Cancer Maps

The mortality and population data used in preparing the color-coded maps were processed and forwarded to the German Cancer Research Center by the statistical bureaus of the 16 German states, which put the statistical data into a form specially designated for the purpose at hand. The mortality data are derived from official cause-of-death statistics, and the population data from censuses and census updates. Both sources of data are described more fully below in separate sections of this chapter.

The data, in summarized form, are available for the two 5-year reporting periods 1981-1985 and 1986-1990. The data are broken down by types of cancer based on the three-digit categories of the International Classification of Diseases, 9th Revision (ICD-9), by gender, and by 5-year age groups for the populations of state districts (comparable to U.S. counties) and of larger cities that have district status.

The 328 districts in western Germany are largely identical to those in the previous Cancer Atlas covering the period 1976-1980 (Becker et al. 1984). For the eastern part of Germany, the new statistical bureaus formed in the five new federal states (Mecklenburg-West Pomerania, Brandenburg, Saxony-Anhalt, Thuringia, and Saxony) recalculated the mortality data from the former GDR to bring it in line with the new regional districting system that was adopted after German reunification in 1990. This districting system is different from that used in the cancer atlas of the former GDR (Möhner et al. 1994). The current territorial status of the unified Germany, including the designations for the 554 districts and cities with district status, is shown on a fold-out map at the end of the atlas.

Although the mortality data are aggregate data that make no reference to patient identifies, the statistical bureaus in several states censored data in cases where only one death was recorded in a particular district and age range, because the bureau felt that it might have been possible to trace the patient's identity. These missing data have no significant impact for the purposes of this atlas, but they do cause the absolute case numbers in the tables to deviate slightly from the numbers stated in official publications.

Trend Lines

The WHO furnished most of the data used in the graphs and tables indicating secular trends and age-dependent mortality rates for particular cancers. The data for western Germany cover the period 1952-1990, and the data for the former GDR cover the periods 1973-1978 and 1980-1990. For reasons unknown, neither the WHO nor the statistical bureaus have data for the year 1979.

The data furnished by the WHO do not include East German mortality figures prior to 1973, but the Robert Koch Institute was able to supply data as far back as 1961 for the more common cancer sites.

Since 1991, the Statistical Bureau of the Federal Republic of Germany has furnished data both for Germany as a whole and separately for the western and eastern parts of the country for purposes of scientific research.

Again, all these data are based on official cause-of-death statistical records. Data furnished by the WHO are supplied in the usual compressed form. Because the 7th and 8th revisions of the ICD are coded according to the A system and the 9th revision according to the somewhat more detailed B system, the data for cancer sites not specifically named in this coding system are not available for all periods of interest. Data with the three-digit ICD code are available for certain cancer sites regardless of whether the A or B system is used. While these data were not always available for a whole period of interest, we did take them into account in making our evaluations. The data furnished by the Federal Statistical Office since 1991 have a three-digit code conforming to the 9th revision of the ICD.

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