Accuracy Of US Cancer Surveillance Under Threat

A report obtained by The Lancet Oncology details a precipitous decline in US Veteran Affairs (VA) reporting of new cancer cases to California registries beginning in late 2004—from 3000 cases in 2003 to almost none by the end of 2005. Inconsistent and incomplete case reporting by VA Hospitals are also long-standing problems for other US states and could mean that cancer rates appear artificially low across the USA.

The omission of veteran data would introduce “uncorrectable bias” in epidemiological studies, and research from the mid-2000s will not be correct, according to Dennis Deapen of the Los Angeles Cancer Surveillance Program. Furthermore, it will hamper efforts to identify quality-of-care issues for VA patients with cancer.

A draft version of the VA policy directive on cancer reporting was obtained by The Lancet Oncology which revealed that the directive will formalise the prohibitions on sharing veteran cancer data between states and forbid the “re-lease” of veteran data to researchers whose studies have not been approved by the VA. “This could become a serious issue for the validity of epidemiological studies” according to Elizabeth Ward of the American Cancer Society. The VA has since posted the final directive on its website.