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首页> 美国卫生研究院文献>British Journal of Cancer >Why are a quarter of all cancer deaths in south-east England registered by death certificate only? Factors related to death certificate only registrations in the Thames Cancer Registry between 1987 and 1989.
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Why are a quarter of all cancer deaths in south-east England registered by death certificate only? Factors related to death certificate only registrations in the Thames Cancer Registry between 1987 and 1989.

机译：为什么英格兰东南部所有癌症死亡人数中有四分之一仅通过死亡证明进行登记？ 1987年至1989年之间仅与死亡证书相关的因素才在泰晤士河癌症登记处注册。

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This paper describes the results of a study set up to investigate factors associated with the high proportions of 'death certificate only' registrations (DCOs) for all cancers registered in south-east England between 1987 and 1989 and to identify those which might be subject to registry intervention. DCOs as a proportion of all registrations (n = 162,131) were analysed by age, sex, district of residence, place of death and survival. DCO registration ratios (standardised for age and sex) were then derived for each of the 56 districts in the Thames Regions. A multiple logistic regression model was generated to estimate the effect of age at diagnosis, tumour survival and patient sex on final source of registration. To minimise the number of dummy variables needed, each of the 56 districts was ranked into quartiles: quartile 1 contained the 14 districts with the lowest age- and sex-standardised ratios for DCO registrations and quartile 4 comprised the 14 districts with the highest DCO ratios. Final source of registration was treated as a binomial trial (case notes or death certificates). The significance of associations was measured using the deviance difference as an approximate chi-square statistic. The effect of each variable on source of registration was estimated as an odds ratio. Interaction terms were also fitted. To estimate the effect of place of death on DCO registrations, a second model was generated for deceased patients only (n = 98,455, adding 'place of death' to the list of explanatory variables already used. A further interaction term was fitted to account for interaction between place of death and district quartile of residence. Around 24% of all patient deaths were registered as DCOs by the Thames Cancer Registry between 1987 and 1989. Of these, 40.9% died in an acute NHS hospital setting, 37.1% died at home, 10.4% died in hospices and 3.4% died in non-NHS hospitals. Increasing age, decreasing survival, district of residence and place of death were positively associated with death certificate registrations. The district effect was sustained in the regression model with significant positive associations shown for DHA quartile of residence. In the deceased group of patients, both district of residence and place of death were independent predictors of DCOs. Death occurring outside the acute NHS hospital setting increased the odds of being a DCO within and across district quartiles. DCOs could be reduced by better case ascertainment in some districts.(ABSTRACT TRUNCATED AT 400 WORDS)
机译：本文介绍了一项研究的结果，该研究旨在调查与1987年至1989年之间在英格兰东南部注册的所有癌症的“仅死亡证书”注册（DCO）的比例较高相关的因素，并确定可能受到哪些因素影响注册表干预。按年龄，性别，居住地区，死亡地点和生存率分析了DCO在所有注册中的比例（n = 162,131）。然后，为泰晤士地区的56个地区中的每个地区得出了DCO注册比率（按年龄和性别标准化）。生成了多元逻辑回归模型以估计诊断时的年龄，肿瘤存活率和患者性别对最终注册来源的影响。为了最大程度地减少所需的虚拟变量数量，将56个区中的每个区划分为四分位数：四分位数1包含14个DCO注册年龄和性别标准化比率最低的区，四分位数4包含14个DCO比率最高的区。最终注册来源被视为二项式试验（案例记录或死亡证明）。使用差异差异作为近似卡方统计量来测量关联的显着性。估计每个变量对注册来源的影响为比值比。互动条件也适合。为了估计死亡地点对DCO注册的影响，仅针对已故患者生成了第二个模型（n = 98,455，将“死亡地点”添加到已使用的解释变量列表中）。死亡地点和居住区四分位数之间的相互作用。1987年至1989年之间，泰晤士癌症登记处将所有患者死亡中的约24％登记为DCO。其中，有40.9％在急性NHS医院中死亡，有37.1％在家中死亡，有10.4％的人在医院中死亡，而3.4％的人在非NHS医院中死亡，年龄增加，存活率下降，居住区和死亡地点与死亡证明书注册呈正相关；在回归模型中，区效应得以持续，并具有显着的正相关性在死者的患者组中，居住地区和死亡地点都是DCO的独立预测因子。 NHS医院的设置增加了在四分位数之内和之间四舍五入的DCO的可能性。通过在某些地区更好地确定案情，可以减少DCO。（摘要截断为400字）

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