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Expert review of the diagnosis and histologic classification of Hodgkin disease in a population‐based cancer registry
Author(s) -
Glaser Sally L.,
Dorfman Ronald F.,
Clarke Christina A.
Publication year - 2001
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20010715)92:2<218::aid-cncr1312>3.0.co;2-6
Subject(s) - medicine , cancer registry , medical diagnosis , incidence (geometry) , population , confidence interval , nodular sclerosis , disease registry , disease , cancer , pediatrics , pathology , lymphoma , hodgkin lymphoma , environmental health , optics , physics
BACKGROUND The reliability of Hodgkin disease (HD) diagnosis and histologic classification is an ongoing concern but has not been evaluated in a population‐based case series in 20 years. Yet, diagnostic error in cancer registry data used in surveying HD occurrence may produce statistics that misrepresent incidence, mortality, or survival. METHODS Uniform pathology review was attempted for all 395 women ages 19–79 years with incident HD reported to a population‐based cancer registry in 1988–94. Agreement between original registry and review diagnoses was measured with positive predictive values and kappa statistics. Incidence rates and survival probabilities were computed based on registry and review diagnoses. RESULTS Registry and review diagnosis agreed for 245 of the 362 reviewed cases. Positive predictive values varied by histologic subtype (nodular sclerosis, 95%; lymphocyte predominance, 69%; mixed cellularity, 58%; lymphocyte depletion, 0%; not otherwise specified, 40%), but agreement was good overall (kappa, 0.66, 95% confidence interval, 0.56–0.76). Eleven patients were determined not to have HD; all were older than age 44 years. Hodgkin disease incidence rates differed for original and review diagnoses only in older women, for whom registry rates slightly overestimated incidence. Five‐year survival rates did not differ for registry and review data overall or by age group. CONCLUSIONS For most adult women patients, the diagnosis of HD was confirmed on review, reflecting the very good agreement between registry and review diagnoses for nodular sclerosis, the most common subtype. Thus, cancer registry statistics for this time period can provide accurate estimates of disease patterns for HD overall and for the nodular sclerosis variant. For other histologic subtypes, rates may be unreliable, and HD occurrence overall may be less dependable in populations with larger proportions of these subtypes. Cancer 2001;92:218–24. © 2001 American Cancer Society.