open access: Impact of using multiple causes of death codes to compute site-specific, death certificate-based cancer mortality statistics in the United States 10.1016/j.canep.2011.07.004 : Cancer Epidemiology | ScienceDirect.com

"Background: Cancer mortality statistics, an important indicator for monitoring cancer burden, are traditionally restricted to instances when cancer is determined to be the underlying cause of death (UCD) based on information recorded on standard certificates of death. This study's objective was to determine the impact of using multiple causes of death codes to compute site-specific cancer mortality statistics."

Table 1. Proportion of non-UCD cancer deaths by cancer site listed on the death certificate.

"There are a number of limitations to this analysis. For example, this analysis did not examine all causes of death retrospectively with regard to a cancer registry, and includes data from only three states within the United States; among those three states, the deaths eligible for this analysis do not reflect the full population of cancer deaths. Specifically, this analysis focused on cancer-related deaths and excluded cancer patients who died in another state, cancers diagnosed prior to 1993, individuals with multiple primaries, and death certificate and autopsy only deaths...."