Re: Source of cancer data

[BERNARD L COHEN <blc+@PITT.EDU>]

	Many thanks for the info. If you have time, I have a few questions

below.





On Wed, 19 Dec 2001, Otto G. Raabe wrote:



> At 11:10 AM 12/19/01 -0500, BERNARD L COHEN wrote:

> >

> >The argument was that

> >SEER data, which is based on incidence rather than mortality, was claimed

> >to be better.

> >If that is true, I would like to know why. Does anyone know why such

> >claims are correct?

> *************************************************************

> December 19, 2001

>

> The Atomic Bomb survivor incidence data has been found to be more reliable

> than the mortality data because the mortality data is based on death

> certificate information that is inclined to be biased (Pierce, D.A.,

> Shimizu, Y., Preston, D.L., Vaeth, M., and Mabuchi, K. Studies of the

> Mortality of Atomic Bomb Survivors. Report 12, Part 1. Cancer: 1950-1990,

> Radiat. Res. 146, 1-27 (1996), see top of page where is says "...proximal

> survivors...had a slightly higher chance of cancer being recorded on the

> death certificate than distal survivors with the same evidence for the

> cause of death....")



	--Why wouldn't incidence also have a higher chance of being

recorded by proximal than by distal survivors? Why should the evidence for

incidence be clearer than the evidence on mortality?



 In the US survival of cancer may vary by region or

> county depending on medical treatment or economic factors, so that

> incidence data might be better for looking for dose-response information.

> Also, the cause of death may be decided by a resident physician or coroner

> rather the a physician familiar with the medical record. Lung cancer might

> be missed as the underlying cause of death if a full medical record is not

> available and a secondary immediate cause, such as respiratory distress, is

> more apparent.

>

	--Are you saying essentially that more care is taken to get a

proper diagnosis at incidence than after death? I can understand that if

experts agree on it.

	Is there anything compelling physicians to report incidence? Is

there evidence that all, or nearly all incidence is reported? By

law, they are required to report cause of death.



> Therefore, I conclude that incidence of disease is probably more accurate

> than mortality data. However, in the case of lung cancer, the difference

> between incidence data and mortality data may not be too great since

> survival is low and lung cancer is relatively common.

>

> Otto

>

> **********************************************

> Prof. Otto G. Raabe, Ph.D., CHP

> Center for Health & the Environment

> (Street Address: Bldg. 3792, Old Davis Road)

> University of California, Davis, CA 95616

> E-Mail: ograabe@ucdavis.edu

> Phone: (530) 752-7754   FAX: (530) 758-6140

> ***********************************************

>



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