Sánchez Garrido M V, Izquierdo Font A, Beltrán Fabregat M, Bosch José F X, Viladiu Quemada P
Institut Català d'Oncologia, Hospital Santa Caterina, Girona.
Gac Sanit. 1996 Mar-Apr;10(53):67-72. doi: 10.1016/s0213-9111(96)71878-2.
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.
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.
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.
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.
未另作说明的子宫癌（NOS）常被记录在死亡证明中作为死因。本研究的目的是对西班牙赫罗纳地区所有提及妇科癌症的死亡证明进行重新编码，并比较重新编码前后宫颈癌死亡率的趋势。
识别出1985年至1989年期间在赫罗纳省（人口50万）开具的提及妇科癌症的死亡证明。查阅病历和当地癌症登记处的档案，以评估诊断的准确性并对原发灶的合适部位进行重新编码。然后将所得分布应用于加泰罗尼亚（包括赫罗纳在内，人口600万）的死亡率统计数据，并分析死亡率趋势。
未另作说明的子宫癌重新分类如下：子宫颈癌24%，子宫体癌29%，卵巢癌13%，其他14%。在20%的病例中，编码仍为未另作说明的子宫癌。当将此分布应用于1975 - 1992年加泰罗尼亚的死亡率统计数据时，各年龄组的宫颈癌死亡率均呈下降趋势。
死亡证明中约三分之一未另作说明的子宫癌对应子宫颈癌，三分之一对应子宫体癌。死亡率趋势受到编码为未另作说明的子宫癌的证明比例的严重影响。没有迹象表明加泰罗尼亚年轻女性的宫颈癌死亡率有所上升。
