Centers for Disease
Control and Prevention
Division of Cancer
Prevention and Control
4770 Buford Hwy NE
Atlanta, GA 30341
TTY: (888) 232-6348
United States Cancer Statistics (USCS)
Interpreting the Data: Mortality Data
Cancer mortality statistics on this Web site are influenced by the accuracy of information on the death certificate. Cause of death determined by autopsy combined with clinical data is considered the best estimate of the true cause of death.1 Autopsy studies of mortality data coded according to the eighth or ninth revision of the International Classification of Diseases (ICD) (ICD-8A or ICD-9) indicate that, when neoplasms (cancers) are an underlying cause of death, the sensitivity of death certificates was 87%–93%, and their predictive value positive was 85%–96%.1 2 3 However, these studies are limited by selection bias, and less than 10% of deaths in the United States are autopsied.4
Death Certificates Reliability
Improving the Accuracy of Vital Statistics
1Kircher T, Nelson J, Burdo H. The autopsy as a measure of accuracy of the death certificate. New England Journal of Medicine 1985;313(20):1263–1269.
2Engel LW, Strauchen JA, Chiazze L Jr, Heid M. Accuracy of death certification in an autopsied population with specific attention to malignant neoplasms and vascular diseases. American Journal of Epidemiology 1980;111(1):99–112.
3Schottenfeld D, Eaton M, Sommers SC, Alonso DR, Wilkinson C. The autopsy as a measure of accuracy of the death certificate. Bulletin of the New York Academy of Medicine 1982;58(9):778–794.
4Sinard JH. Factors affecting autopsy rates, autopsy request rates, and autopsy findings at a large academic medical center. Experimental and Molecular Pathology 2001;70(3):333–343.
5German RR, Fink AK, Heron M, Stewart SL, Johnson CJ, Finch JL, Yin D; the Accuracy of Cancer Mortality Study Group. The accuracy of cancer mortality statistics based on death certificates in the United States. Cancer Epidemiology 2011;35(2):126–131.
Page last reviewed: October 22, 2013
Page last updated: October 22, 2013
Content source: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion