancer Statistics. 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