Interpreting international comparisons of cancer survival: The effects of incomplete registration and the presence of death certificate only cases on survival estimates
Interpreting international comparisons of cancer survival: The effects of incomplete registration and the presence of death certificate only cases on survival estimates
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DOI：
10.1016/j.ejca.2007.01.007
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发表时间：
2007-03-01
影响因子：
8.4
通讯作者：
Moller, Henrik
中科院分区：
文献类型：
--
作者：
Robinson, David;Sankila, Risto;Moller, Henrik
我们根据癌症登记数据评估了癌症病例不完全确定以及存在纯粹根据死亡证明信息登记的病例(DCO病例)对生存估计的影响。使用泰晤士河和芬兰癌症登记处的数据，我们获得了12个癌症部位的五年相对生存率估计，通常不包括DCO。然后，我们进行了调整，以考虑到已知的危险物品比例和每个地点的估计失踪案件比例的影响。一般来说，根据DCO进行调整会导致较低的存活率估计，而对不完整情况进行调整则会产生相反的效果。芬兰的数据基本上是完整的，DCO的比例很小，因此调整对估计存活率的影响很小。泰晤士河流域估算的变化更为显著。在进行队列生存分析时(基于1990至1994年间的诊断)，经不完全因素调整后的生存估计数增加的大部分被调整为DCOs因素后的减少所抵消。然而，在根据1997-2001年期间(当时泰晤士河的DCO比率与前一时期相比下降了约一半)进行期间生存分析时，最终估计数(经两种影响调整后)一般高于未经调整的值--从而缩小了两国之间的明显差异。在比较不同人群之间的生存估计时，重要的是要考虑到DCO比例和/或完整性的差异。(C)2007爱思唯尔有限公司。保留所有权利。
We have assessed the impact on survival estimates based on cancer registry data of incomplete ascertainment of cancer cases and the presence of cases registered purely from death certificate information (DCO cases). Using data from the Thames and Finnish Cancer Registries we obtained five-year relative survival estimates for 12 cancer sites, excluding DCOs as usual. We then made adjustments to allow for the effects of both the known proportion of DCOs and the estimated proportion of missing cases for each site. In general, adjusting for DCOs led to lower survival estimates, whilst adjusting for incompleteness had the opposite effect. The Finnish data were largely complete and had small proportions of DCOs, and hence the adjustments had little effect on estimated survival. The changes in the Thames estimates were more marked. When performing cohort survival analysis (based on diagnoses between 1990 and 1994), the increases in the survival estimates gained from adjusting for incompleteness were for the most part offset by the decrease produced when adjusting for DCOs. However, when performing period survival analysis based on the period 1997-2001 (when the DCO rate at Thames had fallen by around a half relative to the earlier period), the final estimates (adjusted for both effects) were generally higher than the unadjusted values - thus reducing the apparent difference between the two countries. It is important to take variations in DCO proportion and/or completeness into consideration when comparing survival estimates between different populations. (c) 2007 Elsevier Ltd. All rights reserved.