Comparing Cancer Mortality Estimates in Mexico By Using Two National Death Registries

Abstract

Abstract 49 Background: Mexico has low cancer mortality compared with other Latin American countries and high-income economies. The National Institute of Geography and Statistics (INEGI) uses an automated coding system that has been adapted from the Centers for Disease Control system to process death certificates. In contrast, the System for Epidemiologic Death Statistics (SEED) relied on a standardized manual process. We hypothesized that the low cancer mortality could be explained by processing procedures. We undertook this work to compare cancer mortality rates from two national death registries that independently code and attribute cause of death from death certificates. Methods: We calculated age-standardized cancer mortality rates for all cancers and specific sites by sex for 2010 to 2014 by using data from INEGI and SEED. We calculated stroke mortality rates for comparison. We obtained age-adjusted mortality rates and 95% CIs by using direct method and World Population Prospects 2010 as a standard. Results: Age-standardized mortality rate per 100,000 women for all cancers was 74.8 (95% CI, 74.0 to 75.6) in INEGI and 74.1 (95% CI, 73.3 to 74.9) in SEED for 2010. In contrast, for men, cancer mortality rate was 69.0 (95% CI, 68.2 to 69.7) in INEGI and 68.4 (95% CI, 67.7 to 69.7) in SEED. We did not observe substantial differences across cancer sites and years; however, when analyzing cases with cancer as a contributing condition, INEGI reported approximately 50% more compared with SEED. In contrast, stroke mortality significantly differed between registries for all years. For women, in 2010, INEGI reported 29.4 (95% CI, 29.0 to 29.9) compared with 26.5 (95% CI, 26.0 to 26.9) in SEED. Corresponding estimates for men were 36.6 (95% CI, 36.0 to 37.1) and 33.0 (95% CI, 32.4 to 33.5), respectively. Conclusion: Cancer mortality estimates were minimally affected by use of distinct processing procedures. Death certification in Mexico should be further evaluated. Funding: AstraZeneca, GlaxoSmithKline, and Merck. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Susana Lozano-Esparza No relationship to disclose Dalia Stern No relationship to disclose Juan Eugenio Hernandez-Avila No relationship to disclose Evangelina Morales-Carmona No relationship to disclose Rafael Lozano No relationship to disclose Eduardo Lazcano-Ponce Consulting or Advisory Role: Merck Sharp & Dohme Research Funding: Roche, Roche (Inst), BD, Qiagen (Inst) Travel, Accommodations, Expenses: GlaxoSmithKline, Merck Sharp & Dohme, Qiagen Ruy Lopez-Ridaura Research Funding: AstraZeneca Martin Lajous Research Funding: AstraZeneca