Does exclusion of cancers registered only from death-certificate information diminish socio-demographic disparities in recorded survival?

Tervonen, HE; Roder, D; Morrell, S; You, H; Currow, DC

Does exclusion of cancers registered only from death-certificate information diminish socio-demographic disparities in recorded survival?

Tervonen, HE Roder, D Morrell, S You, H Currow, DC

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Publication Type:: Journal Article
Citation:: Cancer Epidemiology, 2017, 48 pp. 70 - 77
Issue Date:: 2017-06-01

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Field	Value	Language
dc.contributor.author	Tervonen, HE	en_US
dc.contributor.author	Roder, D	en_US
dc.contributor.author	Morrell, S	en_US
dc.contributor.author	You, H	en_US
dc.contributor.author	Currow, DC https://orcid.org/0000-0003-1988-1250	en_US
dc.date.available	2017-04-01	en_US
dc.date.issued	2017-06-01	en_US
dc.identifier.citation	Cancer Epidemiology, 2017, 48 pp. 70 - 77	en_US
dc.identifier.issn	1877-7821	en_US
dc.identifier.uri	http://hdl.handle.net/10453/123594
dc.description.abstract	© 2017 Background Death Certificate Only (DCO) cancer cases are commonly excluded from survival analyses due to unknown survival time. This study examines whether socio-demographic factors are associated with DCO diagnosis, and the potential effects of excluding DCO cases on socio-demographic cancer survival disparities in NSW, Australia. Methods NSW Cancer Registry data for cases diagnosed in 2000–2008 were used in this study. Logistic regression was used to estimate the odds of DCO registration by socio-demographic sub-group (socio-economic disadvantage, residential remoteness, country of birth, age at diagnosis). Cox proportional hazard regression was used to estimate the probability of death from cancer by socio-demographic subgroup when DCO cases were included and excluded from analyses. Results DCO cases consisted of 1.5% (n = 4336) of all cases (n = 299,651). DCO diagnosis was associated with living in socio-economically disadvantaged areas (most disadvantaged compared with least disadvantaged quintile: odds ratio OR 1.25, 95%CI 1.12–1.40), living in inner regional (OR 1.16, 95%CI 1.08–1.25) or remote areas (OR 1.48, 95%CI 1.01–2.19), having an unknown country of birth (OR 1.63, 95%CI 1.47–1.81) and older age. Including or excluding DCO cases had no significant impact on hazard ratios for cancer death by socio-economic disadvantage quintile or remoteness category, and only a minor impact on hazard ratios by age. Conclusion Socio-demographic factors were associated with DCO diagnosis in NSW. However, socio-demographic cancer survival disparities remained unchanged or varied only slightly irrespective of including/excluding DCO cases. Further research could examine the upper limits of DCO proportions that significantly alter estimated cancer survival differentials if DCOs are excluded.	en_US
dc.relation.ispartof	Cancer Epidemiology	en_US
dc.relation.isbasedon	10.1016/j.canep.2017.04.002	en_US
dc.subject.classification	Oncology & Carcinogenesis	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Neoplasms	en_US
dc.subject.mesh	Death Certificates	en_US
dc.subject.mesh	Registries	en_US
dc.subject.mesh	Survival Analysis	en_US
dc.subject.mesh	Demography	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Child	en_US
dc.subject.mesh	Child, Preschool	en_US
dc.subject.mesh	Infant	en_US
dc.subject.mesh	Infant, Newborn	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	Does exclusion of cancers registered only from death-certificate information diminish socio-demographic disparities in recorded survival?	en_US
dc.type	Journal Article
utslib.citation.volume	48	en_US
utslib.for	1112 Oncology and Carcinogenesis	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.publication-status	Published	en_US
pubs.volume	48	en_US

Abstract:

© 2017 Background Death Certificate Only (DCO) cancer cases are commonly excluded from survival analyses due to unknown survival time. This study examines whether socio-demographic factors are associated with DCO diagnosis, and the potential effects of excluding DCO cases on socio-demographic cancer survival disparities in NSW, Australia. Methods NSW Cancer Registry data for cases diagnosed in 2000–2008 were used in this study. Logistic regression was used to estimate the odds of DCO registration by socio-demographic sub-group (socio-economic disadvantage, residential remoteness, country of birth, age at diagnosis). Cox proportional hazard regression was used to estimate the probability of death from cancer by socio-demographic subgroup when DCO cases were included and excluded from analyses. Results DCO cases consisted of 1.5% (n = 4336) of all cases (n = 299,651). DCO diagnosis was associated with living in socio-economically disadvantaged areas (most disadvantaged compared with least disadvantaged quintile: odds ratio OR 1.25, 95%CI 1.12–1.40), living in inner regional (OR 1.16, 95%CI 1.08–1.25) or remote areas (OR 1.48, 95%CI 1.01–2.19), having an unknown country of birth (OR 1.63, 95%CI 1.47–1.81) and older age. Including or excluding DCO cases had no significant impact on hazard ratios for cancer death by socio-economic disadvantage quintile or remoteness category, and only a minor impact on hazard ratios by age. Conclusion Socio-demographic factors were associated with DCO diagnosis in NSW. However, socio-demographic cancer survival disparities remained unchanged or varied only slightly irrespective of including/excluding DCO cases. Further research could examine the upper limits of DCO proportions that significantly alter estimated cancer survival differentials if DCOs are excluded.

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http://hdl.handle.net/10453/123594