title: High accuracy of Swedish death certificates in men participating in screening for prostate cancer: a comparative study of official death certificates with a cause of death committee using a standardized algorithm.
abstract: OBJECTIVE
  Recently, the first mortality data from the Göteborg Randomized Population-based Prostate Cancer Screening Trial showed a 44% reduction in prostate cancer (PC)-specific mortality as a result of screening with prostate-specific antigen (PSA). As death of PC is the main endpoint, an accurate determination of the cause of death (COD) is crucial. The aim of this study was therefore to investigate the accuracy of death certificates of men in the Göteborg Randomized Population-based Prostate Cancer Screening Trial.
  
  
  METHODS
  Men with a PC diagnosis and who died within the study period (1995-2008) were included. Relevant medical information, including death certificate, was collected. An independent COD committee reviewed the material following a flowchart to classify the COD. The committee's decision was compared with the COD on the death certificate.
  
  
  RESULTS
  Of the 285 men included in the study, 278 men were eligible for a comparative analysis. The committee and the death certificates agreed on PC as the underlying COD in 116 men and causes other than PC in 151. There were 11 discordant cases, for an overall agreement of 96%. Men with PC in the screening group had, compared with the control group, a significantly lower PC-specific mortality but did not differ in non-PC-specific mortality.
  
  
  CONCLUSIONS
  This study concludes that Swedish death certificates are of high accuracy and can be used for endpoint evaluation in screening studies for PC.
authors.affiliation: Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at Universityof Göteborg, Sweden. r.godtman@gmail.com
authors.forename: Rebecka
authors.initials: R
authors.lastname: Godtman
authors.forename: Erik
authors.initials: E
authors.lastname: Holmberg
authors.forename: Johan
authors.initials: J
authors.lastname: Stranne
authors.forename: Jonas
authors.initials: J
authors.lastname: Hugosson
mesh_terms: D000368:Aged; D000465:Algorithms; D002423:Cause of Death; D003644:Death Certificates; D023381:Endpoint Determination; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality*; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology
chemical_list: D017430:Prostate-Specific Antigen