[Trends in cervix cancer mortality in Catalonia, 1975-1992: analysis of death certificates and cancer registry of Girona].

INTRODUCTION

Uterine cancer not otherwise specified (NOS) is often recorded in death certificates as cause of death. The purpose of the study is to recode all death certificates mentioning gynecological cancers in the area of Girona, Spain and to compare trends in cervical cancer mortality before and after recodification.

METHODS

Death certificates issued between 1985 and 1989 in the province of Girona (population 500,000) mentioning gynecological cancer were identified. Medical records and the files of the local Cancer Registry were reviewed to assess the accuracy of the diagnosis and to recode the appropriate site of the primary. The resulting distributions were then applied to the mortality statistics of Catalonia (population 6,000,000 including Girona) and mortality trends were analyzed.

RESULTS

Uterus NOS were reclassified as follows: cervix uteri 24%, corpus 29%, ovary 13%, other 14%. In 20% of the cases the code remained as uterus NOS. When this distribution was applied to the Catalan mortality statistics for 1975-1992, a downward trend was observed for cervical cancer at all age groups.

CONCLUSIONS

About one third of uterus NOS in death certificates corresponded to cervix and one third to corpus. Mortality trends are severely affected by the proportion of certificates coded as uterus NOS. There is no indication of an increase in cervical cancer mortality among young women in Catalonia.