Makinen T.¹, Karhunen P.², Aro J.³, Lahtela J.⁴, Tammela T.¹, Auvinen A.⁵

Presented on March, 23 2007

INTRODUCTION & OBJECTIVES: An accurate determination of the causes of death is critical in evaluating the final outcome of the ongoing prostate cancer screening trials. We compared here the official causes of death with an independent expert review in the Finnish prostate cancer screening trial.

MATERIAL & METHODS: The Finnish trial belongs to the European Randomized Study of Screening for Prostate Cancer. Since nearly 80,000 men were involved, death cause evaluation was restricted to men with a known diagnosis of prostate cancer. Medical records were retrieved, and the cause of death was assigned by an expert review board for all those died in 1996-2003. The board decision was compared with both death certificates and the official causes of death assigned at Statistics Finland.

RESULTS: Of a total 316 deaths, the review board assigned 127 (41%) deaths to prostate cancer and 185 (59%) to other causes, whereas the corresponding figures for death certificates were 124 (40%) and 188 (60%). Four cases were excluded because of insufficient amount of information. The death certificates were in agreement with the review board in 305 of 312 cases (overall agreement 97.8%, κ 0.95) When compared with the official causes of death assigned by Statistics Finland, the overall agreement was 97.4% (304/312, κ 0.95). The sensitivity of the death certificates to identify prostate cancer deaths was 96.1% (122/127). Correspondingly, the specificity (i.e., ability to correctly identify those in whom death was unrelated to prostate cancer) was 98.9% (183/185).

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