Agreement and validity of asbestos-related cancers in the hospital information system of the brazilian unified health system

Abstract

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.