Estimating cancer incidence based on claims data from medical insurance systems in two areas lacking cancer registries in China

Tian, Hong‐Rui; Yang, Wei; Hu, Yan-Jun; Liu, Zhen; Chen, Lei; Liu, Liang; Zhang, Fan; Cai, Fen; Xu, Huawen; Liu, Mengfei; Guo, Chuanhai; Chen, Yun; Xiao, Ping; Chen, Junhui; Ji, Ping; Fang, Zhengyu; Liu, Fangfang; Liu, Ying; Pan, Yaqi; dos‐Santos‐Silva, Isabel; He, Zhonghu; Ke, Yang

doi:10.1016/j.eclinm.2020.100312

Cited by 35 publications

(56 citation statements)

References 18 publications

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“…This study also has several limitations. First, the basic medical insurance database lacks some detailed information, such as tumour stage, clinical characteristics, results of pathological examination and laboratory results, which limits the possibility to stratify the diagnosis in greater detail and analyze the data in more depth, similar to other previous studies based on claim data 58 , 59 . Second, rural inhabitants and certain urban populations, such as military soldiers are not included in the UEBMI and URBMI system because they have different types of medical insurance.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of mammary Paget’s disease in urban China in 2016

Yin

Wang

et al. 2021

Sci Rep

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No national data have been available on descriptive epidemiology of mammary Paget’s disease (MPD) in China. This population-based study aimed to estimate the prevalence of MPD and its pattens by sex, age and area in China. We conducted a population-based study using data in 2016 from China’s Urban Employee Basic Medical Insurance and Urban Resident Basic Medical Insurance, covering approximately 0.43 billion residents. MPD cases were identified based on the diagnostic names and codes in claim data. A total of 825 patients of confirmed diagnosis of MPD were found during the study period. The prevalence of MPD in 2016 was 0.42 per 100,000 population (95% CI 0.19 to 0.73), with marked female predominance. The prevalence rates peaked at 40–59 years and ≥ 80 years in females and males, respectively. The prevalence rates varied among different regions, ranging from 0.06 (95% CI 0.00 to 0.23) in Northeast China to 1.21 (95% CI 0.07 to 3.72) in Northwest China. MPD showed marked female predominance in China. Chinese female patients were much younger, with lower prevalence than that in the United States. Obvious sex difference in the age pattern of MPD prevalence was also observed in China.

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Section: Discussionmentioning

confidence: 99%

Prevalence of mammary Paget’s disease in urban China in 2016

Yin

Wang

et al. 2021

Sci Rep

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“…First, information regarding the clinical treatment regimen of the participants was collected with linkage to claims data from the New Rural Cooperative Medical Scheme (NCMS), which is a government-run health insurance program in rural China with coverage of nearly 100% in the study area that had previously proved to be a reliable data source regarding cancer diagnosis and treatment. [13] , [14] , [15] Detailed claims records from the NCMS for all participants from January 2012 to September 2017 were carefully reviewed to confirm whether they had received cancer-related therapy, which included endoscopic therapy, radical surgery, radiotherapy, and chemotherapy.…”

