Cancer occurrence in the elderly: Agreement between three major data sources

PURPOSE: To explore agreement on cancer occurrence and site among Medicare Part A, Massachusetts Cancer Registry, and death certificates. METHODS: We linked these data sources with the cohort of the population bas ed East Boston Senior Health Project, a component of the National Institute on Aging's Established Populations for Epidemiologic Studies of the Elderl y. The cohort consists of 905 subjects dying between January 1986 and Decem ber 1990. RESULTS: We detected the following agreements on cancer occurrence: hospita lization data and death certificates (kappa = 0.70), hospitalization and ca ncer registry data (kappa = 0.59), and cancer registry and death certificat e data (kappa = 0.50). Measures of agreement changed little when the analys es were stratified by age, sex, calendar year and place of death, autopsy p erformance, cigarette smoking or alcohol consumption. Site-specific agreeme nts were higher for colorectal and respiratory tract cancer compared to bre ast and prostate across ail three comparisons. CONCLUSIONS: The results should assist epidemiologists to better understand the strengths and limitations of these data sources. (C) 1998 Elsevier Sci ence Inc.