Original Article Misclassification of Sex in Central Cancer Registries

Abstract: Background: Intrarecord edits on site–sex combinations are a standard tool to identify errors in the coding of sex in cancer registry data. However, the percentage of sex-specific cancers, like cervix, is low (20 % of total invasive cases). Visual review and follow-back to improve the quality of the sex coding is labor intensive and typically only performed as a special project on subsets of data. The New York State Cancer Registry (NYSCR) created an edit for identifying potential sex misclassification in cancer registry data and has made its components available for use through the North American Association of Central Cancer Registries (NAACCR). The edit uses the most popular male and female first names based on decade of birth to identify potentially miscoded cases. This paper provides a summary of 3 independently conducted assessments of the sex edit at the central cancer registry level and includes a focus on misclassification of sex for breast cancer. Methods: The sex edit was applied in 3 state cancer registries: Alabama, Alaska, and Florida. Alabama applied the edit to their entire database for 1996–2004 (N = 190,614) and compared the results to external databases available to most cancer registries. Alaska applied the edit to their entire database (N = 46,645) and were able to compare the results to 2 unique, state-based databases (Alaska Permanent Fund Dividend database and State Troopers database). Florida applied the sex edit to a sample of sites (n = 953,074) with particular attention to breast cancer. Results for breast cases were com-pared to results from an a priori quality control project on Florida male breast cancer cases. Using the Florida data, issues specific to male breast cancer were evaluated. Results: In Alabama, 45 % of 977 cases flagged as potentially miscoded se