Quality of cancer registry birthplace data for Hispanics living in the United States

“In addition, we recently documented a bias in the completeness of birthplace data for Asians [ 20 ], suggesting that the utility of birthplace data in this group is potentially limited for the types of analyses described above.”

“, those with ‡200 beds) were more likely than smaller facilities to report collecting data on race/ethnicity [15] and to collect more complete data on patient birthplace [12, 14].”

“In addition to a range of patient demographic and tumor information, the CCR also includes data on the reporting (usually diagnosing) hospital for each diagnosis and has been linked to hospital utilization data from the California Office of Statewide Health Planning and Development (OSHPD) to include information on ho…”

“Such an analysis has not been conducted, in part, due to missing data about birthplace for a sizable proportion (∼25%) of Hispanic cancer cases in cancer registry data (21, 22).”

“Hispanic ethnicity is often underreported on hospital records and death certificates (37, 38), and certain years”

“For cases for whom birthplace information was reported to the registry (the vast majority), we have also shown that this classification shows excellent agreement in comparison with self-reported birthplace (4, 5); for the remaining cases, we applied a validated birthplace classification algorithm with good sensitivity…”

“Misclassification of cases might stem from the method of ascertaining the outcome through cancer registries as the result of possible incomplete reporting, 77–79 errors in the registry, 80–82 mismatched cases, 83 residential mobility, and subsequent losses to follow-up.”

“Our prior research shows that these data, when available, are highly accurate at the level of US- and foreign-born (30, 31).”

“The imputation method used to classify nativity is subject to error and may have led to some misclassification; however, most participants (about 65 %) were classified based on cancer registry birthplace data, previously shown to have high accuracy [11, 36].”

“To our knowledge such an analysis has not been previously conducted in part due to missing data regarding birthplace for a sizable percentage (approximately 25%) of Hispanic cancer cases in CCR data.(18,19) Therefore, through statistical imputation of nativity for cancer cases with missing birthplace and in combinatio…”

“…false SSNs would have affected only some of the 15.3% of cases with missing birthplace data in the cancer registry; 84.7% of our nativity data was derived from patients’ medical records or death certificates, which we have previously shown to be highly accurate for birthplace information (39, 40).”

“Although important work has been done to examine data accuracy (eg, clinical information system data comparison to self-report), prior studies have only analyzed a central data source or a single setting.(11,17,19) Furthermore, studies that have examined central data sources, like state cancer registries or the Survei…”

“This may be partly due to the limited ability to conduct analyses by birthplace due to the high prevalence and non-random distribution of missing birthplace data [43, 48–52].”

“Greater Bay Area Cancer Registry [36], we randomly assigned 56.”

“Table 1 shows demographic and tumor characteristics according to birthplace among 65,211 black women with breast cancer in the United States.”

“Since birthplace is differentially missing between US- and foreign-born Hispanics, and by vital status [14], nativity was imputed for Hispanic patients with unknown birthplace using patients’ social security numbers (SSN).”

“The cut point of 20 years was determined by comparisons with self-reported nativity from interviews with 1127 Hispanic cancer patients [16,17] as noted above.”

“Explorations of large-scale databases are used to: (1) monitor changes in disease incidence and mortality, (2) develop public health interventions designed to make the best use of limited resources, (3) ground research foci and methodological approaches, (4) evaluate the impact of public health interventions on diseas…”

“Income <$20,000 365 (20) 65 (30) 84 (32) 142 (44) 12 (18) 131 (38)”

“First, although missing birthplace data in registries is a well-known phenomenon [25,27,29,30], missingness (60.”

“Often, Hispanic SEER registry birthplace data is missing or unknown [22].”

“However, migrant studies of HL in US Hispanics have been impeded by methodologic challenges, including cultural and genetic heterogeneity [23–28], which can dilute study findings, and missing cancer registry information on birthplace for a sizeable, non-random segment of cases, which may introduce bias into estimated…”

“Birthplace often is missing from registry data.(36-39) Imputation is necessary because dropping patients for whom information regarding birthplace is missing reduces generalizability and introduces bias due to the unique reasons why the data are missing.”

“The cutpoint of 20 years was determined by comparison with self-reported nativity from interviews with 1127 Hispanic patients with cancer and maximization of the area under the resultant receiver operating characteristic curve.(22,23) The selected cutpoint resulted in immigrant status classifications associated with 8…”

“Because the ~30% of AA patients in the cancer registry with unknown birthplace data are more likely to be US-born than those with available data (33, 42-44), we applied a validated method based on patients’ Social Security numbers (SSN) to classify patient immigrant status for patients with unknown data, as described…”

“With regard to birthplace, SEER data are well documented to be incomplete (ie, unknown) for up to one-third of Hispanic cases, and those without a recorded birthplace have been shown to be more likely to be US-born and alive.(2,3) These findings have significant implications for the accuracy of survival analyses compa…”

“Questions remain as to the consistency in collection of these data within and across hospitals (Stewart et al. 1999; Kressin et al. 2003; Gomez and Glaser 2005; Gomez et al. 2005).”

“As birthplace is missing differentially between US- and foreign-born Hispanics in registry data [23], we imputed nativity, when missing, using a validated method based on issuance date of the patient’s social security number [24].”

“Furthermore, the distribution of missing data are nonrandom and is related to variables including nativity, vital status, age, sex, ethnicity, and certain hospital characteristics.(9-13) Of particular concern for nativity disparities research is the observation that missing birthplace data are more common among US-born”

“Our research has shown that cancer cases with missing birthplace data are more likely to be alive, of younger age, and US-born than those with known data, and thus, random imputation of birthplace will underestimate rates in US-born individuals and overestimate them in foreign-born individuals.(12,13,35,36) The SSN-ba…”

“Previous studies have reported biases in reporting birthplace information among Asians and Hispanics in population-based cancer registry [19, 20].”

“, deceased patients are more likely to have known birthplace, as obtained from death certificates) [14,15].”

“They justify the use of incomplete nativity data by citing both our observations that nativity, where available, is accurate [3, 4], and the previous use of incomplete data.”