MORTALITY-RATES BY STAGE-AT-DIAGNOSIS

Mortality rates by stage-at-diagnosis are not possible from usual mortality data. Normally, mortality data are based solely on information provided on death certificates, and stage-at-diagnosis is not generally reported on these documents. However, mortality rates by stage are possible when one can link diagnostic data with mortality data. Population-based cancer registries collect these types of data routinely in determining the survival of cancers in their registry. Thus, using cancer registry data, mortality rates by stage-at-diagnosis can be calculated. We report stage-specific mortality rates for the Surveillance, Epidemiology, and End Results Program, representing 10% of the cancers in the U.S. for the four sites with the largest mortality rates for females and for males. For an individual site, the stage-specific mortality rates allow one to determine how the different stages are contributing 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 disease mortality is the largest contributor to all stage cancer mortality for breast cancer and male colorectal cancer. In addition, localized disease mortality is the second largest contributor to all stage mortality for breast cancer and prostate cancer. (C) 1994 Wiley-Liss, Inc.*