Abstract
Pleural mesothelioma is a rare tumour associated with exposure to asbestos fibres. Fewer than than one-quarter of cases registered in the Quebec Tumour Registry (QTR) have been compensated as work-related. While establishing a surveillance system, this led to questioning as to whether there has been over-registration of cases that are not authentic pleural mesotheliomas in the QTR. To assess whether registered cases of pleural mesothelioma could be confirmed. A medical chart review was designed to assess the proportion of mesothelioma cases newly registered in the QTR in 2001⁄2002 that could be confirmed. For each registered case, clinical, medical imaging and pathology information were sought and, occasionally, additional immunohistochemistry staining was obtained. Three specialists - a chest physician, a radiologist and a pathologist - reviewed the available information and material, coding each mesothelioma case as to degree of certainty of the mesothelioma diagnosis. The QTR reported 190 incident cases of mesothelioma (81% males) for the period. The specialists classified 81% of charts as 'certain⁄probable' or 'possible' mesotheliomas, 8% as 'unlikely to be a mesothelioma' and 11% as 'not a mesothelioma'. After excluding chart summaries of unsatisfactory quality, 87% to 88% of the charts were classified as 'certain⁄probable' or 'possible' mesotheliomas, and 9% to 11% were still considered 'not a mesothelioma'. Tumour registry data are a valid source of information for mesothelioma surveillance. While there is some over-registration of mesothelioma cases in the QTR, a significant majority of registered cases appeared to be authentic. Over-registration cannot explain the greater proportion of cases that were not compensated.
Highlights
Pleural mesothelioma is a rare tumour associated with exposure to asbestos fibres
A clinical validation study was undertaken to estimate the proportion of pleural mesothelioma cases identified through the Quebec Tumour Registry (QTR) that could be confirmed by an expert review of all available clinical, imaging and pathology information
During 2001 and 2002, 190 cases of pleural mesothelioma were registered in the QTR; of these, 187 medical charts were accessible
Summary
Fewer than than one-quarter of cases registered in the Quebec Tumour Registry (QTR) have been compensated as workrelated. While establishing a surveillance system, this led to questioning as to whether there has been over-registration of cases that are not authentic pleural mesotheliomas in the QTR. OBJECTIVE: To assess whether registered cases of pleural mesothelioma could be confirmed. METHODS: A medical chart review was designed to assess the proportion of mesothelioma cases newly registered in the QTR in 2001/2002 that could be confirmed. The specialists classified 81% of charts as ‘certain/ probable’or ‘possible’ mesotheliomas, 8% as ‘unlikely to be a mesothelioma’ and 11% as ‘not a mesothelioma’. CONCLUSION: Tumour registry data are a valid source of information for mesothelioma surveillance. While there is some over-registration of mesothelioma cases in the QTR, a significant majority of registered cases appeared to be authentic. Over-registration cannot explain the greater proportion of cases that were not compensated
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