Measuring the incidence of cancer in elderly americans using medicare claims data

Abstract

Background. The Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute is the most frequently used and best estimate of the incidence of cancer in the United States. Although synthetic estimates based on the SEER information can be used to plan cancer prevention and intervention programs, the evaluation of these action programs and the monitoring of cancer incidence in states or other geographic areas requires information on the population for whom the program is directed. Methods. The age‐adjusted incidence of six cancers among persons 65 years of age and older for 1986–1987 living in the five states participating in the SEER program was compared with the incidence derived from hospitalization records contained in the Health Care Financing Administration's (HCFA) administrative data files. Age‐adjusted incidence rates for 1990 developed from HCFA data for persons living in the nine SEER program areas were contrasted with the incidence rates for persons living in the rest of the United States and were developed for each of the 50 states and the District of Columbia. Results. The comparison of the SEER and HCFA overall age‐adjusted cancer incidence rates in the elderly for 1986–1987 showed that for four of the six cancers (breast, colon, lung, and corpus uteri) the rates differed by 5% or less. The HCFA derived rates were 6.37% and 7.65% greater than the SEER rates for prostate and esophagus cancer, respectively. The incidence of cancer between 1986 and 1990 was neither uniformly higher nor lower among elderly SEER program area residents compared with residents of the rest of the country. Incidence rates varied greatly among states for each of the cancers. Conclusions. HCFA administrative data can be used by states or other geographic units to monitor the incidence of cancer in the elderly as well as to plan and evaluate cancer prevention and intervention programs.

Improving Primary Care for Older Adults with Cancer and Depression

“…Although use of ICD-9 codes to ascertain cancer diagnoses has been shown to be valid, some misclassification may have occurred, such as with provisional diagnoses. [52][53][54] Moreover,…”

Sensitivity of Administrative Claims to Identify Incident Cases of Lung Cancer: A Comparison of 3 Health Plans

“…[3][4][5] Studies comparing the accuracy of administrative codes for lung cancer compared with cancer registry records among Medicare-eligible patients have found sensitivities of administrative codes ranging from 56% to 90%. [5][6][7] Knowledge of administrative code sensitivity may facilitate future database and claims research, for example, with research conducted in geographic areas where linkage to clinical data such as medical records or a cancer registry-such as the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-is not possible or not feasible.…”

The Elevated Breast Cancer Mortality in the Northeastern U.S. is Secondary to Poorer Survival Rather Than Increased Incidence

“…A major challenge facing investigators utilizing these data is how to identify incident cases of disease. Approaches to identify these newly diagnosed cases have all employed complex algorithms based on combinations of data elements in the files [18][19][20][21][22][23].…”

“…For breast cancer in particular, previous approaches to case ascertainment with Medicare claims, hospital discharge data bases and similar types of administrative data have used combinations of diagnosis and procedure codes from hospital stay or billing records to estimate incidence [20][21][22][23], describe patterns of surgical treatment [24][25][26][27][28][29][30][31] and estimate costs of cancer related services [32][33][34][35][36][37][38][39]. The validity of these approaches is supported by further evidence that 1) cancer is a diagnosis reliably coded on hospital billing records [40] and 2) algorithms to estimate cancer incidence rates from hospital claims have produced estimated rates similar to those of cancer registries [20][21].…”

“…The validity of these approaches is supported by further evidence that 1) cancer is a diagnosis reliably coded on hospital billing records [40] and 2) algorithms to estimate cancer incidence rates from hospital claims have produced estimated rates similar to those of cancer registries [20][21]. However, attempts to identify specific cases of breast cancer (as distinguished from overall incidence rates) using administrative data have raised concerns about the claims' ability to identify individual subjects with incident disease, particularly with hospital data alone [23,41].…”