Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus.
Clin Epidemiol. 2012;4 Suppl 2(Suppl 2):11-6. doi: 10.2147/CLEP.S31574. Epub 2012 Aug 17.
The purpose of this study was to investigate the completeness of TNM (Tumor, Node, Metastasis) staging for breast cancer in the Danish Cancer Registry.
We identified 26,488 patients with a first diagnosis of breast cancer between 2004 and 2009 from the Danish Cancer Registry. We obtained information on comorbidity through the Danish National Patient Registry. We estimated the completeness of TNM registration in the Danish Cancer Registry and stratified the analysis by gender, age, year of cancer diagnosis, and comorbidity. We designed an algorithm categorizing breast cancer into localized, regional, distant, or unknown stage based on TNM codes.
The overall completeness of TNM registration was 85.4%. The completeness varied little by gender and study year, but decreased from 91.3% in patients aged 0-39 years to 57.0% in patients aged 80 years or more, and from 87.9% among patients with a low level of comorbidity to 69.7% among patients with a high level of comorbidity.
The completeness of the TNM registration varied substantially by age and level of comorbidity. Thus, depending on the outcome under study, stage-specific analyses may yield biased results. The completeness of TNM should be considered in study designs using TNM information.
本研究旨在调查丹麦癌症登记处乳腺癌的 TNM（肿瘤、淋巴结、转移）分期的完整性。
我们从丹麦癌症登记处确定了 2004 年至 2009 年间 26488 例首次诊断为乳腺癌的患者。我们通过丹麦国家患者登记处获得了合并症信息。我们估计了丹麦癌症登记处 TNM 登记的完整性，并按性别、年龄、癌症诊断年份和合并症进行了分层分析。我们设计了一种基于 TNM 编码将乳腺癌分为局限性、区域性、远处或未知阶段的算法。
TNM 登记的总体完整性为 85.4%。完整性在性别和研究年份之间差异不大，但从 0-39 岁患者的 91.3%降至 80 岁或以上患者的 57.0%，从合并症低水平患者的 87.9%降至合并症高水平患者的 69.7%。
TNM 登记的完整性随年龄和合并症水平有很大差异。因此，根据研究的结果，特定阶段的分析可能会产生有偏倚的结果。在使用 TNM 信息的研究设计中应考虑 TNM 的完整性。
