. "7 Monitoring and Reporting." The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved. Washington, DC: The National Academies Press, 1999.
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cancer, then all the major causes of death for all ethnic groups must be included. Although cancers at many sites are continuously monitored, reporting should routinely focus on the sites associated with the greatest burden of cancer while aggregating data on cancers at other sites.
Aggregation of deaths from cancer from those causing the highest rate of mortality to those causing the lowest rate of mortality is only one approach to the problem. The Breslow Committee suggested consideration of three other alternatives: cancers that can be grouped according to preventable cancers, cancers that can be controlled by timely screening and detection, and cancers against which efficacious treatments exist (Extramural Committee to Assess Measures of Progress Against Cancer, 1990). These alternatives would facilitate easy linkage to the present state of knowledge and practice with respect to prevention, control, and treatment. Whatever aggregation method is used, the objective would be to avoid the overwhelming amount of data that would be accumulated if the data included all possible types of cancer for all ethnic groups. As in the case of the group by ethnic groups, the aggregation should include entries for "all other sites" and for total sites.
The left margin of the table would then appear as follows:
Reporting on Mortality
Despite the problems associated with recording and coding of deaths, the mortality data remain the most important measure of success of the efforts being made against cancer. The denominator data for calculation of the rates are derived from the census and the numerator data are derived from death certificates. The mortality data are obtained from NCHS of the Centers for Disease Control and Prevention. Reported data would be the most recent available, which currently means information on events that occurred 2 or more years prior to publication. A separate table could then show changes in mortality, and it is the change or lack of change that