Validation of an algorithm for identifying incident cancer cases based on long-term illness and diagnosis related group program data from the French National Health Insurance Information System (SNDS).

PURPOSE: Three generic claims-based algorithms based on the Illness Classification of Diseases (10th revision- ICD-10) codes, French Long-Term Illness (LTI) data, and the Diagnosis Related Group program (DRG) were developed to identify retirees with cancer using data from the French national health insurance information system (Système national des données de santé or SNDS) which covers the entire French population. The present study aimed to calculate the algorithms' performances and to describe false positives and negatives in detail. METHODS: Between 2011 and 2016, data from 7544 participants of the French retired self-employed craftsperson cohort (ESPrI) were first matched to the SNDS data, and then toFrench population-based cancer registries data, used as the gold standard. Performance indicators, such as sensitivity and positive predictive values, were estimated for the three algorithms in a subcohort of ESPrI. RESULTS: The third algorithm, which combined the LTI and DRG program data, presented the best sensitivities (90.9%-100%) and positive predictive values (58.1%-95.2%) according to cancer sites. The majority of false positives were in fact nearby organ sites (e.g., stomach for esophagus) and carcinoma in situ. Most false negatives were probably due to under declaration of LTI. CONCLUSION: Validated algorithms using data from the SNDS can be used for passive epidemiological follow-up for some cancer sites in the ESPrI cohort.

Lifetime occupational exposure proportion estimation methods: a sensitivity analysis in the general population.

OBJECTIVE: To present a sensitivity analysis of the most widely used means of estimating lifetime occupational exposure proportion (LOEP) and their respective impacts on LOEP and population-attributable fraction (PAF) estimates. METHODS: A French population-based sample with full job history (N = 10,010) was linked with four Matgéné job-exposure matrices: flour, cement, silica and benzene. LOEP and the 95% confidence interval were estimated using four methods: the maximum exposure probability during the career (Proba_max), two methods subdividing careers into job-periods (job-period_M1, job-period_M2) and one into job-years (job-year). To quantify differences between methods, percentages of variation were calculated for proportion values and PAF, and compared with published results for France using cross-sectional proportion multiplied by a factor. RESULTS: For each agent, LOEP estimated from the maximum probability during the career (Proba_max) was consistently lower than proportion taking account of job-periods or job-years. LOEP on Proba_max for flour, cement, silica and benzene were, respectively, 4.4% 95% CI (4.0-4.7), 4.3% (3.9-4.6), 6.1% (5.7-6.5) and 3.9% (3.6-4.2). Percentage of variation ranged from 0 to 55.8% according to the agent. The number of cancer cases varied by a twofold factor for exposure to silica and lung cancer and by a fourfold factor for exposure to benzene and acute myeloid lymphoma. CONCLUSIONS: The present study provides a description of several LOEP estimation methods based on exposure assessment over the entire career and describes their impact on PAF. For health monitoring purposes, we recommend to report a range of LOEP with low and high estimates obtained using job-periods (job-period_M1 and job-period_M2).

Surveillance Programme of Work-related Diseases (WRD) in France.

The surveillance programme of work-related diseases (WRD) is based on a network of occupational physicians who notify all WRD diagnosed during a two-week observation period. The aims are mainly to estimate the prevalence of non-compensated WRD in the working population according to socio economic factors; to determine new indicators of occupational health; to update the lists of compensable occupational diseases; to understand and assess under-compensation and under-notification. The participation rate for occupational physicians is around 33% in 2008. The main WRD are the musculoskeletal disorders, followed by the mental disorders. This 2-week protocol, repeated regularly, provides useful data on frequency of pathologies linked to employment as well as an estimate of unreported WRD subject to compensation or non-compensated WRDs, and the trends of WRDs over the time.