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Title: Misclassification of colorectal cancer stage and area variation in survival
Authors: Yu XQ; O'Connell DL; Gibberd RW; Abrahamowicz M; Armstrong BK
Categories: Cancer Type - Bowel & Colorectal Cancer
Cancer Control, Survivorship, and Outcomes Research - Resources and Infrastructure
Keywords: Adolescent; Colon; colorectal cancer; Colorectal Neoplasms; diagnosis; Diagnosis,Differential; epidemiology; Female; Humans; Male; metabolism; Adult; Middle Aged; mortality; Neoplasm Invasiveness; Neoplasm Staging; Neoplasms; New South Wales; Probability; Registries; Research; Risk; Aged; SEER Program; survival; Survival Analysis; Wales; Aged,80 and over; analysis; Australia; cancer; cancer registry; cancer survival
Year: 2007
Journal Title: International Journal of Cancer
Volume: 122
Issue: 2
Page number start: 398
Page number end: 402
Abstract: We previously investigated the impact of health area of residence on colon and rectal cancer survival by estimating area-specific relative excess risk of death (RER), stratified by stage at diagnosis. The aims of this study were to quantify errors in colorectal cancer stage obtained from an Australian population-based cancer registry and assess the potential impact of errors in stage on these estimates. For a subset of cases, we compared the cancer registry stage with that from a survey of treating surgeons. We then randomly reallocated all cases to a simulated 'corrected' stage according to the estimated misclassification probabilities and repeated the analysis of area variation stratified by simulated stage 1,000 times. We found 70% agreement between the Registry and Survey stage. This reallocation of the Registry cases by stage resulted in substantial variation in area-specific RERs across the simulated samples. Area variation in survival for localized colon and localized rectal cancer, which were previously statistically significant when classified using Registry stage, appeared no longer to be so. Misclassification of cancer registry stage can have an important impact on estimates of spatial variation in stage-specific colon and rectal cancer survival. If population-based cancer registry data are to be effectively used in evaluating and improving cancer care, the quality of the stage data may need to be improved
Programme: Health Services Research
Division: Cancer Research Division
Appears in Collections:Research Articles

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