Factors affecting the mesothelioma detection rate within national and international epidemiological studies: insights from Scottish linked cancer registry-mortality data

Abstract

ICD-9 code 163 (malignant neoplasm of pleura) listed as underlying cause of death detected only 40% of Scottish mesothelioma cases (all body sites) from the cancer registry in 1981 -1999. This is lower than both the previously published 55% figure, derived from UK mesothelioma register data 1986 -1991, which is based on any mention of mesothelioma on death certificates, crossreferenced to cancer registry data, and the 44% figure derived from Scottish mortality data 1981 -1999, which captured any mention of mesothelioma on the death certificate. Detection from cancer registry data increased to 75% under ICD-10 in Scotland, confirming earlier predictions of the benefit of ICD-10's more specific mesothelioma codes. Including the accidental poisoning codes E866.4 (ICD-9) and X49 (ICD-10), covering poisoning by 'unspecified' and 'other' causes, which appear to have been used as coding surrogates for mesothelioma when asbestos exposure was explicitly mentioned in deaths suggestive of a mesothelioma, and which are recorded as the underlying cause of death in 4 -7% of mesotheliomas, may improve the mesothelioma detection rate in future epidemiological studies.

Ionizing radiation: a risk factor for mesothelioma

“…In a study of mesothelioma cases (all sites) listed in the Scottish cancer registry from 1981 to 1999, the ICD-9 code of 163 (malignant neoplasm of the pleura) was listed for only 40% of the confirmed mesothelioma cases [64]. This was slightly lower than the 55% detection rate reported in the UK mesothelioma registry from 1986 to 1991 [65].…”

Mortality among British asbestos workers undergoing regular medical examinations (1971-2005)

“…The Great Britain Asbestosis Register shows that of the 373 deaths with asbestosis mentioned on the death certificate in 2005, 134 deaths had underlying cause recorded as asbestosis 24. Before the use of ICD-10 many mesotheliomas were not recorded as pleural or peritoneal cancer as the underlying cause of death,5 25 but were coded as malignant neoplasm of ill-defined, secondary and unspecified sites. Furthermore, the majority of national deaths recorded as pleural cancer as the underlying cause prior to the use of ICD-10 were in fact mesotheliomas, but only a minority (approximately 20% during the period 1979–1999) of national deaths recorded as peritoneal cancer were mesotheliomas.…”

Certified causes of death in patients with mesothelioma in South East England

“…In the previous revisions of ICD, mesothelioma deaths were commonly assigned to code 163 (Malignant neoplasm of pleura), 162 (Malignant neoplasm of bronchus and lung) or 199 (Malignant neoplasm, unspecified site) [4]. …”