Phekoo Karen, Møller Henrik, Richards Mike, Schey Steve
Department of Haematology, Guy's Hospital, Thames Cancer Registry, Kings College London, UK.
Br J Haematol. 2002 Dec;119(3):697-705. doi: 10.1046/j.1365-2141.2002.03854.x.
No large-scale study has been performed to assess the problem of registering all subtypes of haematological malignancies. We compared registration of haematological malignancies between 1994 and 1996 by haematologists in 14 National Health Service Trusts in the Eastern part of the South Thames Region with data for the same area recorded by the Thames Cancer Registry (TCR). Case ascertainment and diagnostic accuracy were the two main outcome measures. A combined total of 4714 haematological malignancies were recorded over the 3-year period. Of these, 1329 (28%) were common to both databases, 1975 (42%) were recorded only by the TCR and 1410 (30%) were recorded only by the haematologists. Nearly one-third (31%) of all cases recorded by the TCR were death certificate-only registrations. The TCR records were obtained from 30 clinical specialities. Haematology only accounted for 35% of these cases. Discordant diagnoses were recorded in 20% of the cases that were recorded in both databases. Our data suggests that both registers have deficiencies in collecting and validating data on the incidence of haematological malignancies. To address this, a partnership was established in 1998 between haematologists in the South Thames Region and the Thames Cancer Registry. It is anticipated that engaging clinicians in the collection and validation of data will enhance the completeness of case ascertainment and improve the quality of data on haematological malignancies.
尚未开展大规模研究来评估血液系统恶性肿瘤所有亚型的登记问题。我们比较了1994年至1996年期间南泰晤士地区东部14个国民健康服务信托机构的血液科医生对血液系统恶性肿瘤的登记情况与泰晤士癌症登记处（TCR）记录的同一地区的数据。病例确诊和诊断准确性是两个主要的结果指标。在这3年期间共记录了4714例血液系统恶性肿瘤。其中，两个数据库共有的有1329例（28%），仅TCR记录的有1975例（42%），仅血液科医生记录的有1410例（30%）。TCR记录的所有病例中近三分之一（31%）仅通过死亡证明登记。TCR的记录来自30个临床专科。血液科仅占这些病例的35%。两个数据库都记录的病例中有20%存在诊断不一致的情况。我们的数据表明，两个登记系统在收集和验证血液系统恶性肿瘤发病率数据方面都存在缺陷。为解决这一问题，1998年南泰晤士地区的血液科医生与泰晤士癌症登记处建立了合作关系。预计让临床医生参与数据收集和验证将提高病例确诊的完整性，并改善血液系统恶性肿瘤数据的质量。
