Factors associated with under-reporting of head and neck squamous cell carcinoma in cause-of-death records: A comparative study of two national databases in France from 2008 to 2012

Caroline Even (1) , Luis Sagaon Teyssier (2, 3) , Yoann Pointreau (4) , Stéphane Temam (1) , Florence Huguet (5) , Lionnel Geoffrois (6) , Michaël Schwarzinger (3, 7)

1 CCF - Département de cancérologie cervico-faciale [Gustave Roussy]
2 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
3 THEN - Translational Health Economics Network [Paris]
4 Centre Jean Bernard [Institut Inter-régional de Cancérologie - Le Mans]
5 CHU Tenon [AP-HP]
6 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
7 CHU Bordeaux

Objective: To date, no study has evaluated the detection rate of head and neck squamous cell carcinoma (HNSCC) in cause-of-death records in Europe. Our objectives were to compare the number of deaths attributable to HNSCC from two national databases in France and to identify factors associated with under-reporting of HNSCC in cause-of-death records. Methods: The national hospital discharge database and the national underlying cause-of-death records were compared for all HNSCC-attributable deaths in adult patients from 2008 to 2012 in France. Factors associated with under-reporting of HNSCC in cause-of-death records were assessed using multivariate Poisson regression. Results: A total of 41,503 in-hospital deaths were attributable to HNSCC as compared to 25,647 deaths reported in national UCoD records (a detection rate of 62%). Demographics at death were similar in both databases with respect to gender (83% men), age (54% premature deaths at 25–64 years), and geographic distribution. In multivariate Poisson regression, under-reporting of HNSCC in cause-of-death records significantly increased in 2012 compared to 2010 (+7%) and was independently associated with a primary HNSCC site other than the larynx, a former primary or second synchronous cancer other than HNSCC, distant metastasis, palliative care, and death in hospitals other than comprehensive cancer care centers. The main study results were robust in a sensitivity analysis which also took into account deaths outside hospital (overall, 51,129 HNSCC-attributable deaths; a detection rate of 50%). For the year 2012, the age-standardized mortality rate for HNSCC derived from underlying cause-of-death records was less than half that derived from hospital discharge summaries (14.7 compared to 34.1 per 100,000 for men and 2.7 compared to 6.2 per 100,000 for women). Conclusion: HNSCC is largely under-reported in cause-of-death records. This study documents the value of national hospital discharge databases as a complement to death certificates for ascertaining cancer deaths.

Mots clés: Head and neck squamous cell carcinoma; Esophageal cancer; Death rates; Cancers and neoplasms; France; Head and neck cancers; Physicians; Nasopharyngeal carcinoma

Domaines: Médecine humaine et pathologie; Cancer; Santé publique et épidémiologie

Caroline Even, Luis Sagaon Teyssier, Yoann Pointreau, Stéphane Temam, Florence Huguet, et al.. Factors associated with under-reporting of head and neck squamous cell carcinoma in cause-of-death records: A comparative study of two national databases in France from 2008 to 2012. PLoS ONE, 2021, 16 (2), pp.e0246252. ⟨10.1371/journal.pone.0246252⟩. ⟨hal-03131477⟩