Re: Source of cancer data

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

	Many thanks to Otto and to all who responded to my question about

incidence vs mortality.

	A few last comments: The LNT theory I was testing was based on

lung cancer mortality --not incidence-- among uranium miners. On the other

hand, there were autopsies done by experienced pathologists on all these

cases. I don't believe they were included if they died of causes other

than lung cancer.

	Another cause for differences between our mortality data and

Field's incidence data is that different time periods were covered. We

used 1970-1979 in the original paper and 1979-1994 in the Update paper;

there was little difference in national results between them. Statistics

is also an important issue as many counties have less than 5 cases per

year.

	Since my studies cover the entire nation, there was little choice

for me in using mortality data. Moreover, all of the problems considered

in this discussion should average out in considering data for 1600

counties from all over U.S. To matter, there would have to be a strong

correlation between these problems and radon levels, extending all over

the nation. There would be a much better chance for such a correlation

within a single state.



Bernard L. Cohen

Physics Dept.

University of Pittsburgh

Pittsburgh, PA 15260

Tel: (412)624-9245

Fax: (412)624-9163

e-mail: blc+@pitt.edu





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



> 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.

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

> 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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