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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

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  • Emma L Turner
  • Chris Metcalfe
  • Jenny L Donovan
  • Sian Noble
  • Jonathan A C Sterne
  • J Athene Lane
  • Eleanor I Walsh
  • Elizabeth M Hill
  • Liz Down
  • Yoav Ben-Shlomo
  • Simon Evans
  • Peter Brindle
  • Naomi J Williams
  • Laura J Hughes
  • Charlotte F Davies
  • Siaw Yein Ng
  • David E Neal
  • Freddie C Hamdy
  • Peter Albertsen
  • Colette M Reid
  • Jon Oxley
  • John McFarlane
  • Mary C Robinson
  • Jan Adolfsson
  • Anthony Zietman
  • Michael Baum
  • Anthony Koupparis
  • Richard M Martin


Publication details

JournalBritish journal of cancer
DateAccepted/In press - 30 Apr 2016
DateE-pub ahead of print - 2 Jun 2016
DatePublished (current) - 28 Jun 2016
Issue number1
Number of pages5
Pages (from-to)90-4
Early online date2/06/16
Original languageEnglish


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.

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