Finding incident cancer cases through outpatient oncology clinic claims data and integration into a state cancer registr
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BRIEF REPORT
Finding incident cancer cases through outpatient oncology clinic claims data and integration into a state cancer registry Christopher R. Cogle1 · Gary Levin2 · David J. Lee2 · Steven Peace2 · Megsys C. Herna2 · Jill MacKinnon2 · Clement K. Gwede3 · Celeste Philip4 · Tara Hylton4 Received: 3 April 2020 / Accepted: 11 November 2020 © Springer Nature Switzerland AG 2020
Abstract Cancer data from population-based cancer registries under-report cancer cases, especially for cancers primarily diagnosed and treated in outpatient clinical settings, away from hospital-based cancer registrars. Previously, we developed alternative methods of cancer case capture including a claims-based method, which identified a large proportion of cancer cases missed by traditional population-based cancer registries. In this study, we adapted a claims-based method for statewide implementation of cancer surveillance in Florida. Between 2010 and 2017 the claims-based method identified 143,083 cancer abstracts, of which 42% were new and 58% were previously registered. The claims-based method led to the creation of 53,419 new cancer cases in the state cancer registry, which made up 9.3% of all cancer cases registered between 2010 and 2017. The types of cancers identified by the claims-based method were typical of the kinds primarily diagnosed and treated in outpatient oncology clinic settings, such as hematological malignancies, prostate cancer, melanoma, breast cancer, and bladder cancer. These cases were added to the Florida cancer registry and may produce an artefactual increase in cancer incidence, which is believed to be closer to the actual burden of cancer in the state. Keywords Cancer Registry · Epidemiology · Billing claims
Introduction State cancer registries are charged with providing valid and verifiable population-based data on cancer incidence. Prior epidemiology studies of the myelodysplastic syndromes (MDS) reported low incidence [1]. We hypothesized that MDS cases, which were often indolent, were diagnosed outside of hospital settings, and therefore not captured by cancer registrars which are primary means of data collection for the state cancer registry. Therefore, we developed two alternative methods for MDS case ascertainment: one querying electronic pathology (E-Path) reports emailed to * Christopher R. Cogle [email protected] 1
Division of Hematology and Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
2
Florida Cancer Data System, Miami, FL, USA
3
H. Lee Moffitt Cancer Center, Tampa, FL, USA
4
Florida Department of Health, Tallahassee, FL, USA
the state cancer registry and another querying claims. Both alternative methods identified a high rate of MDS cases not captured by traditional population-based case capture [2, 3]. MDS cases outside of the cancer registry were from younger patients, more likely female, and lower risk disease severity [4]. We found under-reporting to the state cancer registry for other myeloid malign
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