Age-Standardized Mortality Rates in the Caribbean: One Source, Three Different Interpretations

Nicholas G Wolf,Camille Morgan,John S Flanigan

doi:10.1200/jgo.18.19000

Abstract

Abstract 74 Purpose A recent publication in the Morbidity and Mortality Weekly Report (MMWR) provided the opportunity to calculate differences in published cancer mortality estimates for Caribbean jurisdictions from three organizations, MMWR, the International Agency for Research on Cancer, and the Institute for Health Metrics and Evaluation. This comparison study serves to educate end users of these data. Methods We downloaded the publicly available cancer mortality estimates for 15 jurisdictions and the United States from the three organizations. We compared reported age-standardized mortality rates for each jurisdiction, and calculated the range among the estimates for each jurisdiction. We repeated this analysis after applying the same world population standard to all estimates. Results For males, ranges of Caribbean estimates were between 49% (Grenada and Trinidad) and 201% (US Virgin Islands) of the MMWR value, with an average of 88%. For females, ranges were between 15% (Trinidad) and 171% (US Virgin Islands) of the MMWR value, with an average of 64%. After all estimates were compared using the same population standard, ranges of Caribbean estimates for males were between 6% (Grenada) and 111% (US Virgin Islands) of the MMWR value, with an average of 34%. For females, ranges were between 7% (Grenada) and 97% (US Virgin Islands), with an average of 28%. Conclusion The use of different standard populations complicates comparisons across organizations. Data modeling does not completely compensate for the quality of source data, as our analysis has demonstrated by the differences in mortality rates despite the good quality of the vital registration in the Caribbean. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

Highlights

Nicholas G.Wolf Camille Morgan John S.FlaniganAuthor affiliations and support information appear at the end of this article
For males, the ranges of the Caribbean estimates were between 49% (Grenada and Trinidad) and 201% (US Virgin Islands) of the Morbidity and Mortality Weekly Report (MMWR) value, with an average of 88%
The ranges were between 15% (Trinidad) and 171% (US Virgin Islands) of the MMWR value, with an average of 64%

Summary

Introduction

Nicholas G.Wolf Camille Morgan John S.FlaniganAuthor affiliations and support information (if applicable) appear at the end of this article. The growing burden of cancer in low- and middle-income countries (LMICs) has gained attention in recent years To address this burden, health policymakers rely on functioning health information systems to generate the critical data needed to guide health policy decisions.[1] Reliable and timely data are essential to produce efficient health policies, establish research priorities, and monitor the effectiveness of cancer control strategies.[2,3,4,5] Mortality data, as an indicator of the most serious outcome of cancer, are a useful metric for both describing burden and evaluating efforts in prevention, early diagnosis, and treatment.[2] The civil registration and vital statistics system (CRVS) of a country is the administrative recording of the occurrence and characteristics of vital events such as death and is considered to be the optimal source of mortality data.[6,7] A CRVS aims to provide medically certified, cause-specific mortality information on a continuous basis and is intended to cover the entire population. The lack of improvement in strengthening CRVSs has been characterized as “the single most critical development failure in the last 30 years.”8(p1526)

Methods

Results

Conclusion