© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 23, 1822-1823,
December 5, 2001
© 2001 Oxford University Press
BRIEF COMMUNICATION |
Determining Cause of Death in Prostate Cancer: Are Death Certificates Valid?
Affiliations of authors: D. F. Penson, U.S. Department of Veterans Affairs Puget Sound Health Care System, University of Washington School of Medicine, and Fred Hutchinson Cancer Research Center, Seattle; P. C. Albertsen, University of Connecticut School of Medicine, Farmington; P. S. Nelson, University of Washington School of Medicine, and Fred Hutchinson Cancer Research Center; M. Barry, Medical Practices Evaluation Center, Massachusetts General Hospital, Boston; J. L. Stanford, Fred Hutchinson Cancer Research Center.
Correspondence to: David F. Penson, M.D., M.P.H., U.S. Department of Veterans Affairs Puget Sound Health Care System Section of Urology, 112-UR, 1660 South Columbian Way, Seattle, WA 98108 (e-mail: penson@u.washington.edu).
Accurate assessment of cause of death (COD) is important for determining cause-specific survival in cancer research. It is possible to reliably ascertain COD by meticulous review of inpatient and outpatient medical records with the use of predetermined clinical algorithms (1). Unfortunately, this method, although useful for small retrospective studies, is impractical for large datasets and national tumor registries that are commonly used for cancer research. When these large databases are used, COD is assigned with a standardized decision algorithm that uses International Classification of Diseases, ninth revision (2), codes to assign both immediate and underlying COD (3). However, this methodology is unreliable (4,5), particularly when patients are older or have considerable comorbidity, as is the case in prostate cancer (6,7). In a study of mortality trends, Grulich et al. (8
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