Accuraey of Cancer Death Certificates in KOREA: A comparison between diagnoses in the central cancer registry and certified underlying causes of death / 대한암학회지

PURPOSE: We evaluated the accuracy of death certificates for persons who registered in the Central Cancer Registry in 1993 and died from 1993 to 1995. MATERIALS AND METHODS: The study consisted of 27,058 cases which were classified into five groups. according to the possibility of accuracy of the underlying causes of death. We compared the distribution of five groups according to several demographic factors. Also we calculated the detection rate and the confirmation rate for a selected 23,858 persons reported to die of a cancer. RESULTS: Among the 27,058 deaths, only 64.4% was included in the group which had reported the same cancer site with registry as underlying cause of death. The accuracy decreased with increasing age and was worse for women and rural residence. And physicians certification was an important factor to improve the accuracy. Cancers of stomach, lung, esophagus and breast were included into the high accuracy group, cancers of the colon, rectum and gallbladder and extrahepatic biliary tract into the low accuracy group. Cancers of the colon, pancreas, liver and lung were overreported, varied from 1.2 to 1.4 times, and cervical cancer was severely underreported, about 0.5 times. CONCLUSION: These results suggest that the caution in the use and interpretation of cancer certificate data would be required.

An Epidemiologic Study on Death Caused by Cancer in Pusan / 예방의학회지

This study surveyed and measured the level and structure of cancer deaths and their trends over time for offering the fundamental data of the cancer prevention and control in Pusan city in the future. Authors conducted the study of descriptive epidemiology using materials derived from the computerized data of total 3,722 certified cancer deaths in Pusan city from January 1 to December 31, 1993 registered on the National Statistical Office, the Republic of Korea. The obtained results were as follows: 1. According to the total registered cases of deaths(16,331 cases) in Pusan city during 1993, cancer(3,722 cases) and cerebrovascular disease(2,718 cases) were the first and second cause of deaths as 23.1% and 16.9%, respectively. These pattern showed the change between cancer(14.7%) and cerebrovascular disease(18.5%) in order of frequency in comparison to 1982. Also, the total number of cancer deaths was increased in comparison to 1982. The rate of death certification by physicians was 87.1% of all registered deaths, which was increased to 6.8% in comparison to 1982(80.3%). 2. Crude death rate and cancer specific death rate was 4.06 per 1,000 populations and 93.8 per 100,000 populations(male:117.8, female:70.0), respectively. The former was similar to that of 1982, but the latter was increased to 1.6 times as that of 1982. 3. Age-adjusted cancer specific death rate by standardization with whole country population was 111.9(male:141.5, female:106.7) per 100,000 populations, higher than not age-adjusted cancer specific death rate(93.8), and the sex difference was statistically significant with male predominance(p<0.05). 4. Cancer specific death rate by age was generally increased with age and most of cancer deaths(male:91.8%, female:88.5%) occurred since 40 years old. 5. The major cancer(cancer specific death rate per 100,000 populations) in male was liver(30.6) followed by stomach(25.6), lung(21.9), and GB and EHBD(5.7), in female stomach(15.7), liver(9.9), lung(7.3), and uterus(6.9). The relative frequency of the leading three cancer among total cancer deaths marked 66.3% in male and 47.1% in female, and decreased in comparison to 1982(male:72.2%, female:54.5%). 6. The total ratio of male to female cancer specific death rate showed 1.68 to 1 with male predominance. And the ratio was above 2.0 in larynx, oral cavity & pharynx, esophagus, liver, lung, bladder cancer and the ratio was 1.0~1.9 in stomach, pancreas, gall bladder and EHBD, brain, rectum and anus cancer, leukemia, but the ratio was reversed in thyroid and colon cancer. In conclusion, cancer was the first cause of deaths. The proportion of lung cancer was increased, that of stomach & uterine cancer was decreased relatively, and liver cancer was constantly higher proportion. In the future, it is necessary to conduct the further investigations on the cancer risk factors considering areal specificity.