What is a death certificate only (DCO) case and how should it be treated in analysis?

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Multiple Choice

What is a death certificate only (DCO) case and how should it be treated in analysis?

A death certificate only case is one that the cancer registry identifies solely from the death certificate, with no prior record of diagnosis in the registry or medical charts before death. This situation often signals late ascertainment—the cancer wasn’t captured earlier, so the death certificate is the first indication of the cancer. For analysis, include these cases in incidence counts to avoid underestimating burden, but treat them with caution because they lack crucial clinical details such as date of diagnosis, site verification, stage, and treatment. Follow established guidelines: include in incidence analyses, but do not rely on them for survival analyses or methods that require a valid prior diagnosis date. This keeps incidence totals accurate while acknowledging the uncertain data quality of DCO cases. Choices referring to autopsy reports, pathology from biopsy, or hospital discharge data describe other sources of case identification and are not the definition of a death certificate–only case, which is specifically identified solely from the death certificate.

A death certificate only case is one that the cancer registry identifies solely from the death certificate, with no prior record of diagnosis in the registry or medical charts before death. This situation often signals late ascertainment—the cancer wasn’t captured earlier, so the death certificate is the first indication of the cancer.

For analysis, include these cases in incidence counts to avoid underestimating burden, but treat them with caution because they lack crucial clinical details such as date of diagnosis, site verification, stage, and treatment. Follow established guidelines: include in incidence analyses, but do not rely on them for survival analyses or methods that require a valid prior diagnosis date. This keeps incidence totals accurate while acknowledging the uncertain data quality of DCO cases.

Choices referring to autopsy reports, pathology from biopsy, or hospital discharge data describe other sources of case identification and are not the definition of a death certificate–only case, which is specifically identified solely from the death certificate.

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