Objectives Mesothelioma is a cancer principally caused by occupational exposure to asbestos, but less than one-half of mesothelioma patients receive workers' compensation in Canada. We evaluated a letter sent to physicians of patients newly diagnosed with mesothelioma by the British Columbia Cancer Agency informing them of workers' compensation benefits and asking them to advise their patients to seek compensation.

Methods Mesothelioma cases in the BC cancer registry were linked with accepted workers' compensation mesothelioma claims. The proportion of compensation cases in the pre-letter period (Jan 2000 to Oct 2004) was compared to the proportion in the post-letter period (Nov 2004 to Dec 2009), by demographic, clinical and geographic characteristics. Adjusted incidence rate ratios investigated the effect of the letter on compensation status.

Results Between 2000 and 2009, 668 mesothelioma cases were diagnosed in BC. During the letter period, 216 of 364 cases received a physician letter. Those with a longer survival time were more likely to receive the letter. The proportion of compensation was 43 claims per 100 cases during the pre-letter period compared to 40 claims per 100 cases during the post-letter period (IRR=1.12, 95% CI: 0.84 to 1.49). Among those sent the letter, there were modest increases for women, younger (<55 years) workers and those with a shorter survival time (<2 months).

Conclusions The letter intervention had little effect in increasing mesothelioma compensation except among groups with historically low compensation rates (eg, women). Interventions such as physician and patient education may be needed to increase the compensation rate of mesothelioma.