Stage at diagnosis of prostate cancer is a major determinant of survival. Among Blacks, prostate cancer is diagnosed at a later stage of disease than among Whites. This study examined the accuracy of routine coding of prostate cancer stage in the Connecticut (United States) Tumor Registry (CTR) and its effect on the Black/White stage difference. Medical records were collected for 115 Black and 136 White men with prostate cancer diagnosed between 1987 and 1990. Stage at diagnosis was determined by a panel of two of the study members and compared with the stage in the CTR file. According to the panel, 32 percent of Blacks, but only 15 percent of Whites, were diagnosed with distant stage disease. Fifty-eight cases (26 percent of Whites and 20 percent of Blacks) were staged incorrectly by the CTR. Two-fifths of the errors were due to incomplete medical records at the CTR and three-fifths were due to CTR coding or data management errors. The more accurate staging did not have an appreciable impact on the Black/White stage difference. Further work is needed to characterize the accuracy of routinely coded cancer registry stage data for different cancer sites, to devise ways of improving accuracy, and to determine the impact of staging inaccuracies on research that utilizes these data.
Similar content being viewed by others
References
Ries, LAG, Miller, BA, Hankey, BF, Kosary, CL, Harras, A, Edwards, BK, eds. SEER Cancer Statistics Review: 1973–1990: Tables and Graphs. Bethesda, MD (USA): National Cancer Institute, 1994; NIH Pub. No. 94–2789:372.
Polednak, AP, Flannery, JT. Black versus White racial differences in clinical stage at diagnosis and treatment of prostatic cancer in Connecticut. Cancer 1992; 70: 2152–8.
Ragland, KE, Selvin, S, Merrill, DW. Black-White differences in stage-specific cancer survival: analysis of seven selected sites. Am J Epidemiol 1991; 133: 672–82.
Liff, JM, Chow, WH, Greenberg, RS. Rural-urban differences in stage at diagnosis—possible relationship to cancer screening. Cancer 1991; 67:1454–9.
Targonski, PV, Guinan, P, Phillips, CW. Prostate cancer: the stage disadvantage in the black male. J Natl Med Assoc 1991; 83: 1094–6.
Brawn, PN, Johnson, EH, Kuhl, DL, et al. Stage at presentation and survival of White and Black patients with prostate carcinoma. Cancer 1993; 71: 2569–73.
Schmidt, JD, Mettlin, CJ, Natarajan, N, et al. Trends in patterns of care for prostate cancer, 1974–1983: results of surveys by the American College of Surgeons. J Urol 1986; 136: 416–21.
Dayal, HH, Polissar, L, Dahlberg, S. Race, socioeconomic status, and other prognostic factors for survival from prostate cancer. JNCI 1985; 74: 1001–6.
Murphy, GP, Natarajan, N, Pontes, JE, et al. The national survey of prostate cancer in the United States by the American College of Surgeons. J Urol 1982; 127: 928–34.
Dayal, HH, Chiu, C. Factors associated with racial differences in survival for prostatic carcinoma. J Chron Dis 1982; 35: 553–60.
Page, WF, Kuntz, AJ. Racial and socioeconomic factors in cancer survival — a comparison of Veterans Administration results with selected studies. Cancer 1980; 45: 1029–40.
Levine, RL, Wilchinsky, M. Adenocarcinoma of the prostate: a comparison of the disease in blacks versus whites. J Urol 1979; 121: 761–2.
Shambaugh, EM, Ries, LG, Young, JL, et al. SEER Extent of Disease — 1988 Codes and Coding Instructions. Bethesda, MD (USA): National Cancer Institute, 1988.
American Joint Committee on Cancer. Manual for Staging of Cancer. Philadelphia, PA (USA): J.B. Lippincott Co., 1988:177–82.
Murphy, GP, Gaeta, JF, Pickren, J, Wajsman, Z. Current status of classification and staging of prostate cancer. Cancer 1980; 45: 1889–95.
Feigl, P, Polissar, L, Lane, WW, Guinee, V. Reliability of basic cancer patient data. Stat Med 1982; 1:191–204.
Polissar, L, Feigl, P, Lane, WW, Glaefke, G, Dahlberg, S. Accuracy of basic cancer patient data: results from an extensive recoding survey. JNCI 1984; 72: 1007–14.
Author information
Authors and Affiliations
Additional information
This study was supported by grant 5-PO1-CA42101 from the US National Cancer Institute. Dr Dubrow received support from an NCI Preventive Oncology Academic Award, K07-CA01463.
Rights and permissions
About this article
Cite this article
Liu, WL., Kasl, S., Flannery, J.T. et al. The accuracy of prostate cancer staging in a population-based tumor registry and its impact on the Black-White stage difference (Connecticut, United States). Cancer Causes Control 6, 425–430 (1995). https://doi.org/10.1007/BF00052182
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00052182