Background: Claims databases that include standardized medical and administrative information routinely collected on patients are becoming increasingly prevalent in many industrialized countries. Some of them have a national scope and are an efficient source of information on large heterogeneous patient populations. These databases can help to describe cancer incidence in the absence of national cancer registries. A literature review was performed to describe the use of these databases to identify incident cancer cases.
Methods: References (1990 and 2000) were extracted from MEDLINE. A final selection of the articles to be analyzed was made by appraising the references using defined criteria.
Results: Most of the studies retrieved were based on the Medicare databases. Identification of new cases was based on the detection of cancer diagnosis codes or on the finding of cancer-specific diagnosis and procedure codes. The standards used to evaluate identification were either cancer registries or medical records. Evaluation was based on comparison of incidence rates or carried out on a person-level basis according to a cross-linkage of claims and standard databases. Only studies that reported sensitivity and specificity for identification were able to define the best compromise between a high identification rate and a low false positive rate. These studies were based on breast cancer and reported sensitivity and specificity varying from 75 to 90% and from 99.75 to 99.86%, respectively.
Conclusions: Identification methods can be used to obtain an accurate number of incident cancer cases if an appropriate statistical method is applied. We proposed a method that take into account lack of sensitivity and specificity.
claims database - registry - incidence - neoplasm - medicare