Mortality from cancer in Tunisia in 2020 and death certification quality

Introduction-Aim: According to the World Health Organization, cardiovascular disease and cancer figure among leading causes of death worldwide. This aim of our study was to identify the deadliest cancers in Tunisia and to assess the quality of medical certification related to cancer deaths.

We led a descriptive observational study based on data from the national information system on causes of deaths in 2020. Were included all medical death certificates received by the National Institute of Health and related to deaths occurring in 2020. Causes of death were coded according to the International Classification of Diseases (ICD-10). The share of Garbage codes was determined by ANACONDA software. Data entry and analysis, were performed by SPSS software.

In total, 45420 deaths were enrolled, including 7001 deaths from cancer, representing 15.1% of all deaths. The sex ratio (Male/Female) was to 1.7 with median age was 67 years ±0.2. The deadliest cancers were the following cancers: bronchopulmonary (22.8%), colorectal (7.9%), breast (7.4%), prostate (5.9%), liver (4.9%) and pancreas (4.8%). The share of garbage codes was 12%, dominated by cancers with "unspecified primary location" (6.1%), "primary cancers with multiple independent locations" (1.6%), uterine cancer of undefined location (1.3%), "cancer of the digestive tract of undefined location" (1.2%).

Our study highlighted the important place of cancer among all deaths in Tunisia. We recommend training of certifying doctors on the rules of good quality certification, and the strengthening of primary prevention by fighting against risk factors and secondary prevention by screening and early diagnosis of cancers.