Imputation of missing prostate cancer stage in English cancer registry data based on clinical assumptions.
Clarke, Noel W
van der Meulen, J
AffiliationDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, England
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AbstractBACKGROUND: Cancer stage can be missing in national cancer registry records. We explored whether missing prostate cancer stage can be imputed using specific clinical assumptions. METHODS: Prostate cancer patients diagnosed between 2010 and 2013 were identified in English cancer registry data and linked to administrative hospital and mortality data (n?=?139,807). Missing staging items were imputed based on specific assumptions: men with recorded N-stage but missing M-stage have no distant metastases (M0); low/intermediate-risk men with missing N- and/or M-stage have no nodal disease (N0) or metastases; and high-risk men with missing M-stage have no metastases. We tested these clinical assumptions by comparing 4-year survival in men with the same recorded and imputed cancer stage. Multi-variable Cox regression was used to test the validity of the clinical assumptions and multiple imputation. RESULTS: Survival was similar for men with recorded N-stage but missing M-stage and corresponding men with M0 (89.5% vs 89.6%); for low/intermediate-risk men with missing M-stage and corresponding men with M0 (92.0% vs 93.1%); and for low/intermediate-risk men with missing N-stage and corresponding men with N0 (90.9% vs 93.7%). However, survival was different for high-risk men with missing M-stage and corresponding men with M0. Imputation based on clinical imputation performs as well as statistical multiple imputation. CONCLUSION: Specific clinical assumptions can be used to impute missing information on nodal involvement and distant metastases in some patients with prostate cancer.
CitationParry MG, Sujenthiran A, Cowling TE, Charman S, Nossiter J, Aggarwal A, et al. Imputation of missing prostate cancer stage in English cancer registry data based on clinical assumptions. Cancer Epidemiol. 2018 Nov 18;58:44-51.
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