UICC World Cancer Congress 2006

Objective: This analysis endeavored to discern the impact of misclassification of Cause of Death from lung cancer, in Kentucky for the period 1979 to 2003. For this time, the national cancer mortality maps indicate a dramatic rise in lung cancer mortality for the state. Smoking patterns concur with this level for cause-specific mortality rates, yet do not explain the temporal trend. We postulated that misclassification of lung cancer deaths has improved over the interval, with increasing access to health care for rural and Appalachia residing persons. This improvement in classification may explain the apparent rise, for a long existing [albeit dubious] distinction for the Bluegrass state.

Methods: Vital data was obtained for the twenty-five year time period from the National Center for Health Statistics webpage [http://cdc.gov/wonder]. Analyses of the temporal variation for Chronic Obstructive Pulmonary Disease, and for Emphysema were compared to race-gender specific rates for lung cancer, by five-year time period and county of residence. Both Pearson Product-moment regression and Spearman correlation were used for these analyses. In addition, the pattern for classification of ‘other cancer' was evaluated for a ‘within-disease' misclassification of anatomic tumor site.

Results: This analysis is in progress at the time of the abstract submission. However, the profound spatial variation for lung cancer mortality rates, over time poses a provocative basis for making an assessment of a changing pattern for classification of lung cancer as the ‘underlying cause of death.' Endeavoring to explain the distinct Appalachian aggregation is a cornerstone for the analysis.