Published online May 28, 2017. doi: 10.4254/wjh.v9.i15.704
Peer-review started: February 1, 2017
First decision: March 6, 2017
Revised: March 16, 2017
Accepted: April 23, 2017
Article in press: April 24, 2017
Published online: May 28, 2017
To study the trend of hepatocellular carcinoma incidence after correcting the misclassification in registering cancer incidence across Iranian provinces in cancer registry data.
Incidence data of hepatocellular carcinoma were extracted from Iranian annual of national cancer registration reports 2004 to 2008. A Bayesian method was implemented to estimate the rate of misclassification in registering cancer incidence in neighboring province. A beta prior is considered for misclassification parameter. Each time two neighboring provinces were selected to be entered in the Bayesian model based on their expected coverage of cancer cases which is reported by medical university of the province. It is assumed that some cancer cases from a province that has an expected coverage of cancer cases lower than 100% are registered in their neighboring facilitate province with more than 100% expected coverage.
There is an increase in the rate of hepatocellular carcinoma in Iran. Among total of 30 provinces of Iran, 21 provinces were selected to be entered to the Bayesian model for correcting the existed misclassification. Provinces with more medical facilities of Iran are Tehran (capital of the country), Razavi Khorasan in north-east of Iran, East Azerbaijan in north-west of the country, Isfahan in central part and near to Tehran, Khozestan and Fars in south and Mazandaran in north of the Iran, had an expected coverage more than their expectation. Those provinces had significantly higher rates of hepatocellular carcinoma than their neighboring provinces. In years 2004 to 2008, it was estimated to be on average 34% misclassification between North Khorasan province and Razavi Khorasan, 43% between South Khorasan province and Razavi Khorasan, 47% between Sistan and balochestan province and Razavi Khorasan, 23% between West Azerbaijan province and East Azerbaijan province, 25% between Ardebil province and East Azerbaijan province, 41% between Hormozgan province and Fars province, 22% betweenChaharmahal and bakhtyari province and Isfahan province, 22% between Kogiloye and boyerahmad province and Isfahan, 22% between Golestan province and Mazandaran province, 43% between Bushehr province and Khozestan province, 41% between Ilam province and Khuzestan province, 42% between Qazvin province and Tehran province, 44% between Markazi province and Tehran, and 30% between Qom province and Tehran.
Accounting and correcting the regional misclassification is necessary for identifying high risk areas and planning for reducing the cancer incidence.
Core tip: In many developing countries and even in some developed countries some errors occur in disease registry system. Since registered data is used for planning at the national and sub-national level, correcting the existed errors has a great importance. One of these errors is misclassification in registering cancer incidence. It occurs because some patients from divested provinces prefer to get more qualified diagnostic and treatment services at their adjacent provinces with more medical facilities without mentioning their permanent residence. The aim of this study is to investigate the trend of hepatocellular carcinoma after correcting for misclassification error in Iran’s cancer registry using Bayesian method.