The accuracy of cancer mortality statistics based on death certificates in the United States

101

112

Background: Although colorectal cancer death rates in the United States have declined by half since 1970, large geographic disparities persist. Spatial identification of high-risk areas can facilitate targeted screening interventions to close this gap.Methods: We used the Getis-Ord Gi Ã statistic within ArcGIS to identify contemporary colorectal cancer "hotspots" (spatial clusters of counties with high rates) based on county-level mortality data from the national vital statistics system. Hotspots were compared with the remaining aggregated counties (non-hotspot United States) by plotting trends from 1970 to 2011 and calculating rate ratios (RR). Trends were quantified using joinpoint regression.Results: Spatial mapping identified three distinct hotspots in the contemporary United States where colorectal cancer death rates were elevated. The highest rates were in the largest hotspot, which encompassed 94 counties in the Lower Mississippi Delta

Section: Discussionmentioning

confidence: 99%

Where Can Colorectal Cancer Screening Interventions Have the Most Impact?

Siegel

Sahar

Robbins

et al. 2015

101

112

“…The interpretation of our findings could also be affected by the accuracy of ICD-10 coding for liver cancer which may vary worldwide with greater accuracy likely in developed countries compared with developing countries. In the United States, the concordance between underlying cause of death and cancer diagnosis for liver cancer using ICD-10 is approximately 76% (36).…”

Section: Discussionmentioning

confidence: 99%

International Trends in Liver Cancer Incidence Rates

Center

Jemal

2011

246

184

Background: Several previous studies have documented region or country-specific liver cancer incidence trends around the world. However, no study has systematically examined the international pattern using the most recently updated incidence data from the International Agency for Research on Cancer.Methods: We examined recent trends in liver cancer incidence rates from 1993 to 2002 by joinpoint analysis for 32 cancer registries worldwide, using Cancer Incidence in Five Continents. We also examined the male to female rate ratios for these and four additional registries, based on the 1998-2002 incidence data.Results: Liver cancer incidence rates for both men and women statistically significantly increased from 1993 to 2002 for 8 of 32 cancer registries considered in the analysis. Increases were largely confined to economically developed countries of Western Europe, North America, and Oceania. In contrast, rates decreased in both men and women in 5 registries including 3 in Asia. Despite this, the incidence rates in Asian countries are twice as high as those in Africa and more than four times as high as rates in North America. Male to female rate ratios varied from 0.9 in sub-Saharan African and South American registries to 5.0 in France and Egypt.Conclusions: Liver cancer incidence rates continue to increase in some low-risk parts of the world whereas they are decreasing in some of the highest risk countries in Asia. Etiologic studies are required to further elucidate factors contributing to the divergent liver cancer incidence trends worldwide.Impact: Our description of international liver cancer incidence trends may stimulate further etiologic studies. Cancer Epidemiol Biomarkers Prev; 20(11); 2362-8. Ó2011 AACR.

“…This assumption may be violated, for example, by less than perfect coding of causes of deaths (21,22). However, misreporting of cancer causes of death has been found to be low compared to other causes of death, and our model calculation would still hold even in the presence of misreporting, as long as underreporting and overreporting of the cancer of interest on death certificate are approximately balanced.…”

Section: Discussionmentioning

confidence: 92%

Deriving Valid Population–Based Cancer Survival Estimates in the Presence of Nonnegligible Proportions of Cancers Notified by Death Certificates Only

Brenner

Holleczek

2011

Background: Studies of cancer survival by population-based cancer registries are a key component in monitoring progress against cancer. Patients notified by death certificates only (DCO) are commonly excluded from such studies. The validity of this "exclude DCO" approach has been questioned and an alternative "correct for DCO" approach has been proposed.Methods: We assess the validity of both the "exclude DCO" approach and the "correct for DCO" approach using model calculations. We illustrate implications for population-based cancer survival analyses by analyses of 5-year relative survival of cancer patients in Saarland, Germany.Results: The "exclude DCO" approach provides (too) optimistic survival estimates and the "correct for DCO" approach provides (too) pessimistic survival estimates under plausible assumptions. For example, in case of true survival of 50%, underascertainment of 5% of surviving patients and of 15% of dying patients (yielding a proportion of DCO cases of 7.7%), the two approaches would provide survival rate estimates of 52.8% and 48.8%, respectively. The difference of survival estimates obtained with both approaches increases with incompleteness of registration and the proportion of DCO cases. Trace back of DCO cases shifts survival estimates from the former toward the latter estimate.Conclusions: In case of nonnegligible DCO proportions, cancer survival studies should not be exclusively based on either the "exclude DCO" or the "correct for DCO" approach. A combination of estimates from both approaches may be useful to delineate a plausibility range for true survival.Impact: Our results may help to enhance validity and comparability of population-based cancer survival estimates. Cancer Epidemiol Biomarkers Prev; 20(12); 2480-6. Ó2011 AACR.