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PSM · Cancer registries: population-based and hospital-based
Sample itemA health officer takes the 300 new oral cancer patients registered in the cancer hospital's registry in one year and divides by the district population to report the district incidence. What is the main flaw?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Hospital patients do not form a defined population, so the denominator does not match
A hospital-based registry records patients attending one institution and has no defined catchment, so it cannot give incidence. A population-based registry collects all new cases from a defined geographic population, giving a valid numerator and denominator. Hospital registries are best for case mix, treatment outcomes and survival.
Option by option
A. Dividing new cases by the population gives prevalence rather than incidence
New cases in a period divided by the population at risk is incidence; the flaw lies in the numerator source.
B. Hospital patients do not form a defined population, so the denominator does not match (correct)
Correct. Without a defined population the numerator does not match the denominator.
C. Incidence can be derived only from mortality data
Incidence is derived from newly diagnosed cases, and mortality data are used for death rates.
D. Hospital registries record only advanced cancers
Hospital registries include all stages of patients attending, so the stage is not the central flaw.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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