Said S M, Hahn J, Koops S, Püschel K
Medizinische Klinik I, Carl-von-Basedow-Klinikum Merseburg, Merseburg, Deutschland.
Dtsch Med Wochenschr. 2007 Oct;132(40):2067-70. doi: 10.1055/s-2007-985642.
Among the causes of death, cancer ranks second after cardiovascular diseases. If a cancer patient dies before the tumor is diagnosed the malignancy may be unreported among post-mortem findings and thus is often not included in cancer and cause of death statistics.
All 8844 autopsies carried out at the Institute of Forensic Medicine for the City of Hamburg from 1994 to 2001 were analysed and those cases with malignant tumor identified. The cases were then included in the cancer registry if this had not been done previously. The postmortem diagnosis of malignancy was made histologically on formalin-fixed tissue. In these cases attempts were made to find out if the initial diagnosis of malignancy had been made before death.
A malignancy was found in 519 autopsies (5.9 %). In 67.3 % of these (349/519) the patients had been aware of the disease. 27.2 % of all malignant tumors (141/519) were discovered during the post-mortem examination. In 5.6 % of cases (29/519) the question of whether the tumor had been diagnosed before death could not be answered because of lack of data or an incomplete case history. In 52.2 % (271/519) of the autopsies the tumor had definitely been the cause of death. Of these 271 tumors 17 % (46/271) were discovered only during the forensic post-mortem examination. The Hamburg Cancer Registry had been notified of only 58 cases of the 519. As a result of this study 451 new cancer cases (86.9 %) were notified to the Hamburg cancer registry.
The registration of cancer deaths in Hamburg is incomplete and the notification of cancer to the Cancer Registry is inadequate. The estimated number of unreported cases is probably greater and cancer as the cause of death is higher than reported in the statistics.
在死因中，癌症仅次于心血管疾病位列第二。如果癌症患者在肿瘤被诊断出来之前死亡，那么在尸检结果中恶性肿瘤可能未被报告，因此通常不被纳入癌症和死因统计数据中。
对1994年至2001年在汉堡市法医学研究所进行的所有8844例尸检进行分析，并确定那些患有恶性肿瘤的病例。如果这些病例之前未被纳入癌症登记处，则将其纳入。对福尔马林固定组织进行组织学检查以做出恶性肿瘤的尸检诊断。在这些病例中，试图查明是否在死亡前已做出恶性肿瘤的初步诊断。
在519例尸检中发现了恶性肿瘤（5.9%）。其中67.3%（349/519）的患者知晓自己患有该疾病。所有恶性肿瘤中有27.2%（141/519）是在尸检过程中发现的。在5.6%的病例（29/519）中，由于缺乏数据或病例史不完整，无法回答肿瘤是否在死亡前已被诊断的问题。在52.2%（271/519）的尸检中，肿瘤肯定是死亡原因。在这271个肿瘤中，17%（46/271）仅在法医尸检过程中被发现。在这519例中，汉堡癌症登记处仅收到58例的通知。由于这项研究，451例新的癌症病例（86.9%）被通知到汉堡癌症登记处。
汉堡市癌症死亡登记不完整，向癌症登记处报告癌症的情况也不充分。未报告病例的估计数量可能更多，癌症作为死因的实际比例高于统计数据中的报告比例。
