Examining the Completeness of Industry and Occupation Data Among Patients Newly Diagnosed with Cancer in North Carolina

Background: Occupational exposure to toxic substances has been associated with cancer. Including industry and occupation (I/O) in cancer surveillance can help identify potential links between occupational exposures and cancers using data already collected to monitor statewide cancer trends. I/O reporting is required in cancer registries and recently in death records. In this study, we examined the completeness of I/O information in North Carolina cancer and death certificate data.

Methods: The North Carolina Central Cancer Registry (NC CCR) is the sole repository of North Carolina cancer incidence data. NC CCR (2020-2021) and death certificate data (2020-2022) were analyzed for completeness of I/O. NC CCR incidence records for 1995-2021 diagnoses were linked to North Carolina death files (2020-2022).

Results: NC CCR data had I/O in 17% to 51% of the cases, depending on cancer type. I/O was included in 41% of 2020 death certificates and increased to a 99.9% inclusion in 2021 and 2022 death certificates. In 2020, 20,018 (18%) of 109,677 total deaths matched with a cancer record during NC CCR data linkage. In 2021, 20,225 (16%) of 119,237 total deaths matched with a cancer record, and in 2022, 20,367 (17%) of 116,406 total deaths matched to a cancer record.

Limitations: Data presented here only examine the completeness of 10 cancer types that the NC CCR regularly analyzes using the most recent data available (2021).

Conclusion: Health care providers should routinely record I/O using the standards explained in the training for providers on I/O data collection, provided by the North Carolina Department of Health and Human Services, and should increase their frequency of reporting I/O to NC CCR. Death certificate data may provide I/O data for individuals whose information is missing from cancer registry data.