Mortality from Pleural Mesothelioma in Rio de Janeiro, Brazil, 1979–2000: Estimation from Death Certificates, Hospital Records, and Histopathologic Assessments

Abstract

To obtain information about the occurrence of pleural mesothelioma on a population basis in Brazil, mortality related to pleural tumors in the State of Rio de Janeiro during 1979-2000 was examined. Death certificates with pleural tumors as the main cause of death and hospital records were analyzed, together with histopathologic material, which was reevaluated. Of 217 death certificates coded as pleural tumors, 34.1% were considered wrongly coded. Results after reclassification were: definite mesothelioma = 45 cases; probable = 7; possible = 31; inconclusive = 65; other tumors = 11. Thus, the number of mesotheliomas in Rio de Janeiro in 1979-2000 is estimated to have been 83. The analysis also suggests a problem with mortality codification in the State.

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

“…Internationally, different sources of the denominator (the 'genuine' number) in published detection rates have been used, including cases followed-up from cancer registries in the USA (Davis et al, 1992), specialist mesothelioma registries in Italy and the UK (Peto et al, 1999;Gorini et al, 2002), and histological series in France (Iwatsubo et al, 2002). The confirmation rate is derived from the percentage of 163 coded deaths that appear related to 'genuine' mesotheliomas, according to whether they are also entered as mesotheliomas within cancer or mesothelioma registries (Davis et al, 1992;Peto et al, 1999), or through case-by-case explorations of medical notes/pathology (Iwatsubo et al, 2002;Pinheiro et al, 2003). By employing compensatory calculations based on, for example, the ratio of mesothelioma to pleural cancer mortality (confirmation rate divided by detection rate), 163-encoded death rates between countries can be more informatively compared (Peto et al, 1999;Gorini et al, 2002).…”

“…Although certain countries (including Scotland) have added supplemental codes or text fields to their death records to record any mention of mesothelioma within the hand-written certificates, this has not been uniform international practice. The majority of studies have, instead, used ICD-9 code 163 (malignant neoplasm of pleura) as a surrogate for 'mesothelioma' in electronic databases (Davis et al, 1992;Peto et al, 1999;Pinheiro et al, 2003). To assess this as a surrogate for mesothelioma, we used Scottish national data, which permits direct linkage of individual patient data from cancer registry and death records, to identify mesothelioma cases and then the codes ultimately used for underlying cause of death in these patients.…”

Diagnósticos histopatológicos das pneumoconioses

“…(11,14) Biópsias por agulha algumas vezes permitem o diag- O Quadro 4 mostra um esquema para subclassificar mesoteliomas malignos pelo exame histológico. (8)(9) Genericamente, podem ser divididos em epiteliais (75%), sarcomatosos (22%) e mistos (24%) .…”

“…Os marcadores mais usados para carcinomas são CEA, B72.3, LeuM1, BEREP4 combinados, conferindo boa especificidade. (8)(9)11) HBME1 funciona em parafina, mas cora 50% dos adenocarcinomas. Trombomodulina cora mesoteliomas e poucos carcinomas, mas é freqüente em adenocarcinomas.…”

“…Com base na experiência que vimos desenvolvendo através de um estudo interinstitucional sobre a morbidade e mortalidade entre trabalhadores expostos ao asbesto, (1)(2)(3)(4)(5)(6)(7)(8)(9) traçou-se como objetivo para esta revisão discutir critérios diagnósticos que envolvam o curso da história natural das doenças relacionadas e que terão importância para o diagnóstico final.…”