BACKGROUND
Studies often rely on death certificates to identify cancer
occurrence. This research assessed the death certificate's ability to
reflect cancer incidence and factors that influence agreement with cancer
registry data.
METHODS
This study compared death certificates to cancer incidence data for
an occupational cohort of 1,795 deceased workers who were registered by the
Iowa Cancer Registry (ICR) between 1973 and 2005. Logistic regression models
examined the effects of factors such as survival time, age at diagnosis, and
gender on the odds of agreement between death certificate and incidence
data.
RESULTS
Death certificates under-reported cancer incidence by 10-100%,
depending on site. A one-year increase in survival decreased the odds of
agreement between death certificate and ICR data by 18%. Younger and female
workers had increased odds of agreement.
CONCLUSIONS
Death certificates can be useful predictors of cancer incidence,
particularly for diseases with shorter survival and among subjects diagnosed
earlier in life.