Abstract
Objectives
Large temporal and geographical variation in survival rates estimated from epidemiological
cancer registries coupled with heterogeneity in death certificate only (DCO) notifications
makes it difficult to interpret trends in survival. The aim of our study is to introduce
a method for estimating such trends while accounting for heterogeneity in DCO notifications
in a cancer site-specific manner.
Study Design and Setting
We used the data of 4.0 million cancer cases notified in 14 German epidemiological
cancer registries. Annual 5-year relative survival rates from 2002 through 2013 were
estimated, and proportions of DCO notifications were recorded. “DCO-excluded” survival
rates were regressed on DCO proportions and calendar years using a mixed linear model
with cancer registry as a random effect. Based on this model, trends in survival rates
were estimated for Germany at 0% DCO.
Results
For most cancer sites and age groups, we estimated significant positive trends in
survival. Age-standardized survival for all cancers combined increased by 7.1% units
for women and 10.8% units for men.
Conclusion
The described method could be used to estimate trends in cancer survival based on
the data from epidemiological cancer registries with differing DCO proportions and
with changing DCO proportions over time.
Keywords
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Article info
Publication history
Published online: January 09, 2018
Accepted:
January 8,
2018
Footnotes
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflicts of interest: None.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
