%0 Journal Article
%T Occupational cancers: can targeting and claim-requests be improved by using the French health insurance fund¡¯s medical data?
%A Bilger P
%A Badouin O
%A Bonnet P
%A Laroze M
%J Revue M¨¦dicale de l'Assurance Maladie
%D 2004
%I 
%X Aims: To estimate the proportion of unrecognized occupational cancers which are inappropriately considered to come under the category of long-term illnesses (ALD) in the Montpellier area of France (approximately 550,000 covered individuals). Method: Between October 1, 2001 and October 1, 2002, we studied 212 requests for coverage under the category of long-term illnesses (ALD) for cancers which are included in the list of occupational cancers. The concerned patients were given the opportunity to be seen by one of the health insurance¡¯s salaried advisor-physicians to provide answers to a medico-professional questionnaire (patients who were unable to come to the practitioner¡¯s office received mail requests). If the answers to the questionnaire suggested the possibility of an occupational cause for the cancer, a thorough administrative study was undertaken to determine if the disorder should be processed as an occupational cancer claim. Results: We were able to study 134 questionnaires. The most frequently found cancers were lung cancer, cancer of the urinary bladder and leukemia (respectively 39 %, 38 % and 18 %). Occupation cancer was deemed possible in five cases (3.7 %); four of them were eventually recognized to be occupational cancers (3.0 %). Conclusion: This study showed that occupational cancers are under-recognized in the Montpellier area. In addition to sensitizing occupational and primary-care physicians to this fact, the health insurance¡¯s medical service in Montpellier decided to systematically send a "screening" questionnaire to all attending physicians who requested coverage for patients with lung or bladder cancer under the heading of the long-term illnesses in order to assist in deciding whether an occupational disease is present. An assessment of the impact of these measures will be performed in late 2005.
%K cancer
%K occupational disease
%K claim recognition.
%U http://www.ameli.fr/fileadmin/user_upload/documents/Cancers_professionnels.pdf