title: Mesothelioma in occupational cohort studies: methodological considerations.
abstract: OBJECTIVE
  This article describes effective strategies for the identification and valid assessment of mortality due to mesothelioma.
  
  
  METHODS
  We manually reviewed all death certificates for mention of mesothelioma for all International Classification of Diseases (ICD) revisions. We tested the accuracy of our ascertainment method by comparing New Jersey death certificate data from our health status registry with histologically confirmed cases from the New Jersey State Cancer Registry.
  
  
  RESULTS
  We found reasonably good agreement between death certificate diagnoses and histologically confirmed cases, κ coefficient 0.86 (95% confidence interval, 0.76 to 0.95). Most mesothelioma deaths in our test and North American cohorts were coded to unspecified anatomical sites.
  
  
  CONCLUSIONS
  Limiting ascertainment to pleura and peritoneum ICD codes underestimates mesothelioma deaths. Reviewing all ICD codes that could contain mesothelioma is the only effective method for complete capture of mesothelioma diagnoses.
authors.affiliation: From ExxonMobil Biomedical Sciences, Inc (Ms Wojcik and Dr Schnatter), Epidemiology & Health Surveillance, Annandale, NJ; and Independent Consultant, Epidemiologist (Dr Huebner), Montclair, NJ.
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Wojcik
authors.forename: A Robert
authors.initials: AR
authors.lastname: Schnatter
authors.forename: Wendy W
authors.initials: WW
authors.lastname: Huebner
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003644:Death Certificates; D004812:Epidemiologic Methods; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008654:Mesothelioma / Q000401:mortality*; D008875:Middle Aged; D009515:New Jersey / Q000453:epidemiology; D009784:Occupational Diseases / Q000401:mortality*; D010534:Peritoneal Neoplasms / Q000401:mortality*; D010997:Pleural Neoplasms / Q000401:mortality*; D012042:Registries