国家死亡索引链接对美国基于人群的癌症生存率的影响。
The impact of National Death Index linkages on population-based cancer survival rates in the United States.
机构信息
Cancer Data Registry of Idaho, Boise, ID 83701, USA.
出版信息
Cancer Epidemiol. 2013 Feb;37(1):20-8. doi: 10.1016/j.canep.2012.08.007. Epub 2012 Sep 7.
BACKGROUND
In order to ensure accurate survival estimates, population-based cancer registries must ascertain all, or nearly all, patients diagnosed with cancer in their catchment area, and obtain complete follow-up information on all deaths that occurred among registered cancer patients. In the US, linkage with state death records may not be sufficient to ascertain all deaths. Since 1979, all state vital statistics offices have reported their death certificate information to the National Death Index (NDI).
OBJECTIVE
This study was designed to measure the impact of linkage with the NDI on population-based relative and cancer cause-specific survival rates in the US.
METHODS
Central cancer registry records for patients diagnosed 1993-1995 from California, Colorado, and Idaho were linked with death certificate information (deaths 1993-2004) from their individual state vital statistics offices and with the NDI. Two databases were created: one contained incident records with deceased patients linked only to state death records and the second database contained incident records with deceased patients linked to both state death records and the NDI. Survival estimates and 95% confidence intervals from each database were compared by state and primary site category.
RESULTS
At 60 months follow-up, 42.1-48.1% of incident records linked with state death records and an additional 0.7-3.4% of records linked with the NDI. Survival point estimates from the analysis without NDI were not contained within the corresponding 95% CIs from the NDI augmented analysis for all sites combined and colorectal, pancreas, lung and bronchus, breast, prostate, non-Hodgkin lymphoma, and Kaposi sarcoma cases in all 3 states using relative survival methods. Additional combinations of state and primary site had significant survival estimate differences, which differed by method (relative versus cause-specific survival).
CONCLUSION
To ensure accurate population-based cancer survival rates, linkage with the National Death Index to ascertain out of state and late registered deaths is a necessary process for US central cancer registries.
背景
为了确保准确的生存估计，基于人群的癌症登记处必须确定其监测区域内所有或几乎所有被诊断患有癌症的患者，并获得所有登记癌症患者死亡的完整随访信息。在美国，与州死亡记录的链接可能不足以确定所有死亡。自 1979 年以来，所有州的生命统计办公室都向国家死亡索引（NDI）报告其死亡证明信息。
目的
本研究旨在衡量与 NDI 链接对美国基于人群的相对和癌症病因特异性生存率的影响。
方法
将 1993-1995 年在加利福尼亚州、科罗拉多州和爱达荷州诊断出的患者的中央癌症登记记录与他们各自州生命统计办公室的死亡证明信息（1993-2004 年死亡）以及 NDI 进行链接。创建了两个数据库：一个包含仅与州死亡记录链接的死亡患者的发病记录，另一个数据库包含与州死亡记录和 NDI 链接的死亡患者的发病记录。按州和原发部位类别比较每个数据库的生存估计和 95%置信区间。
结果
在 60 个月的随访中，42.1-48.1%的发病记录与州死亡记录链接，另有 0.7-3.4%的记录与 NDI 链接。对于所有部位和结直肠癌、胰腺癌、肺癌和支气管、乳腺癌、前列腺癌、非霍奇金淋巴瘤和卡波西肉瘤病例，未使用 NDI 的分析中的生存点估计值不包含在使用相对生存方法的 NDI 增强分析的相应 95%CI 内。使用相对生存方法，所有 3 个州的所有部位和结直肠癌、胰腺癌、肺癌和支气管、乳腺癌、前列腺癌、非霍奇金淋巴瘤和卡波西肉瘤病例的其他州和原发部位组合也存在显著的生存估计差异，且差异因方法（相对与病因特异性生存）而异。
结论
为了确保准确的基于人群的癌症生存率，美国中央癌症登记处需要与国家死亡索引链接以确定州外和后期登记的死亡情况。
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