title: Accurately estimating breast cancer survival in Spain: cross-matching local cancer registries with the National Death Index.
abstract: OBJECTIVE
  To assess the impact of using data from the National Death Index (NDI) of Spain to estimate breast cancer survival rates among residents of Girona and Zaragoza diagnosed in 1995-1999.
  
  
  METHODS
  This was an observational, longitudinal epidemiologic study, using two population-based cancer registries. Data collected were of female residents of Girona or Zaragoza who had been diagnosed with breast cancer in 1995-1999. Observed and relative 5-year survival rates were estimated, first using the information available from the Girona and Zaragoza cancer registries, and then with the inclusion of NDI data. The 5-year relative survival rate and corresponding 95% Confidence Intervals were estimated using the Hakulinen method. The Kaplan-Maier method and Log Rank test were used to compare survival curves.
  
  
  RESULTS
  No statistically significant difference in survival curves was observed in Girona for the data obtained before and after cross-matching with the NDI. However, there was a significant difference in Zaragoza. A comparison of the relative survival rates of each of the two registries before NDI cross-matching showed differences of 3.9% (5-year) and 16.1% (10-year) between the two, whereas after the cross-match, the difference was only 0.5% (5-year) and 1.2% (10-year).
  
  
  CONCLUSIONS
  In Spain it is imperative that there be systematic use of NDI data to supplement cancer registries, so that comparisons of relative survival rates between registries can be improved.
authors.affiliation: Departamento de Salud y Consumo, Gobierno de Aragón, Spain; Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain. cmartos@aragon.es
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Martos
authors.forename: Carme
authors.initials: C
authors.lastname: Saurina
authors.forename: Cristina
authors.initials: C
authors.lastname: Feja
authors.forename: Marc
authors.initials: M
authors.lastname: Saez
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Burriel
authors.forename: Maria Antònia
authors.initials: MA
authors.lastname: Barceló
authors.forename: Pilar
authors.initials: P
authors.lastname: Gómez
authors.forename: Gemma
authors.initials: G
authors.lastname: Renart
authors.forename: Tomás
authors.initials: T
authors.lastname: Alcalá
authors.forename: Rafael
authors.initials: R
authors.lastname: Marcos-Gragera
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D012042:Registries; D015203:Reproducibility of Results; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate