INTERPRETATION OF ENGLAND AND WALES CANCER MORTALITY DATA - THE EFFECT OF INQUIRIES TO CERTIFIERS FOR FURTHER INFORMATION
INTERPRETATION OF ENGLAND AND WALES CANCER MORTALITY DATA - THE EFFECT OF INQUIRIES TO CERTIFIERS FOR FURTHER INFORMATION
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DOI：
10.1038/bjc.1989.164
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发表时间：
1989-05-01
影响因子：
8.8
通讯作者：
SWERDLOW, AJ
中科院分区：
文献类型：
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作者：
SWERDLOW, AJ
对于英格兰和威尔士的一些死亡证明，国家数据中编码和公布的原因信息并不是证明人最初提交的信息，而是后来向证明人询问进一步信息的结果。这些查询可能导致长期死亡率数据中存在大量人为因素，也可能导致特定研究群体（如队列研究中的受试者）的死亡率数据与已公布的死亡率数据之间存在大量不可比性。目前的查询政策有关癌症的描述，并在这一政策的变化，近年来，以帮助解释死亡率数据。说明了查询政策的变化对长期数据的影响。在《国际疾病分类》的四位数字水平，查询政策的改变可使公布的死亡率改变数百个百分点;在三位数字水平，目前查询的最大影响是使编码为眼睛癌症的死亡人数增加35%，而编码为身体癌症（子宫）的死亡人数增加31%;胸腺癌、心脏癌和纵隔癌增加了18%，胸膜癌增加了17%，而几个“其他”和“未具体说明的”类别的癌症减少了10%以上，黑色素瘤死亡率下降了6%
For some death certificates in England and Wales the cause information coded and published in national data is not that initially submitted by the certifier, but instead derives from a subsequent enquiry to the certifier for further information. These enquiries can lead to substantial artefacts in secular mortality data, and also to substantial non-comparabilty between mortality data for special study groups, such as subjects in cohort studies, and published mortality data. A description of current enquiry policy relevant to cancers, and changes in this policy over recent years is given to aid interpretation of mortality data. The effects on secular data of changes in enquiry policy are illustrated. At 4-digit level of the ICD, changes in enquiry policy can alter published mortality rates by several hundred per cent. At 3-digit level the greatest effects of enquiries at present are to increase the number of deaths coded to cancer of the eye by 35% and cancer of the body the uterus by 31%; cancers of the thymus, heart and mediastinum are increased by 18% and pleural cancer by 17%, while decreases of more than 10% are caused for several ''other'' and ''unspecified'' rubrics, and a decrease of 6% for deaths coded to melanoma.