Johnson Christopher J, Hahn Christine G, Fink Aliza K, German Robert R
Cancer Data Registry of Idaho, Division of Public Health, Boise, ID 83702, USA.
Am J Forensic Med Pathol. 2012 Jun;33(2):137-42. doi: 10.1097/PAF.0b013e318219877e.
Death certificates are the source for mortality statistics and are used to set public health goals. Accurate death certificates are vital in tracking outcomes of cancer. Deaths may be certified by physicians or other medical professionals, coroners, or medical examiners. Idaho is one of 3 states that participated in a Centers for Disease Control and Prevention-funded study to assess the concordance between cancer-specific causes of death and primary cancer site among linked cancer registry/death certificate data. We investigated variability in the accuracy of cancer death certificates by characteristics of death certifiers, including certifier type (physician vs coroner), physician specialty, years of experience as death certifier, and number of deaths certified. This study showed significant differences by certifier type/physician specialty in the accuracy of cancer mortality measured by death certificates. Nonphysician coroners had lower accuracy rates compared with physicians. Although nonphysician coroners certified less than 5% of cancer deaths in Idaho, they were significantly less likely to match the primary site from the cancer registry. Results from this study may be useful in the future training of death certifiers to improve the accuracy of death certificates and cancer mortality statistics.
死亡证明是死亡率统计的来源,并用于设定公共卫生目标。准确的死亡证明对于追踪癌症的结局至关重要。死亡证明可由医生或其他医学专业人员、验尸官或法医开具。爱达荷州是参与疾病控制与预防中心资助研究的三个州之一,该研究旨在评估关联的癌症登记处/死亡证明数据中特定癌症死因与原发性癌症部位之间的一致性。我们根据死亡证明开具者的特征,包括开具者类型(医生与验尸官)、医生专业、担任死亡证明开具者的年限以及开具的死亡证明数量,调查了癌症死亡证明准确性的差异。这项研究表明,根据开具者类型/医生专业,死亡证明所衡量的癌症死亡率准确性存在显著差异。与医生相比,非医生验尸官的准确率较低。尽管在爱达荷州,非医生验尸官开具的癌症死亡证明不到5%,但他们将原发性部位与癌症登记处匹配的可能性明显较小。这项研究的结果可能对未来死亡证明开具者的培训有用,以提高死亡证明和癌症死亡率统计的准确性。