Consistency of cancer sites recorded at the Cancer Registry and on death certificates in Puerto Rico
To evaluate the consistency of cancer mortality data in Puerto Rico, the underlying causes of death coded on 4,351 death certificates of 1980 and 1982 were compared with the primary site diagnoses listed on the corresponding clinical records filed with the Puerto Rico Central Cancer Registry. Comparing the diagnoses recorded by the two data systems permitted an evaluation of the sources of variation affecting consistency, such as the patient's demographic characteristics, basis of diagnosis, informant of death, region of death and the type of doctor who certified the death. Using the first three digits of the International Classification of Diseases (1979) for comparison, the consistency between causes-of-death stated on death certificates and medical records diagnoses was 54.5 percent. Among the chief sources of variation in consistency was the basis for diagnosis, age, person informing death, institution, region of death and type of physician who attended the patient. Most clinical cases were diagnosed or confirmed by scientific tests. However, discrepancies are higher for those records in which diagnoses were based on bone marrow and positive histology techniques. This research led to two major recommendations. First, Puerto Rico's vital statistics systems should rigorously investigate the factors associated with high discrepancies between certain specific cancer sites, such as tongue, floor of mouth, small intestine, rectum and gall bladder. In addition, local and federal authorities should devise a standardized methodology for the continuous evaluation of consistency between cancer cause-of-death statements and clinical data in order to provide accurate information to users of cancer data both in Puerto Rico and in the United States.
Laureano, Evelyn, "Consistency of cancer sites recorded at the Cancer Registry and on death certificates in Puerto Rico" (1989). ETD Collection for Fordham University. AAI8919997.