Using Monte Carlo to Evaluate Impact of Mesothelioma Underascertainment

• Activity Number: 86
• Type: Contributed
• Date/Time: Sunday, July 29, 2012 : 4:00 PM to 5:50 PM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Leonid Kopylev*+ and Thomas Bateson
• Companies: EPA and EPA
• Keywords: Monte Carlo ; mesothelioma ; ICD code ; bias

Abstract

Mortality records and death certificates may not always reflect the true cause of death for various reasons (e.g., misdiagnosis, improper recording, miscoding). Mesothelioma, a rare tumor which is caused by exposure to asbestos, is a special case. Until 1999 when the ICD-10 introduced a specific mesothelioma code, mesothelioma deaths were coded to other causes. Even after the introduction of this mesothelioma code, researchers have shown that estimates of mesothelioma mortality rates based on death certificates are still biased downward. We review literature with quantitative information on mesothelioma underascertainment, in particular on different rates of underestimation for pleural and peritoneal mesotheliomas, and suggest two Monte Carlo approaches to estimating downward bias in risk estimates. Approaches are evaluated using a cohort of asbestos-exposed workers from Libby, MT. The methods may be used in analyses of other asbestos-exposed cohorts and in methodologies to predict the future burden of mesothelioma in populations. Similar approaches can be used to assess the impact of undercount of other cancers. Disclaimer: This abstract does not necessarily reflect EPA policy