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Contemporary accuracy of death certificates for coding prostate cancer as a cause of death: Is reliance on death certification good enough? A comparison with blinded review by an independent cause of death evaluation committee

Lookup NU author(s): Dr Mary Robinson



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: Accurate cause of death assignment is crucial for prostate cancer epidemiology and trials reporting prostate cancer-specific mortality outcomes.Methods: We compared death certificate information with independent cause of death evaluation by an expert committee within a prostate cancer trial (2002-2015).Results: Of 1236 deaths assessed, expert committee evaluation attributed 523 (42%) to prostate cancer, agreeing with death certificate cause of death in 1134 cases (92%, 95% CI: 90%, 93%). The sensitivity of death certificates in identifying prostate cancer deaths as classified by the committee was 91% (95% CI: 89%, 94%); specificity was 92% (95% CI: 90%, 94%). Sensitivity and specificity were lower where death occurred within 1 year of diagnosis, and where there was another primary cancer diagnosis.Conclusions: UK death certificates accurately identify cause of death in men with prostate cancer, supporting their use in routine statistics. Possible differential misattribution by trial arm supports independent evaluation in randomised trials.

Publication metadata

Author(s): Turner EL, Metcalfe C, Donovan JL, Noble S, Sterne JAC, Lane JA, Walsh EI, Hill EM, Down L, Ben-Shlomo Y, Oliver SE, Evans S, Brindle P, Williams NJ, Hughes LJ, Davies CF, Ng SY, Neal DE, Hamdy FC, Albertsen P, Reid CM, Oxley J, McFarlane J, Robinson MC, Adolfsson J, Zietman A, Baum M, Koupparis A, Martin RM

Publication type: Article

Publication status: Published

Journal: British Journal of Cancer

Year: 2016

Volume: 115

Issue: 1

Pages: 90-94

Print publication date: 28/06/2016

Online publication date: 02/06/2016

Acceptance date: 30/04/2016

Date deposited: 18/08/2016

ISSN (print): 0007-0920

ISSN (electronic): 1532-1827

Publisher: Nature Publishing Group


DOI: 10.1038/bjc.2016.162


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