Comparison of Methods for Classifying Hispanic Ethnicity in a Population-based Cancer Registry

• Published in: American journal of epidemiology Vol. 149; no. 11; pp. 1063 - 1071
• Main Authors: Stewart, Susan L., Swallen, Karen C., Glaser, Sally L., Horn-Ross, Pamela L., West, Dee W.
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 01-06-1999
• Subjects: bias (epidemiology); Biological and medical sciences; California - epidemiology; classification; Epidemiology; ethnic groups; Female; General aspects; Hispanic Americans; Hispanic Americans - statistics & numerical data; Humans; Incidence; Male; Medical sciences; Methodology; neoplasms; Neoplasms - ethnology; population studies; Population Surveillance - methods; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries - statistics & numerical data; San Francisco - epidemiology; SEER program; Sensitivity and Specificity; Tumors; United States; North America; America; San Francisco; California; Human; Methodology; Register; Classification; Malignant tumor; Latinamerican; Epidemiology; Ethnic group; Public health; Incidence
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/oxfordjournals.aje.a009752

The accuracy of ethnic classification can substantially affect ethnic-specific cancer statistics. In the Greater Bay Area Cancer Registry, which is part of the Surveillance, Epidemiology, and End Results (SEER) Program and of the statewide California Cancer Registry, Hispanic ethnicity is determined by medical record review and by matching to surname lists. This study compared these classification methods with self-report. Ethnic selfidentification was obtained by surveying 1, 154 area residents aged 20–89 years who were diagnosed with cancer in 1990 and were reported to the registry as being Hispanic or White non-Hispanic. Predictive value positive, sensitivity, and relative bias were used to assess the accuracy of Hispanic classification by medical record and surname. Among those persons classified as Hispanie by either or both of these sources, only two-thirds agreed (predictive value positive = 66%), and many self-identified Hispanics were classified incorrectly (sensitivity = 68%). Classification based on either medical record or surname alone had a lower sensitivity (59% and 61%, respectively) but a higher predictive value positive (77% and 70%, respectively). Ethnic classification by medical record alone resulted in an underestimate of Hispanic cancer cases and incidence rates. Bias was reduced when medical records and surnames were used together to classify cancer cases as Hispanic. Am J Epidemiol 1999; 149:1063–71.