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Randomized Controlled Trial
. 2016 Jun 28;115(1):90-4.
doi: 10.1038/bjc.2016.162. Epub 2016 Jun 2.

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

Emma L Turner  1 , Chris Metcalfe  1 , Jenny L Donovan  1 , Sian Noble  1 , Jonathan A C Sterne  1 , J Athene Lane  1 , Eleanor I Walsh  1 , Elizabeth M Hill  1 , Liz Down  1 , Yoav Ben-Shlomo  1 , Steven E Oliver  2 , Simon Evans  3 , Peter Brindle  4 , Naomi J Williams  5 , Laura J Hughes  6 , Charlotte F Davies  1 , Siaw Yein Ng  7 , David E Neal  8 , Freddie C Hamdy  8 , Peter Albertsen  9 , Colette M Reid  10 , Jon Oxley  11 , John McFarlane  3 , Mary C Robinson  12 , Jan Adolfsson  13 , Anthony Zietman  14 , Michael Baum  15 , Anthony Koupparis  16 , Richard M Martin  1   17
Affiliations
Randomized Controlled Trial

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

Emma L Turner et al. Br J Cancer. .

Abstract

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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Figure 1
Process for evaluating cause of death.
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