Use of hospital discharge records to estimate the incidence of malignant mesotheliomas

Epidemiologia e Prevenzione. 2007 Mar-Jun;31(2-3):127-31. [Link]

Stura A, Gangemi M, Mirabelli D.

Università degli studi di Torino, Servizio epidemiologia dei tumori e Centro interdipartimentale G. Scansetti Torino.


Setting: cancer registries usually adopt strategies for active case finding. Interest in using administrative sources of data is rising.

Objective: to assess the usefullness of Hospital discharge records (HDR) to supplement the traditional methods of case finding of the malignant mesothelioma (MM) Registry of the Piedmont Region.

Methods: HDRs have been used since 1996. We assessed the number of cases identified only through HDRs and their influence on MM incidence.

Results: cases identified through HDRs were about 10% of those with histologic confirmation of the diagnosis, 34% of those with cytologic confirmation, and 72% of those without morphologic examination. Cases diagnosed in hospitals located outside the region would have been easily (50%) missed. The age-standardised (standard: Italian pop. at the 1981 census) incidence rate of pleural MM increases from 2.2 to 2.7 per 100,000 per year among men, and from 1.1 to 1.2 among women, when including all cases identified from HDRs, irrespective
of their diagnostic confirmation. Peritoneal MM incidence estimates are unaffected. Overall without access to the hospital discharge files, 179 cases out of 954 would not have been registered between 1996 and 2001. In the same calendar period 59 cases identified by means of active search by the Registry have not been found in the hospital discharge files.

Conclusions: HDRs are useful in addition, but not in substitution, to active search of MM cases.