Death certificate only proportions should be age adjusted in studies comparing cancer survival across populations and over time
Death certificate only proportions should be age adjusted in studies comparing cancer survival across populations and over time
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DOI：
10.1016/j.ejca.2015.10.059
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发表时间：
2016-01-01
影响因子：
8.4
通讯作者：
Jansen, Lina
中科院分区：
文献类型：
--
作者：
Brenner, Hermann;Castro, Felipe A.;Jansen, Lina
背景：仅通过死亡证明（DCO）报告的病例比例是比较不同地区和不同时期癌症生存的研究中常用的数据质量指标。我们的目的是评估DCO比例对癌症患者年龄结构的依赖性。方法：使用来自德国国家癌症生存研究的数据，我们确定了24种常见癌症的年龄特异性和总体（粗）DCO比例。然后，假设年龄特定的DCO比例保持不变，我们分别推导出癌症人群年龄分布变化5年和10年的总体（粗）DCO比例。结果：在15-44岁、45-54岁、55-64岁、65-74岁和75岁以上年龄组中，24种癌症的中位DCO比例分别为2.4、3.7、5.5、8.5和23.9%。年龄减少5岁和10岁导致癌症特异性粗DCO比例分别降低0.4 - 4.8%和0.7 - 8.6%。相反，年龄增加5岁和10岁导致癌症特异性粗DCO比例分别增加0.8至4.8和1.8至9.6%。这些变化与由年龄分布变化引起的粗5年相对生存率的变化幅度相似（但方向相反）。结论：肿瘤患者人群的年龄结构对DCO比例有重要影响。因此，在跨地区和跨时间的癌症生存比较研究中，DCO比例应进行年龄调整。(C) 2015 Elsevier Ltd.版权所有。
Background: The proportion of cases notified by death certificate only (DCO) is a commonly used data quality indicator in studies comparing cancer survival across regions and over time. We aimed to assess dependence of DCO proportions on the age structure of cancer patients.Methods: Using data from a national cancer survival study in Germany, we determined age specific and overall (crude) DCO proportions for 24 common forms of cancer. We then derived overall (crude) DCO proportions expected in case of shifts of the age distribution of the cancer populations by 5 and 10 years, respectively, assuming age specific DCO proportions to remain constant.Results: Median DCO proportions across the 24 cancers were 2.4, 3.7, 5.5, 8.5 and 23.9% in age groups 15-44, 45-54, 55-64, 65-74, and 75+, respectively. A decrease of ages by 5 and 10 years resulted in decreases of cancer specific crude DCO proportions ranging from 0.4 to 4.8 and from 0.7 to 8.6 percent units, respectively. Conversely, an increase of ages by 5 and 10 years led to increases of cancer specific crude DCO proportions ranging from 0.8 to 4.8 and from 1.8 to 9.6 percent units, respectively. These changes were of similar magnitude (but in opposite direction) as changes in crude 5-year relative survival resulting from the same shifts in age distribution.Conclusions: The age structure of cancer patient populations has a substantial impact on DCO proportions. DCO proportions should therefore be age adjusted in comparative studies on cancer survival across regions and over time. (C) 2015 Elsevier Ltd. All rights reserved.