MORTALITY-RATES BY STAGE-AT-DIAGNOSIS

Mortality rates by stage-at-diagnosis are not possible from usual mort ality data. Normally, mortality data are based solely on information p rovided on death certificates, and stage-at-diagnosis is not generally reported on these documents. However, mortality rates by stage are po ssible when one can link diagnostic data with mortality data. Populati on-based cancer registries collect these types of data routinely in de termining the survival of cancers in their registry. Thus, using cance r registry data, mortality rates by stage-at-diagnosis can be calculat ed. We report stage-specific mortality rates for the Surveillance, Epi demiology, and End Results Program, representing 10% of the cancers in the U.S. for the four sites with the largest mortality rates for fema les and for males. For an individual site, the stage-specific mortalit y rates allow one to determine how the different stages are contributi ng to the trends in all stage mortality. For example, distant disease mortality is the largest contributor to all stage cancer mortality for female and male lung cancer, female colorectal cancer, ovarian cancer , prostatic cancer and male pancreatic cancer. In contrast, regional d isease mortality is the largest contributor to all stage cancer mortal ity for breast cancer and male colorectal cancer. In addition, localiz ed disease mortality is the second largest contributor to all stage mo rtality for breast cancer and prostate cancer. (C) 1994 Wiley-Liss, In c.