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Implications of missing data on reported breast cancer mortality
Jennifer K Plichta1,2,3, Christel N Rushing4,5, Holly C Lewis6
1Department of Surgery, Duke University Medical Center, Durham, NC, DUMC 351327710, USA. jennifer.plichta@duke.edu.
Breast Cancer Research and Treatment
|November 5, 2022
Summary
Missing data in cancer registries is common and linked to worse survival. Analyzing incomplete data may underestimate breast cancer mortality, impacting patient care and research accuracy.
Area of Science:
- Oncology
- Biostatistics
- Public Health
Background:
- National cancer registries are crucial for analyzing cancer care patterns and outcomes.
- Missing data in these registries can compromise the accuracy and generalizability of findings.
- Evaluating the impact of missing data on overall survival (OS) is essential.
Purpose of the Study:
- To assess the association between missing data and overall survival (OS) in breast cancer patients.
- To quantify the prevalence of missing data in national cancer registries.
- To understand the implications of data missingness on survival analyses.
Main Methods:
- Utilized data from the National Cancer Database (NCDB) and Surveillance, Epidemiology, and End Results (SEER) Program (2010-2014).
- Assessed missingness for demographic, tumor, and treatment variables in invasive breast cancer cases.
- Employed Cox proportional hazards models to compare OS between patients with and without missing data.
Main Results:
- A significant proportion of patients had missing data (29% in NCDB, 13% in SEER), predominantly tumor variables.
- Missing data was associated with an increased risk of death (NCDB HR 1.23, SEER HR 2.11).
- Patients with complete tumor data exhibited higher unadjusted 5-year OS estimates.
Conclusions:
- Missingness of key variables is prevalent in national cancer registries.
- Data missingness is significantly associated with poorer overall survival.
- Excluding patients with missing data may introduce bias and underestimate breast cancer mortality.
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