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Monte Carlo analysis of impact of underascertainment of mesothelioma cases on underestimation of risk.

Authors
Kopylev-L; Sullivan-PA; Vinikoor-LC; Bateson-TF
Source
Open Epidemiol J 2011 Jan; 4:45-53
NIOSHTIC No.
20038326
Abstract
The accuracy of cancer mortality data varies across different cancers. Mortality records and death certificates may not always reflect the true cause of death for various reasons (e.g., misdiagnosis, improper recording on the death certificate, miscoding of the cause of death recorded on the death certificate). Mesothelioma, a rare tumor which is caused by exposure to asbestos, is a special case. Until 1999 when the 10th revision of the International Classification of Diseases (ICD-10) introduced a specific mesothelioma code, mesotheliom deaths were coded to other causes (e.g., cancer of the pleura, cancer of other or ill-specified sites). Even after the introduction of this mesothelioma code, researchers have shown that estimates of mesothelioma mortality based on death certificates are still biased downward. This article reviews available literature with quantitative information on mesothelioma underascertainment, in particular on different rates of underestimation for pleural and peritoneal mesotheliomas, and suggests two approaches to estimating downward bias in absolute risk estimates due to mesothelioma underascertainment. The choice of approach used depends on whether the information on the proportion of peritoneal mesotheliomas is available. Both approaches are demonstrated and evaluated using a cohort of asbestos workers from Libby, Montana. the methods developed in this article may be used in analyses of other asbestos cohorts and in methodologies to predict future mesothelioma burden in populations. Similar approaches can be used to assess the impact of underascertainment of other cancers on risk estimates of other chemicals.
Keywords
Cancer; Cancer-rates; Mesothelial-cells; Asbestos-workers; Respiratory-system-disorders; Pulmonary-cancer; Lung-cancer; Lung-disease; Mortality-data; Mortality-rates; Risk-analysis; Respiratory-neoplasms; Pleural-cavity; Author Keywords: Pleural mesothelioma; peritoneal mesothelioma; Libby worker cohort; asbestos; death certificates; ICD codes
Contact
Leonid Kopylev, National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, 1200 Pennsylvania Ave. NW, MC 8623P, Washington, DC 20460
CODEN
OEJPE6
CAS No.
1332-21-4
Publication Date
20110119
Document Type
Journal Article
Email Address
kopylev.leonid@epa.gov
Fiscal Year
2011
NTIS Accession No.
NTIS Price
ISSN
1874-2971
NIOSH Division
DRDS
Source Name
The Open Epidemiology Journal
State
DC; WV
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