title: Pleural mesothelioma surveillance: validity of cases from a tumour registry.
abstract: BACKGROUND
  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.
  
  
  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. 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.
  
  
  RESULTS
  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'.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institut national de santé publique du Québec, Université de Montréal, Montréal, Québec. france.labreche@irsst.qc.ca
authors.forename: France
authors.initials: F
authors.lastname: Labrèche
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Case
authors.forename: Gaston
authors.initials: G
authors.lastname: Ostiguy
authors.forename: Jean
authors.initials: J
authors.lastname: Chalaoui
authors.forename: Michel
authors.initials: M
authors.lastname: Camus
authors.forename: Jack
authors.initials: J
authors.lastname: Siemiatycki
mesh_terms: D000368:Aged; D001194:Asbestos / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008654:Mesothelioma / Q000139:chemically induced / Q000453:epidemiology*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects; D010997:Pleural Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D011792:Quebec / Q000453:epidemiology; D012042:Registries; D018571:Sentinel Surveillance
chemical_list: D001194:Asbestos