Arrow Left Health care

Use case: Understanding Oral Cavity cancer survival in the Netherlands and Taiwan

Federated analysis of survival of patients with oral cavity cancer based on cancer registry data.

Medical relevance

Oral cavity cancer is rare in the Netherlands, while endemic in Taiwan. Understanding of differences in risk factors for mortality may improve disease management.


Cancer registries have a history of international collaboration. For example for epidemiological comparative research and providing data to describe the burden of the disease across countries In particular, collaborations across cancer registries is essential to study rare cancers. Therefore, registries are exploring the Personal Health Train as a privacy preserving way to analyze international data. The PHT provides an alternative to the traditional way where patient records are shared. This project is the first implementation of the open source Personal Health Train software ( The project focused on an epidemiological question (differences in patterns in survival for patient with oral cavity cancer) as well a technical one (the implementation of the Personal Health Train in the Netherlands and Taiwan).

Main results

We successfully implemented the PHT at the Netherlands and Taiwan cancer registries and completed a survival analysis (Cox proportional hazard).

Lessons learned

For international comparison of data the use of standards and coding systems in cancer registries is common practice. Therefore, cancer registries are relatively mature FAIR data stations that proved fairly easy to connect to the PHT infrastructure. At the same time, the PHT principles and technology are new. Explaining the technology and its potential involved deliberations with the Taiwan ministry of Health and Welfare, as well as regulatory bodies at both organizations.

Follow up

Having convinced stakeholders about the potential of the Personal Health Train, the PHT can be a real catalyst to conduct international studies using cancer registry data. We already have several follow-up studies planned with the Taiwan Cancer Registry as well as with other registries in East Asia.

Available material

The Cox Hazard Proportional analysis algorithm was added to the library. A scientific publication of the results and clinical implications (manuscript, works in progress).

Project details

Funders IKNL, Taiwan Health Promotion Authority, Taiwan ministry of Health and Welfare
Cooperating partners IKNL, Industrial Technology Research Institute (ITRI), Taiwan Cancer Registry



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