American Journal of Epidemiology Vol. 136, No. 10: 1232-1240
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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Cancer Identification Using a Tumor Registry Versus Death Certificates in Occupational Cohort Studies in the united states
1Department of Environmental Health, University of Washington Seattle, WA
2Department of Epidemiology, University of Washington Seattle, WA
3Program in Epidemiology, Fred Hutchinson Cancer Research Center Seattle, WA
4Department of Medicine, University of Washington Seattle, WA
Reprint requests to Dr. Thomas L. Vaughan, program in Epidemiology, MP 474 1 Fred Hutchinson Cancer Research Center, 1124 Columbia street, seattle, WA 98104
Studies of cancer incidence among occupational cohorts are rarely performed in the United States because of incomplete registration and a limited time period available for follow-up. This study used data from concurrent studies of cancer mortality and incidence among a cohort of 4, 528 fire fighters and police officers employed by the cities of seattle and Tacoma, Washington, between 1944 and 1979 to examine the relative advantages of tumor registry and death certificate information. As expected, an increased ability to study relatively common cancers with low fatality rates was demonstrated using incidence data. the most dramtic example was seen for baldder cancer. Twenty-four baldder cancers had been diagnosed among the study cohort between 1979 and 1989, whereas only two deaths were attributed to this malignancy. The standardized incidence raio for bladder cancer was 1.05 (95% confidence interval 0.6–1.55), whereas the corresponding standardized mortality ratio was 0.46 (95% confidence interval 0.05–1.65). The observed relative risk estimates for rapidly fatal cancers were similar using the two sources of information, and no increase in precision was observed. Of 142 Persons in the registry area who died of cancer during the study period, 20 (14%) had a different site listed on the death certificate than was identified by the registry. Approximately 7% of the potential person-years, Population-based tumor registries can be a useful ersource in the investigation of occupatinal cancer in the united states, especially for the study of cancers with high survival rates. Am J Epidemiol 1992; 136: 1232–40
death certificates; neoplasms; occupational diseases; registries
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