Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Gulf J Oncolog. 2023 Jan;1(41):17-22.
Population-based cancer survival is a key metric for the assessment of cancer control strategies. Accurate estimation of cancer survival requires complete follow-up data for all patients.
To explore the impact of linking national cancer registry data to the national death index on net survival estimates for women diagnosed with cervical cancer in Saudi Arabia during 2005-2016.
We acquired data on 1,250 Saudi women diagnosed with invasive cervical cancer during the 12- year period 2005-2016 from the Saudi Cancer Registry. These included the woman's last known vital status and the date of last known vital status, but this was restricted to information from clinical records and death certificates that mention cancer as a cause of death ("registry follow-up"). We submitted available national ID numbers to the National Information Center (NIC) of the Ministry of Interior, to ascertain the date of death, from any cause of death, for women who had died up until 31 December 2018 ("NIC follow-up"). We estimated age-standardised 5-year net survival using the Pohar-Perme estimator under five different scenarios using the two sources of follow-up, and censoring at the date of last contact with the registry versus extending survival until the closing date if no information on death was obtained.
1,219 women were eligible for survival analysis. Five-year net survival was lowest when using NIC followup only (56.8%; 95%CI 53.5 - 60.1%), and highest when registry follow-up only was used and survival time was extended until closure date for those with no information on death (81.8%; 95%CI 79.6 - 84%).
Reliance solely on information from deaths certified as due to cancer and clinical records leads to a high proportion of missing deaths in the national cancer registry. This is probably due to low quality of certification of the cause of death in Saudi Arabia. Linkage of the national cancer registry to the national death index at the NIC identifies virtually all deaths, providing more reliable survival estimates, and it eliminates the ambiguity in determining the underlying cause of death. Therefore, this should become the standard approach to estimating cancer survival in Saudi Arabia.
基于人群的癌症生存是评估癌症控制策略的关键指标。准确估计癌症生存需要对所有患者进行完整的随访数据。
探讨将国家癌症登记处的数据与国家死亡索引相链接，对 2005 年至 2016 年期间在沙特阿拉伯诊断为宫颈癌的女性的净生存估计值的影响。
我们从沙特癌症登记处获取了在 12 年期间（2005-2016 年）被诊断患有浸润性宫颈癌的 1250 名沙特女性的数据。这些数据包括女性的最后已知生命状态和最后已知生命状态的日期，但仅限于临床记录和提及癌症作为死因的死亡证明中的信息（“登记处随访”）。我们向内政部国家信息中心（NIC）提交了可用的国家身份证号码，以确定截至 2018 年 12 月 31 日因任何原因死亡的女性的死亡日期（“NIC 随访”）。我们使用 Pohar-Perme 估计器，根据两种随访来源，在五个不同的情况下估计年龄标准化的 5 年净生存率，并在与登记处最后一次联系的日期截止，或在没有获得死亡信息的情况下将生存时间延长至截止日期。
1219 名女性有资格进行生存分析。仅使用 NIC 随访时，5 年净生存率最低（56.8%；95%CI 53.5-60.1%），而仅使用登记处随访时，并且对于没有死亡信息的患者，将生存时间延长至截止日期时，生存率最高（81.8%；95%CI 79.6-84%）。
仅依赖于经认证为癌症死亡和临床记录的信息，会导致国家癌症登记处大量缺失死亡信息。这可能是由于沙特阿拉伯死亡原因认证质量低所致。国家癌症登记处与 NIC 国家死亡索引的链接几乎可以识别所有死亡情况，提供更可靠的生存估计，并消除了确定根本死因的歧义。因此，这应该成为在沙特阿拉伯估计癌症生存的标准方法。
