The accuracy of secondary data sources in capturing cases has been explored with results varying upon the source LB-100 mw selected Alisertib cost and gold standard used [6–9]. In the study from Penberthy et al., the Virginia Cancer Registry (CR) and a statewide

hospital discharge file (HDF) were both tested for accuracy in correctly identifying a cancer and its site of origin. Data from inpatient medical records were used as the gold standard. Based on the conclusions stated, nor the CR neither the HDF was sufficient independently to allow the complete capture of incident cancer cases. However, HDF accuracy in capturing incident cancer cases was high, with the overall positive predictive value being 94% and site specific values ranging from 86% (cervix) to 98% (breast) [9]. In Italy, the government supports cancer surveillance throughout a network of population-based local CRs included in the Italian Association of Cancer Registries (AIRTUM). Currently, the AIRTUM covers 33.8% of the Italian population, namely 19 million people out of 61 million inhabitants. A notable disproportion in CRs coverage exists among Northern, Central and Southern areas of Italy (i.e., 50.2%, 25.5% and find more 17.9%, respectively) [10]. We have previously underlined the need to integrate data from the Italian CRs with additional sources and identified the National

Hospital Discharge Records (NHDRs) as a potential tool [11]. In this study we aimed to evaluate the burden of breast cancer in Italian women by analyzing data from the NHDRs through a non-model-based methodology with a specific focus on major surgical procedures. Compared to our previous work, data have been updated to reflect a larger time window (2001–2008 vs. 2000–2005) and methods refined to overcome some of the limitations from our previous study. Materials and methods Data source We used the NHDR database which includes records

from all the Italian public and private hospitals. Data were made available by the Italian Ministry of Health relatively to the time frame between 2001 and 2008. These data were subject to a systematic quality assessment performed at a Regional and central level. The matching with the National Institute for Statistics (ISTAT) by social security code showed a percentage of correct Clomifene linkage increasing from 95.6% in 2001 (50,921 records matched out of 53,226) to 99.8% in 2008 (58,367 records matched out of 58,492) [12, 13]. The years 1999 and 2000 were excluded due to incomplete data. Breast cancer cases were identified on the basis of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) [14, 15]. We considered patients diagnosed with invasive breast cancer (i.e., malignant neoplasm of breast, ICD-9CM codes: 174.0-174.9 and 175.0-175.9). Data related to patients with in situ breast carcinoma (ICD-9-CM major diagnosis 233) were also included.