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Canadian Respiratory Journal
Volume 19, Issue 2, Pages 103-107
Original Article

Pleural Mesothelioma Surveillance: Validity of Cases from a Tumour Registry

France Labrèche,1,2 Bruce W Case,3 Gaston Ostiguy,4,5 Jean Chalaoui,6,7 Michel Camus,2,8 and Jack Siemiatycki7,9

1Institut national de santé publique du Québec, Canada
2Dé partement de santé environnementale et santé au travail, Faculté de Médecine, Université de Montréal, Canada
3Department of Pathology, Faculty of Medicine, McGill University, Canada
4McGill University Health Centre – Montreal Chest Institute, Canada
5Faculty of Medicine, McGill University, Canada
6Centre hospitalier de l’Université de Montréal – Hôpital Notre-Dame, Montréal, Québec, Canada
7Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
8Population Health Division, Health Canada, Ottawa, Ontario, Canada
9Centre de recherche du Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada

Copyright © 2012 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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’.

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.