Affiliation of authors: H. L. Howe, North American Association of Central Cancer Registries, Springfield, IL; P. A. Wingo, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA; M. J. Thun, Epidemiology and Surveillance Research Department, American Cancer Society, Atlanta; L. A. G. Ries, B. K. Edwards (Division of Cancer Control and Population Sciences), E. G. Feigal (Division of Cancer Treatment and Diagnosis), National Cancer Institute, Bethesda, MD; H. M. Rosenberg, Division of Vital Statistics, National Center for Health Statistics, CDC, Hyattsville, MD.
Correspondence to: Holly L. Howe, Ph.D., North American Association of Central Cancer Registries, Inc., 2121 W. White Oaks Dr., Springfield, IL 627046495 (e-mail: hhowe{at}naaccr.org).
We agree with the comments of Dr. Rose regarding the classification issues related to changing diagnostic practices for ovarian and peritoneal tumors. We did discuss the potential impact of these changes on the findings reported in our article. It is difficult to distinguish a true increase in cancer from changes in clinicians' site attribution practices (1). As for Dr. Rose's suggestion that ovarian and peritoneal tumors be combined in a single group for reporting purposes, we believe that it is more meaningful to report statistics for each tumor separately, enabling one to assess information for each group as well as for the combined group. Furthermore, it is unlikely that consolidation of both types of cancer would help clarify the incidence trend, since the number of peritoneal tumors is much smaller than the number of ovarian tumors. The downward trend of the more frequent ovarian tumors would dominate the statistics for the consolidated group.
REFERENCE
1 McGowan L, Norris HJ. The mistaken diagnosis of caricnoma of the ovary. Surg Gynecol Obstet 1991;173:2115.[Medline]
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