Section: Methodsmentioning

confidence: 99%

Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trial

Wang

Liu

Guo

et al. 2021

The Lancet Regional Health - Western Pacific

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Background: To fully realize efficacy in cancer screening, timely and appropriate treatment for participants with malignant lesions is critical. However, the health-seeking behavior of patients with upper gastrointestinal (G.I.) cancer identified in population-level screening programs in China is unknown.Methods: A community-based real-world investigation was conducted with 136 upper G.I. cancer patients detected in a large screening cohort in an area of high-risk for upper G.I. cancer in China. Using local medical claims data and semi-structured face-to-face interview, we collected information regarding the clinical treatment regimen and factors which result in the lack of timely and appropriate treatment. Findings:The treatment records for 133 upper G.I. cancer patients were acquired. Among these, 48 (36 • 09%) patients did not receive treatment within three months of initial diagnosis, and treatment of early-stage cancer was more likely to be delayed. Sixteen patients did not seek further diagnostic testing due to their low health-awareness and socio-economic status. Another 20 participants proactively sought further diagnostic evaluation in health care facilities but were prevented from receiving further treatment due to low sensitivity of given diagnostic test(s), failure to recognize the significance of screening results, and/or lack of basic knowledge of diagnosis and treatment for early cancer on the part of clinicians. The treatment regimen offered to patients depended largely on the level of health care facilities they visited, and non-medical factors were the main reasons for choice of health care facilities.Interpretation: A coordinated, system-based management strategy is urgently needed to support the design of upper G.I. cancer screening programs in rural populations in China.

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“…Hua County is a predominantly rural area in northern Henan Province in China, which has 1¢07 million permanent residents and had a per capita Gross Domestic Product of 24,585 Yuan (US $3715) in 2018 [18À20]. The New Rural Co-operative Medical Care Scheme (NCMS) is the sole medical insurance system for rural residents, and this system has had coverage of 99% since 2010 [15]. The incidence rate of oesophageal cancer ranked second among cancer types in Hua County in 2018, and this rate was 2¢1 times as high as the national level [15,21].…”

Section: Study Sitementioning

confidence: 99%

“…In China, basic medical insurance systems are administered and operated by the government, and cover over 95% of the national population. In a previous study, we established the Medical-Insurance-System-based Cancer Surveillance System (MIS-CASS) and demonstrated that this approach is capable of complete and accurate identification of incident cancer cases, and allows reporting cancer incidence in a timely manner in two regions (six million residents altogether) which are not covered by PBCRs in China [15].…”

Section: Introductionmentioning

confidence: 99%

Estimating cancer survival and prevalence with the Medical-Insurance-System-based Cancer Surveillance System (MIS-CASS): An empirical study in China

Tian

Hu²,

Li³

et al. 2021

EClinicalMedicine

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Background: We aimed to establish a new approach for surveillance of cancer prevalence and survival in China, based on the Medical-Insurance-System-based Cancer Surveillance System (MIS-CASS). Methods: We constructed a standard procedure for data collection, cleaning, processing, linkage, verification, analysis, and estimation of cancer prevalence and survival (including both actual observations and model estimates) by conjoint use of medical insurance claims data and all-cause death surveillance data. As a proofof-principle study, we evaluated the performance of this surveillance approach by estimating the latest prevalence and survival for upper gastrointestinal cancers in Hua County, a high-risk region for oesophageal cancer in China. Findings: In Hua County, the age-standardised relative 5-year survival was 39¢2% (male: 36¢8%; female: 43¢6%) for oesophageal cancer and 33¢3% (male: 29¢6%; female: 43¢4%) for stomach cancer. For oesophageal cancer, better survival was observed in patients of 45À64 years compared with national average estimates, and women of <75 years had better survival than men. The 5-year prevalence rate in Hua County was 99¢8/ 100,000 (male: 105¢9/100,000; female: 93¢3/100,000) for oesophageal cancer and 41¢5/100,000 (male: 57¢4/ 100,000; female: 24¢5/100,000) for stomach cancer. For both of these cancers, the prevalence burden peaked at 65À79 years. The model estimates for survival and prevalence were close to the observations in real investigation, with a relative difference of less than 4¢5%. Interpretation: This novel approach allows accurate estimation of cancer prevalence and survival with a short delay, which has great potential for regular use in general Chinese populations, especially those not covered by cancer registries.

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Estimating cancer incidence based on claims data from medical insurance systems in two areas lacking cancer registries in China

Cited by 35 publications

References 18 publications

Prevalence of mammary Paget’s disease in urban China in 2016

Prevalence of mammary Paget’s disease in urban China in 2016

Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trial

Estimating cancer survival and prevalence with the Medical-Insurance-System-based Cancer Surveillance System (MIS-CASS): An empirical study in China

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