Pröhl A, Alsen-Hinrichs C, Hedderich J, Kruse H, Wassermann O
Institut für Toxikologie, Klinikum der Christian-Albrechts-Universität Kiel.
Gesundheitswesen. 1995 May;57(5):274-84.
In two counties (Dithmarschen and Nordfriesland) of the Federal State of Schleswig-Holstein (in the northern part of Germany) the cancer mortality rates, especially those of stomach and colon cancer, were evaluated for the time period 1980-1991. For this purpose the corresponding death certificates collected in these counties were analysed. The counties were subdivided into 16 and 17 smaller areas, respectively. The age-adjusted mortality rates were calculated and the obtained data scaled into eight sections, which were graphically mapped over the smaller areas of the two counties. The frequency of these cancer mortality rates reflects a wide range of distribution pattern in the smaller areas of the two counties, which greatly differ from the cancer mortality values calculated for the two counties as a whole. In comparison with the frequency of stomach cancer mortality for men published in the German Cancer Atlas in 1984 it could be demonstrated that this cancer mortality further decreased in these counties. However, in some smaller areas of these counties, especially in rural areas, the mortality rates of stomach cancer in men were still rather high. The opposite seems to be reflected regarding the frequency of colon cancer mortality. Here higher frequencies of mortality were seen in the small cities of these counties. We suggest that a more subtile cancer mortality mapping can be performed easily without any risk of hurting the requirements of personal data securities, because cancer mortality data are already continuously evaluated by a trained staff at the offices of statistical affairs. These data may be transferred and used for cancer mortality mapping as described in the present paper. In order to guarantee that there will be no violation of personal data secrecy the cancer mortality mapping must be restricted to cancer sites with high frequencies of mortality. All published data should be supervised by an official with special knowledge of the requirements of personal data protection. This study underlines the necessity for higher resolution (smaller areas) in cancer registries as essential prerequisite for systematical exploration of the origins of cancer mortality and as a basis for preventive measures.
在石勒苏益格-荷尔斯泰因联邦州（德国北部）的两个县（迪特马尔申和北弗里斯兰），对1980年至1991年期间的癌症死亡率，尤其是胃癌和结肠癌的死亡率进行了评估。为此，分析了这些县收集的相应死亡证明。这两个县分别被细分为16个和17个较小的区域。计算了年龄调整后的死亡率，并将获得的数据划分为八个部分，以图形方式绘制在这两个县的较小区域上。这些癌症死亡率的频率反映了这两个县较小区域内广泛的分布模式，与将这两个县作为一个整体计算出的癌症死亡率值有很大差异。与1984年《德国癌症地图集》中公布的男性胃癌死亡率频率相比，可以证明这些县的这种癌症死亡率进一步下降。然而，在这些县的一些较小区域，尤其是农村地区，男性胃癌的死亡率仍然相当高。结肠癌死亡率的频率似乎呈现相反的情况。在这些县的小城市中，观察到更高的死亡率频率。我们建议，可以轻松地进行更精细的癌症死亡率绘图，而不会有任何违反个人数据安全要求的风险，因为癌症死亡率数据已经由统计事务办公室的专业人员持续评估。这些数据可以按照本文所述进行转移并用于癌症死亡率绘图。为了确保不违反个人数据保密规定，癌症死亡率绘图必须限于死亡率高的癌症部位。所有公布的数据都应由对个人数据保护要求有专门知识的官员进行监督。这项研究强调了癌症登记处提高分辨率（更小区域）的必要性，这是系统探索癌症死亡率来源以及作为预防措施基础的基本前提。
