Reply to letters to the editor by Brentisci et al. and Consonni and Mensi

Our plain-English summary of Reply to letters to the editor by Brentisci et al. and Consonni and Mensi, by P. Boffetta, L. Righi, C. Ciocan, et al (Annals of Oncology, 2019).

The study

• Authors: P. Boffetta, L. Righi, C. Ciocan, C. Pelucchi, C. La Vecchia, C. Romano, M. Papotti, E. Pira
• Journal: Annals of Oncology
• Published: 2019;30(2):341
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This letter is the authors' reply to two letters about their earlier study, which checked mesothelioma diagnoses in a cohort of Italian asbestos textile workers. The study included 127 cohort members with mesothelioma on the death certificate. Of these, 76 were matched by record linkage to the regional Mesothelioma Registry, and the authors considered it plausible that most of the 51 unmatched people did not qualify for the Registry. Of 35 matched individuals whose diagnosis the authors' review confirmed, 29 were listed as confirmed Registry cases, an estimated 83% sensitivity. Of 10 matched individuals whose diagnosis was not confirmed by pathology review or rested on the death certificate only, four were listed as confirmed Registry cases. The authors revised their specificity estimate from 41% to 60%, saying the original included additional cases without histologic verification. They said the comparison is uncertain because the Italian registry has a 'confirmed, not elsewhere specified' category with unclear criteria, which made up as much as 31% of confirmed cases in the latest national report. Four authors declared acting as experts in asbestos and mesothelioma litigation.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor: the authors' reply to two published letters about their earlier validation study, with a revised estimate of how their diagnoses compared with registry data
• Who was studied: 127 members of a cohort of Italian asbestos textile workers (Northern Italy) with mesothelioma on the death certificate; 76 of them were matched to the regional Mesothelioma Registry
• Exposure: Work in the asbestos textile industry. The letter names no fiber type and gives no doses.
• Main results:
  • 76 of the 127 individuals were matched through record linkage to the regional Mesothelioma Registry
  • The authors considered it plausible that most of the 51 unmatched individuals did not qualify for inclusion in the Registry
  • Among 35 matched individuals whose diagnosis the authors' review confirmed, 29 were listed as confirmed cases in the Registry, an estimated 83% sensitivity
  • Among 10 matched individuals whose diagnosis was not confirmed by pathology review or was based on the death certificate only, four were listed as confirmed cases in the Registry
  • Specificity was re-estimated at 60%. The original estimate of 41% had included additional cases without histologic verification.
  • In the latest national report of the Mesothelioma Registries, the 'confirmed, not elsewhere specified' subcategory made up as much as 31% of all 'confirmed' cases
  • Only 57% of 'confirmed' cases in the national Registries met the immunohistochemical criteria recommended by international panels, which were the criteria used in the authors' study
• The authors' conclusion: The authors said they think the revised 60% specificity estimate is more appropriate than the original 41%. They added that comparing their validation with the registry data is uncertain because of the Italian registry's diagnostic criteria.
• Limitations the authors state:
  • The comparison with the regional Mesothelioma Registry is subject to uncertainty because of the diagnostic criteria used in the Italian mesothelioma registration system, including a 'confirmed, not elsewhere specified' category with unclear criteria

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

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• Letter to the editor: "Comparing milled fiber, Quebec ore, and textile factory dust: has another piece of the asbestos puzzle fallen into place?" by D. Wayne Berman — J.M. Dement, L.T. Stayner (2010)
• Reply to the editor — M. Baud, P. Forgez, et al. (2013)
• Reply to the editor — W.T. Vigneswaran (2014)
• Letter to the editor on commentary: malignant mesothelioma incidence among talc miners and millers in New York state by M M Finkelstein — R.P. Nolan, J.F. Gamble, et al. (2013)

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