Agreement and validity of asbestos-related cancers in the hospital information system of the Brazilian Unified Health System.

OBJECTIVE

To estimate the degree of agreement and validity of diagnoses of asbestos-related malignant neoplasms registered in the Hospital Information System of the Brazilian Unified Health System (SIH/SUS), in comparison to the Hospital Cancer Registries of the State of São Paulo (HCR/SP).

METHODS

Deaths with records of malignant neoplasms associated with asbestos were identified and extracted from SIH/SUS between 2007 and 2014. Deaths in cases registered in the HCR/SP were extracted for the same period. The databases were linked using software Link Plus. A single ICD-10-coded diagnosis selected from each system was analyzed. The proportion of agreement, and the sensitivity, specificity and predictive values were estimated.

RESULTS

19,458 pairs were found with records in both bases. The proportion of agreement was high, ranging from 92.4% for the unknown primary site, to 99.7% for cancer of the pleura. The Kappa Index ranged from 0.05 (95%CI 0.04 - 0.07) for cancer of the pleura to 0.85 (95%CI 0.84 - 0.87) for lung cancer. Sensitivity varied from 0.08 (95%CI 0.01 - 0.25) for cancer of the pleura, to 0.90 (95%CI 0.90 - 0.91) for lung cancer.

CONCLUSION

Diagnosis of asbestos-related malignancies reached higher levels of agreement and validity when common. Rare diagnoses showed low accuracy in SIH/SUS.