University of Oulu

Maharjan U, Kauppila JH, Gastric cancer completeness in Finnish Cancer Registry and Finnish Patient Registry: a population-based nationwide retrospective cohort study, BMJ Open 2022;12:e056320.

Gastric cancer completeness in Finnish Cancer Registry and Finnish Patient Registry : a population-based nationwide retrospective cohort study

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Author: Maharjan, Urgena1; Kauppila, Joonas H.1,2
Organizations: 1Surgery Research Unit, Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
2Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: BMJ, 2022
Publish Date: 2022-09-30


Background: Gastric cancer is the fourth-leading cause of cancer-related deaths worldwide. The only curative treatment options of gastric cancer are perioperative chemotherapy and surgical resection. Many nationwide registries have high validity and provide vast range of opportunities for registry-based research. Cancer diagnoses in the Finnish Cancer Registry (FCR) are reported by pathology laboratories and clinician forms, while discharge diagnosis codes are reported to the Finnish Patient Registry (HILMO) automatically. Finland is known for complete registries but the completeness of gastric cancer in FCR and HILMO remains unclear.

Objectives: The aim of this study is to assess the registry coverage for gastric cancer in FCR and HILMO and to explore potential reasons for possible differences between these registries.

Design: Population-based nationwide retrospective cohort study.

Participants: All patients diagnosed with gastric cancer in Finland during 1990 to 2014, with follow-up until 31 December 2019.

Results: Out of 21 468 total gastric cancers reported to either registry, 17 107 (79.7%) had a gastric cancer diagnosis in both registries. A substantial decrease from 88.3% to 83.4% was observed in the proportion of cases reported to FCR over time. The completeness of FCR was estimated at 87%. For HILMO, the completeness was 92.7%. Death due to gastric cancer was most common in those with gastric cancer in both registries (80.8%), and less common in those reported to only FCR (36.3%), followed by those reported to only HILMO (9.3%).

Conclusions: The study indicates that gastric cancer is well captured by both FCR and HILMO but there is an alarming decrease in the proportion of cases captured by the FCR over time. Some gastric cancer diagnoses in HILMO might, however, be misclassified due to cancer diagnoses being assigned based on clinical suspicion.

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Series: BMJ open
ISSN: 2044-6055
ISSN-E: 2044-6055
ISSN-L: 2044-6055
Volume: 12
Issue: 4
Article number: e056320
DOI: 10.1136/bmjopen-2021-056320
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
3126 Surgery, anesthesiology, intensive care, radiology
Funding: This work is supported by research grants from the Sigrid Juselius Foundation (Sigrid Juseliuksen Saatio), The Finnish Cancer Foundation (Syopasaatio), and Paivikki and Sakari Sohlberg Foundation.
Copyright information: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: