Data Reliability and Coding Completeness of Cancer Registry Information Using Reabstracting Method in the National Cancer Institute: Thailand, 2012 to 2014.

PURPOSE: Data quality is a core value of cancer registries, which bring about greater understanding of cancer distribution and determinants. Thailand established its cancer registry in 1986; however, studies focusing on data reliability have been limited. This study aimed to assess the coding completeness and reliability of the National Cancer Institute (NCI) hospital-based cancer registry, Thailand. METHODS: This study was conducted using the reabstracting method. We focused on seven cancer sites-the colon, rectum, liver, lung, breast, cervix, and prostate-registered between 2012 and 2014 in the NCI hospital-based cancer registry. Missing data were identified for coding completeness calculation among important variables. The agreement rate and κ coefficient were computed to represent data reliability. RESULTS: For reabstracting, we retrieved 957 medical records from a total of 5,462. These were selected using the probability proportional to size method, stratified by topology, sex, and registered year. The overall coding completeness of the registered and reabstracted data was 89.9% and 93.6%, respectively. In addition, the overall agreement rate among variables ranged from 84.7% to 99.6%, and κ coefficient ranged from 0.619 to 0.995. The misclassification among unilateral organs caused lower coding completeness and agreement rate of laterality coding. The completeness of current residency could be improved using the reabstracting method. The lowest agreement rate was found among various categories of diagnosis basis. Sex misclassification for male breast cancer was identified. CONCLUSION: The coding completeness and data reliability of the NCI hospital-based cancer registry met the standard in most critical variables. However, some challenges remain to improve the data quality. The reabstracting method could identify the critical points affecting the quality of cancer registry data.

Trends in Incidence of Two Major Subtypes of Liver and Bile Duct Cancer: Hepatocellular Carcinoma and Cholangiocarcinoma in Songkhla, Southern Thailand, 1989-2030.

BACKGROUND: The incidence of liver and bile duct cancer continues to rise, especially in Thailand. We aimed to project the trends in incidence of this rare but lethal cancer in southern Thailand in order to determine its future disease burden. METHODS: Gender-specific trends in age-standardized incidence rates per 100,000 person-years for hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) cases in Songkhla province of southern Thailand diagnosed between 1989 and 2013 were estimated and projected up to year 2030 using three different modeling techniques: a joinpoint model, an age-period-cohort model, and a modified age-period-cohort model. RESULTS: Of 2,676 liver and bile duct (LBD) cancer cases identified, 73% were males, 51% were aged between 50 and 69 years, and HCC (44.4%) was slightly more common than CCA (38.1%). The models all predicted an increase in the incidence rate of CCA up to 2025 for both sexes whereas the incidence of HCC is expected to decrease among males and stabilize among females. The incidence rates of HCC and CCA among males in 2030 could reach 6.7 and 9.4 per 100,000 person-years, respectively, whereas the expected rates of HCC and CCA among females are expected to be around 1.5 and 3.9 per 100,000 person-years, respectively. CONCLUSIONS: The incidence of cholangiocarcinoma is expected to increase in Songkhla and will contribute a larger proportion of LBD cancers in the future. Future public health efforts and research studies should focus on this increasing trend.

Estimation of the Incidence of Hepatocellular Carcinoma and Cholangiocarcinoma in Songkhla, Thailand, 1989-2013, Using Multiple Imputation Method.

PURPOSE: Histological specimens are not required for diagnosis of liver and bile duct (LBD) cancer, resulting in a high percentage of unknown histologies. We compared estimates of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) incidences by imputing these unknown histologies. MATERIALS AND METHODS: A retrospective study was conducted using data from the Songkhla Cancer Registry, southern Thailand, from 1989 to 2013. Multivariate imputation by chained equations (mice) was used in re-classification of the unknown histologies. Age-standardized rates (ASR) of HCC and CCA by sex were calculated and the trends were compared. RESULTS: Of 2,387 LBD cases, 61% had unknown histology. After imputation, the ASR of HCC in males during 1989 to 2007 increased from 4 to 10 per 100,000 and then decreased after 2007. The ASR of CCA increased from 2 to 5.5 per 100,000, and the ASR of HCC in females decreased from 1.5 in 2009 to 1.3 in 2013 and that of CCA increased from less than 1 to 1.9 per 100,000 by 2013. RESULTS: of complete case analysis showed somewhat similar, although less dramatic, trends. CONCLUSION: In Songkhla, the incidence of CCA appears to be stable after increasing for 20 years whereas the incidence of HCC is now declining. The decline in incidence of HCC among males since 2007 is probably due to implementation of the hepatitis B virus vaccine in the 1990s. The rise in incidence of CCA is a concern and highlights the need for case control studies to elucidate the risk factors.

Success of a cervical cancer screening program: trends in incidence in songkhla, southern Thailand, 1989-2010, and prediction of future incidences to 2030.

BACKGROUND: Cervical cancer has been a leading female cancer in Thailand for decades, and has been second to breast cancer after 2007. The Ministry of Public Health (MoPH) has provided opportunistic screening with Pap smears for more than 30 years. In 2002, the MoPH and the National Health Security Office provided countrywide systematic screening of cervical cancer to all Thai women aged 35-60 years under universal health care coverage insurance scheme at 5-year intervals. OBJECTIVES: This study characterized the cervical cancer incidence trends in Songkhla in southern Thailand using joinpoint and age period cohort (APC) analysis to observe the effect of cervical cancer screening activities in the past decades, and to project cervical cancer rates in the province, to 2030. MATERIALS AND METHODS: Invasive and in situ cervical cancer cases were extracted from the Songkhla Cancer Registry from 1990 through 2010. Age standardized incidence rates were estimated. Trends in incidences were evaluated by joinpoint and APC regression models. The Norpred package was modified for R and was used to project the future trends to 2030 using the power of 5 function and cut trend method. RESULTS: Cervical cancer incidence in Songkhla peaked around 1998-2000 and then dropped by -4.7% per year. APC analysis demonstrated that in situ tumors caused an increase in incidence in early ages, younger cohorts, and in later years of diagnosis. CONCLUSIONS: Both joinpoint and APC analysis give the same conclusion in continuation of a declining trend of cervical cancer to 2030 but with different rates and the predicted goal of ASR below 10 or even 5 per 100,000 women by 2030 would be achieved. Thus, maintenance and improvement of the screening program should be continued. Other population based cancer registries in Thailand should analyze their data to confirm the success of cervical cancer screening policy of Thailand.

Incidence of intussusception among children 0-5 years of age in Thailand, 2001-2006.

To provide baseline incidence data of intussusception among Thai children under 5 years old, outpatient and inpatient records from 2001 to 2006 from five hospitals were reviewed. 112 cases of intussusception were identified, confirmed by either ultrasonography (65%), radiology procedure (32%) or surgery (3%). Common presenting symptoms were vomiting, mucous bloody stool and fever. 50% of intussusceptions were ileocolic in location and 49% underwent surgery. Male to female ratio was 1.7:1 and 86% of cases were under 1 year of age. No deaths were reported. 89 of 112 cases were resident in the study catchment area, for an annual incidence of 19.70-47.83 and 4.36-11.44 per 100,000 children under 1 and 5 years of age, respectively. This is somewhat lower than other regional studies emphasising need to continue and enhance surveillance prior to starting a universal rotavirus vaccine program.