Re: Source of cancer data

["Otto G. Raabe" <ograabe@UCDAVIS.EDU>]

At 12:45 PM 12/19/01 -0500, BERNARD L COHEN wrote:

>	--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.

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December 19, 2001



I am suggesting that there are two factors that make cancer incidence data

more accurate than mortality data: 



(1) During diagnosis and treatment there is usually accurate information

about the specific type of cancer, but there may be a disconnect between

that diagnosis and what is reported on the death certificate because the

physician required to fill out the death certificate may not have time to

review the total medical record and may not know about the earlier

diagnosis. Also, the direct cause of death may be ancillary to lung cancer.



(2) Those patients who are cured of a given type of cancer or who are not

cured but succumb to some other disease may not show up as having had that

cancer (e.g., lung cancer) on the death certificate. For example, someone

who has had lung cancer, had surgery, and dies in a car accident will not

be shown to have had lung cancer on their death certificate. If they die of

pneumonia that is some how related to an underlying case of lung cancer,

the certificate may still only be coded for pneumonia.



Otto



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