The Effect of Inaccuracies in Death Certification and Coding Practices in the European Economic Community (EEC) on International Cancer Mortality Statistics

An investigation into the effect of national death certification and coding practices on published mortality statistics in eight EEC countries is reported. Doctors in each country were asked to complete specimen death certificates for a bank of written case histories. Certificates from each country were coded by their own offices and then by a WHO reference centre. Within and between countries, discrepancies occurred both in the doctors' diagnoses and in the codes assigned to certificates. At an international level these differences had serious implications for the comparability of mortality data for cancers of the cervix and uterus, and for mesotheliomas.